Objectives: ：This study was designed to investigate the effect of sleep quality on depression symptoms and the mediating effect of interpretation bias and anxiety symptoms in psychiatric patients. Methods: ：Data accumulated for outpatients and inpatients in the Department of Mental Health Medicine at Hanyang University Guri Hospital were used. The measurement tools were Pittsburgh Sleep Quality Index (PSQI), Ambiguous/Unambiguous Situations Diary-Extended Version (AUSD-EX), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II). Correlation analysis and bootstrapping analysis were conducted using SPSS 25.0 and SPSS Macro based on 162 patient data. Results: ：As a result of the study, the double mediating effect of interpretation bias for Ambiguity and anxiety symptoms was significant in the relationship between sleep quality and depression symptoms. Conclusions ：In this study, it was confirmed that low sleep quality sequentially affects anxiety and depression symptoms through interpretation bias for ambiguity. Based on this, it is expected that the development of other psychiatric symptoms can be prevented by preferentially performing therapeutic intervention on preceding symptoms.

PURPOSE: The quality of problem representation is critical for developing students' problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students' experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. METHODS: A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. RESULTS: The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. CONCLUSION: SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.
Cohort Studies ; Curriculum ; Humans ; Learning ; Methods ; Motivation ; Problem-Based Learning* ; Thinking

PURPOSE: The aims of this study were to define the necessity and effectiveness of patient safety education during surgical clerkship to develop competency for managing and preventing medical errors. METHODS: Fifty 3rd-year students participated in the patient safety education program during a 4-week surgical clerkship. The students were divided into 4 groups: control group, pretest-only group, education-only group, and pretest and education group. Students were assessed using short essays and an oral exam for reasoning skills, clinical performance exams for patient education and communication skills, and multisource feedback and direct observation of error reporting for real-world problem-solving skills. The results were analyzed with SPSS 14.0K. The reliability (Cronbach alpha) of the entire assessment was 0.893. RESULTS: There was no difference in scores between early and late clerkship groups. Reasoning skills were improved by the pretest. Reasoning, patient education, and error reporting skills were much more developed by patient safety education. Real-world error identification, reporting, and communication did not change after the 4-week course. CONCLUSIONS: Patient safety education during surgical clerkship is necessary and effective. Error prevention and competency management in the real world should developed.
Clinical Clerkship ; Clinical Competence ; Humans ; Medical Errors ; Patient Education as Topic ; Patient Safety ; Safety Management

PURPOSE: The purpose of this study was to explore the relationships among medical students' assessments on peers' group presentations, instructors' assessments of those presentations, and students' educational achievements in other assignments and tests. METHODS: A total of 101 first-year students from a medical school participated in the study. The students' educational achievements in a 4-week long integrated curriculum were analyzed. Student's final grades were comprised of the following education criteria: two written tests (60%), 15 group reports (25%), one individual report (7%), and four group presentations (15%). We compared scores of the group presentation assessed by the peers and the two instructors. Furthermore, we compared peers' assessment scores with each component of the evaluation criteria. RESULTS: Pearson correlation analysis showed significant correlaton for the assessments between peers and instructors (r=0.775, p<0.001). Peer assessment scores also correlated significantly with scores for the group assignments (r=0.777, p<0.001), final grades on the curriculum (r=0.345, p<0.001), and scores for individual assignments (r=0.334, p<0.001); however, no significant correlation was observed between the peer-assessed group presentation scores and the two written test scores. CONCLUSION: Peer assessments may be a reliable and valid method for evaluating medical students' performances in an integrated curriculum, especially if the assessments are used to academic processes, such as presentations, with explicit evaluation and judgment criteria. Peer assessments on group presentations might assess different learning domains compared to written tests that primarily evaluate limited medical knowledge and clinical reasoning.
Curriculum ; Education ; Educational Status ; Group Processes ; Humans ; Judgment ; Learning ; Methods ; Peer Review ; Schools, Medical ; Self-Evaluation Programs ; Students, Medical*

OBJECTIVE: We sought to determine the predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion (MARPE) in young adults. METHODS: The following variables were selected as possible predictors: chronological age, palate length and depth, midpalatal suture maturation (MPSM) stage, midpalatal suture density (MPSD) ratio, the sella-nasion (SN)-mandibular plane (MP) angle as an indicator of the vertical skeletal pattern, and the point A-nasion-point B (ANB) angle for anteroposterior skeletal classification. For 31 patients (mean age, 22.52 years) who underwent MARPE treatment, palate length and depth, MPSM stage and MPSD ratio from the initial cone-beam computed tomography images, and the SN-MP angle and ANB angle from lateral cephalograms were assessed. The midpalatal suture opening ratio was calculated from the midpalatal suture opening width measured in periapical radiographs and the MARPE screw expansion. Statistical analyses of correlations were performed for the entire patient group of 31 subjects and subgroups categorized by sex, vertical skeletal pattern, and anteroposterior skeletal classification. RESULTS: In the entire patient group, the midpalatal suture opening ratio showed statistically significant negative correlations with age, palate length, and MPSM stage (r = −0.506, −0.494, and −0.746, respectively, all p < 0.01). In subgroup analyses, a strong negative correlation was observed with the palate depth in the skeletal Class II subgroup (r = −0.900, p < 0.05). CONCLUSIONS The findings of this study indicated that age, palate length, and MPSM stage can be predictors of midpalatal suture expansion by MARPE in young adults.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations. Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room. Results: In the spatial scale domain, items such as “sufficient width to comply with disability standards (wheelchair accessible)” and “larger space should be provided for patients with a large range of motion or requiring special medical procedures” emerged as priorities. In the movement system domain, priorities included “anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage.” In the spatial organization domain, priorities included “installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients’ activities reflecting psychiatric characteristics is not necessary.” Conclusion Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.