PURPOSE: This study explores how to design a flipped classroom for a predental science course and evaluate its course through student self-assessment in order to provide practical implications for flipped learning in an undergraduate level. METHODS: Second- and third-year predental students in the Seoul National University School of Dentistry enrolled in Biodiversity and Global Environment, a 15-week, three-credit course based on a flipped learning model. At the end of the course, the students were asked to rate their self-directed learning, attitude toward social media, discussion skills, learning readiness, and class satisfaction. Out of the 82 predental students, 61 (74.3%) answered the survey. Pearson correlation and multivariate regression analyses were employed to examine the relationship between the self-rated measurements and the performance scores. RESULTS: The majority of the students felt somewhat more prepared than the medium level before the class (mean score of 3.17 out of 5.00), whereas they expressed relatively low preference concerning social media use and attitude (mean score of 2.49). Thus, it was found that learning readiness was significantly associated with both discussion skills and class satisfaction. In particular, multivariate regression analysis confirmed that learning readiness had a significant influence on learning outcomes. CONCLUSION: This study offered insights into how to design a flipped learning course in terms of predental students' preference and their learning readiness. Although learning success in a flipped classroom depends on the students' self-perceived level of preparedness, much still remains to be achieved in order to apply social media benefits in a flipped learning context.
Biodiversity ; Dentistry ; Humans ; Learning ; Self-Assessment* ; Seoul ; Social Media

Background: Many studies report the positive effects of outcome-based education in improving medical education quality. An important aspect of outcome-based education is the statement of learning outcomes, which is closely associated with medical schools’ mission, vision, and educational goals. Medical schools’ mission statement not only sets the standards to determine educational goals and outcomes but also provides an indicator to monitor and evaluate medical education quality.Purpose: This study identified a methodology to provide optimal mission statements at medical schools through the framework of suggested decision-making method. Methods: This study analyzed the focus of the mission development suggested by World Federation for Medical Education and Liaison Committee on Medical Education medical education standards and searched for appropriate decision-making methods based on these standards. In addition to validate the suggested framework of mission statement, case analysis of medical schools was conducted. Results: Consequently, a mission development method that applies the mission statement based on stakeholders’ priority (MSSP) was derived. The MSSP involves (1) content analysis, (2) candidate extraction, (3) priority evaluation, and (4) priority validation. The keywords of the mission system derived during this process were categorized and listed in ranks to be suggested as the mission, vision, and core values. The proposed MSSP was applied in two South Korean medical schools and, thereby, the mission, vision, and core values were determined for each medical school. Conclusion The two schools’ case analysis verified MSSP’s effectiveness as a decision-making methodology to gather and converge diverse opinions from stakeholders for the mission statement at the medical schools.

Learning by teaching (LbT) has long been recognized as an important learning behavior that constructs meaning based on interactions between learners. This study aimed to explore the meaning of LbT as an important learning activity for future implementation in education. LbT is based on the cultural historical activity theory and sociocultural learning theory, as developed by scholars including Vygotsky. These frameworks value the construction of meaning based on language, and LbT is reported to be effective in constructing meaning. In addition, within the zone of proximal development posited by Vygotsky, learning through interaction between learners improves academic achievement, higher-order thinking, deep learning, and reflective learning. LbT also promotes students’ learning presence, and strengthens various competencies such as collaboration and communication skills. Interactive behavior between learners in the form of LbT has been explored as an approach to teaching and learning, with methods including peer learning, peer tutoring, peer teaching, peer mentoring, Lernen durch Lehren, and peer-assisted learning. LbT has also been applied as a learning method. In the future, LbT has boundless potential to improve learning through activities such as flipped learning or online learning based on interactions between learners.

Background: Many studies report the positive effects of outcome-based education in improving medical education quality. An important aspect of outcome-based education is the statement of learning outcomes, which is closely associated with medical schools’ mission, vision, and educational goals. Medical schools’ mission statement not only sets the standards to determine educational goals and outcomes but also provides an indicator to monitor and evaluate medical education quality.Purpose: This study identified a methodology to provide optimal mission statements at medical schools through the framework of suggested decision-making method. Methods: This study analyzed the focus of the mission development suggested by World Federation for Medical Education and Liaison Committee on Medical Education medical education standards and searched for appropriate decision-making methods based on these standards. In addition to validate the suggested framework of mission statement, case analysis of medical schools was conducted. Results: Consequently, a mission development method that applies the mission statement based on stakeholders’ priority (MSSP) was derived. The MSSP involves (1) content analysis, (2) candidate extraction, (3) priority evaluation, and (4) priority validation. The keywords of the mission system derived during this process were categorized and listed in ranks to be suggested as the mission, vision, and core values. The proposed MSSP was applied in two South Korean medical schools and, thereby, the mission, vision, and core values were determined for each medical school. Conclusion The two schools’ case analysis verified MSSP’s effectiveness as a decision-making methodology to gather and converge diverse opinions from stakeholders for the mission statement at the medical schools.

