PURPOSE: This study was designed to estimate the prevalence of depression and the factors that influence it in Korean medical students. METHODS: We evaluated depression in 122 first- and second-year medical students in December 2011 using the Korean Beck Depression Inventory (K-BDI). Sixteen potential factors were considered: gender, class year, grade point average, breakfast habits, residence type, leisure activity, sleep satisfaction, relationship status, a close friend or a significant other, finances, present health status, history of mood disorders, family history of mood disorders, religion, and self-esteem. RESULTS: The average BDI score was 8.9. There were 80 (65.6%), 16 (13.1%), 15 (12.3%), and 11 (9.0%) students with minimal, mild, moderate, and severe depression, respectively. The group with depressive symptoms comprised males with a total BDI score > or =24 and females with total BDI > or =25 and constituted 9.0% of students. Students in the depressive symptom group had lower self-esteem and lower grade point averages and were more frequently ill, less likely to be in a relationship, and more likely to have a history of mood disorders (p<0.05 for all). In particular, low self-esteem score was an independent factor. CONCLUSION: The BDI scores in our study were similar to those that have been reported in other countries but slightly higher than in other Korean medical and university students. Self-esteem, grade point average, health status, history of mood disorders, family history of mood disorders, and presence of a significant other correlated significantly with depression in medical students.
Breakfast ; Depression* ; Female ; Friends ; Humans ; Leisure Activities ; Male ; Mood Disorders ; Prevalence* ; Self Concept ; Students, Medical*

PURPOSE: The aim was to present our experiences implementing a cultural diversity (CD) education program. METHODS: The authors held a 4-hour CD class for third-year medical students. The aim of the class was to facilitate students to realize and reflect on the importance of CD on healthcare delivery in Korea. The class was comprised of an orientation about CD in Korea, physicians and multicultural guests sharing their experiences with students, small group discussion, and Q&A panel with multicultural guests. Students provided written feedback for program evaluation. Authors classified their comments qualitatively. RESULTS: Students mostly responded positively to the class with a significant focus on interacting with the multicultural guests. Students realized the significance of CD in healthcare and reflected deeply on their discussion with the multicultural patients. Students needed more time to interact with multicultural guests from a greater range of cultures represented in Korea. Most did not need English interpretation. CONCLUSION: The aim of the class was achieved. Medical students' interaction with multicultural patients may promote the students' understanding and reflection about CD in health care.
Cultural Competency ; Cultural Diversity* ; Culturally Competent Care ; Delivery of Health Care ; Education ; Education, Medical, Undergraduate ; Healthcare Disparities ; Humans ; Korea ; Patient Safety ; Program Evaluation ; Students, Medical*

No abstract available.
Cultural Diversity ; Humans

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.
Caregivers ; Curriculum ; Drug-Related Side Effects and Adverse Reactions ; Education ; Education, Medical, Undergraduate ; Ethics, Medical ; Follow-Up Studies ; Humans ; Korea ; Learning ; Medical Errors ; Mental Competency ; Patient Safety ; Professionalism ; Quality Improvement ; Schools, Medical ; Students, Medical

This review of the literature explored the experiences and effects of peer-assisted learning in basic medical education. Peer-assisted learning is most commonly utilized to teach clinical skills (including technical skills) and medical knowledge (76.4%). It has also been used, albeit less frequently, to facilitate small-group discussions including problem-based learning, to promote students’ personal and professional development, to provide mentoring for career development and adaptation to school, to give tutoring to at-risk students, and to implement work-based learning in clinical settings. Near-peer learning is a common type. The use of active learning techniques and digital technology has been increasingly reported. Students’ leadership had frequently been described. Student tutor training, programs for teaching skills, institutional support, and assessments have been conducted for effective peer-assisted learning. There is considerable positive evidence that peer-assisted learning is effective in teaching simple clinical skills and medical knowledge for tutees. However, its effects on complex skills and knowledge, small-group discussions, personal and professional development, peer mentoring, and work-based learning have rarely been studied. Additionally, little evidence exists regarding whether peer-assisted learning is effective for student tutors. Further research is needed to develop peer-assisted learning programs and to investigate their learning effects on student tutors, small-group discussion facilitation, personal and professional development, peer mentoring, and peer-led work-based learning in the clinical setting in South Korea. Formal programs and system advancement for a student-led learning culture is needed for effective peer-assisted learning.