Cohorts are established and operated at medical schools as part of efforts to improve the quality of education. Chosun University College of Medicine clarified the purpose of establishing three cohorts in light of its core values and developed criteria and indicators for each purpose. An organization focusing on cohort construction and operation was established as the Cohort Committee under the Quality Improvement Committee, and guidelines were proposed. In addition, a database and system were developed to handle primary data efficiently, and tools for measuring psychological variables were created. The data collected by establishing a cohort, regions, and admission types of graduates were first analyzed for the following projects: (1) an analysis of the educational process and quality improvement to educate medical professionals who contribute to the community after graduation, and (2) an analysis of the educational process and quality improvement to secure excellence in the medical field (e.g., knowledge and clinical reasoning), using information on the academic achievements of students and graduates as primary data. Chosun University College of Medicine is conducting cohorts and longitudinal studies gradually, starting with a simple, practically feasible system to solve the difficulties faced in cohort establishment and operation. Medical educators hope that future data collection and analysis will improve the quality of medical school education and have practical implications.

PURPOSE: The purpose of this study was to evaluate the contributions and limitations of the cervical cancer screening test with accuracy in Korea. METHODS: This was a retrospective observational study. The study population consisted of all participants who underwent cervical cancer screening test from 2009 to 2014. The data were obtained from National Health Information Database (NHID) which represents medical use records of most Koreans. As the indices for contributions and limitations of the screening test, crude detection rate, incidence rate of interval cancer, sensitivity, specificity, and positive predictive value were used. RESULTS: The crude detection rate of screening test per 100,000 participants increased from 100.7 in 2009 to 102.1 in 2014. The incidence rate of interval cancer per 100,000 negatives decreased from 13.0 in 2009 to 10.2 in 2014. The sensitivities of screening test were 88.7% in 2009 and 91.2% in 2014, and the specificities were 98.5% in 2009 and 97.7% in 2014. The positive predictive value of screening decreased from 6.2% in 2009 to 4.3% in 2014. CONCLUSIONS: The Korean national cervical cancer screening program has improved in accuracy and has contributed to detection of early stage of cervical cancer over the years. Along with efforts to promote participation in cancer screening programs, quality control over the screening program should be enhanced.
Carcinoma in Situ ; Early Detection of Cancer ; Incidence ; Korea* ; Mass Screening* ; Observational Study* ; Papanicolaou Test ; Quality Control ; Retrospective Studies* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Background: The coronavirus disease 2019 (COVID-19) pandemic is an emerging threat worldwide. It remains unclear how comorbidities affect the risk of infection and severity of COVID-19. Methods: This is a nationwide retrospective case-control study of 219,961 individuals, aged 18 years or older, whose medical costs for COVID-19 testing were claimed until May 15, 2020. COVID-19 diagnosis and infection severity were identified from reimbursement data using diagnosis codes and on the basis of respiratory support use, respectively. Odds ratios (ORs) were estimated using multiple logistic regression, after adjusting for age, sex, region, healthcare utilization, and insurance status. Results: The COVID-19 group (7,341 of 219,961) was young and had a high proportion of female. Overall, 13.0% (954 of 7,341) of the cases were severe. The severe COVID-19 group had older patients and a proportion of male ratio than did the non-severe group. Diabetes (odds ratio range [ORR], 1.206–1.254), osteoporosis (ORR, 1.128–1.157), rheumatoid arthritis (ORR, 1.207–1.244), substance use (ORR, 1.321–1.381), and schizophrenia (ORR, 1.614–1.721) showed significant association with COVID-19. In terms of severity, diabetes (OR, 1.247; 95% confidential interval, 1.009–1.543), hypertension (ORR, 1.245–1.317), chronic lower respiratory disease (ORR, 1.216–1.233), chronic renal failure, and end-stage renal disease (ORR, 2.052–2.178) were associated with severe COVID-19. Conclusion We identified several comorbidities associated with COVID-19. Health care workers should be more careful while diagnosing and treating COVID-19 when patients have the abovementioned comorbidities.

OBJECTIVES: This study evaluated the incidence of colorectal cancer (CRC) according to the number of metabolic syndrome (MetS) components. METHODS: Using health checkup and insurance claims data of 6,365,409 subjects, the occurrence of CRC according to stage of MetS by sex was determined from the date of the health checkup in 2009 until December 31, 2018. RESULTS: Cumulative incidence rates (CIR) of CRC in men and women was 3.9 and 2.8 per 1000 (p < 0.001), respectively. CIR of CRC for the normal, pre-MetS, and MetS groups in men was 2.6, 3.9, and 5.5 per 1000 (p < 0.001) and CIR in women was 2.1, 2.9, and 4.5 per 1000 (p < 0.001), respectively. Compared with the normal group, the hazard ratio (HR) of CRC for the pre-MetS group was 1.25 (95% CI 1.17-1.33) in men and 1.09 (95% CI 1.02-1.17) in women, and the HR of CRC for the MetS group was 1.54 (95% CI 1.43-1.65) in men and 1.39 (95% CI 1.26-1.53) in women after adjustment. CONCLUSIONS We found that MetS is a risk factor for CRC in this study. Therefore, the prevention and active management of MetS would contribute to the prevention of CRC.