PURPOSE: Standardized patients (SPs) tend to rate medical students’ communication skills subjectively and comprehensively, in contrast to such objective skill set defined in the clinical performance examination (CPX). Meanwhile, medical school instructors have a different approach in their evaluation of students’ communication skills. We aim to analyze medical students’ verbal communication skills using objective methods, and to determine the contributing factors of a patient–physician interaction (PPI) score. METHODS: Students with high- and low-ranking scores for PPI in CPX were selected. The Roter interaction analysis system was used to compare verbal communication behaviors of the students and SPs. Patient-centeredness scores (PCSs), physician’s verbal dominance, and number of utterances were compared between the two groups. RESULTS: PCSs and physician’s verbal dominance had no difference between the groups. The number of utterances during the limited time of 5 minutes of CPX was higher for the high-ranking students. They tended to employ more paraphrase/check for understanding, and closed questions for psychosocial state and open questions for medical condition. The SPs interviewed by high-ranking students gave more medical information and requested for more services. CONCLUSION: In the case of the routine checkup, smooth conversations with more frequent utterances were detected in the high-ranking students. More medical information exchange and requests for services by SPs were higher for the high-ranking students. Medical communication instructors should keep in mind that our results could be indicators of a high PPI score.
Education, Medical ; Health Information Exchange ; Humans ; Schools, Medical ; Students, Medical ; Verbal Behavior

PURPOSE: The aim of the study was to introduce our experience of establish task-based learning outcomes for core clinical clerkships. METHODS: We first define our educational goal and objectives of the clinical clerkship curriculum according to knowledge, cognitive function and skill, and attitude. We selected clinical presentations and related diseases with expert panels and allocated them to core clinical departments. We classified doctor's tasks into 6 categories: history taking, physical examination, diagnostic plan, therapeutic plan, acute and emergent management, and prevention and patient education. We described learning outcomes by task using behavioral terms. RESULTS: We established goals and objectives for students to achieve clinical competency on a primary care level. We selected 75 clinical presentations and described 377 learning outcomes. CONCLUSION: Our process can benefit medical schools that offer outcome-based medical education, especially for clinical clerkships. To drive effective clerkships, a supportive system including assessment and faculty development should be implemented.
Clinical Clerkship ; Curriculum ; Education, Medical ; Humans ; Learning ; Patient Education as Topic ; Physical Examination ; Primary Health Care ; Schools, Medical

PURPOSE: Nurse educators can use film effectively to promote nursing students' motivation and indirect experiences. The purpose of this study was to develop a teaching-learning design using films based on Kolb's experiential learning model for understanding of child growth and development, and to evaluate students' satisfaction with cinenurducation according to learning type and content. METHODS: Participants were seventy-four first year nursing students in the spring semester of 2013 at a private university located in Busan. In each class, participants watched film, participated in peer-to-group discussion and an educator's lecture, and wrote a composition based on Kolb's four learning stages. After class, participants filled out a questionnaire developed by the researchers. RESULTS: Results showed a high satisfaction with cinenurducation regardless of learning type and content concerning child growth and development. Advantages of cinenurducation included it being "fun and interesting," "helpful to understand the characteristics of children," and "develop critical thinking through discussions." Disadvantages included "length of time needed," and "burdensome." CONCLUSION: Films are advantageous in that they provide indirect experience for nursing students. Selection of appropriate films and evaluation of learning goal achievements are important to maximize the effectiveness of cinenurducation.
Busan ; Child* ; Education ; Growth and Development* ; Humans ; Learning ; Motion Pictures as Topic ; Motivation ; Nursing ; Problem-Based Learning* ; Students, Nursing ; Thinking ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to evaluate the changing pattern of communication skills of medical students according to length and methods of training. METHODS: We evaluated a 1-week communications training course in 2003, a 1-year course in 2004, and a 1-semester course in 2005 during development of our curriculum. We have conducted the 10-minute CPX on abdominal pain annually since 2002 to assess the clinical performance of medical students who have completed the 3rd year clerkship. We selected CPX videos that were appropriate for assessment. One hundred sixty-four videos were available (1-week didactics: 42 cases, 1-week training: 28 cases, 1-semester training: 50 cases, 1-year training: 44 cases). We developed a 10-item global rating checklist to assess communication skills. A 5-point Likert scale was used to evaluate each item (4-very likely, 0-least likely). Two expert standardized patient (SP) raters evaluated the communication skills of students independently. We analyzed the outcomes based on the training length and methods. The reliability (G coefficient) was 0.825 with 2 SPs and 1 station. RESULTS: The communication skills of students improved with practice and longer training, especially with regard to opening the interview, expressing empathy, understanding the patient's perspective, and preparing for the physical examination. Rapport-building, organization of the interview, understandable explanation, nonverbal communication, active listening and consideration during the physical examination was unchanged between durations of training. The scores for empathetic expression, active listening and understanding the patient's perspective were low across all groups. CONCLUSION: We should concentrate our efforts to improve students' skills in empathetic expression, active listening and understanding the patient's perspective.
Abdominal Pain ; Checklist ; Curriculum ; Educational Measurement ; Empathy ; Humans ; Nonverbal Communication ; Physical Examination ; Reproducibility of Results ; Students, Medical