Purpose: This study aimed to compare and evaluate the efficiency and accuracy of computerized adaptive testing (CAT) under 2 stopping rules (standard error of measurement [SEM]=0.3 and 0.25) using both real and simulated data in medical examinations in Korea. Methods: This study employed post-hoc simulation and real data analysis to explore the optimal stopping rule for CAT in medical examinations. The real data were obtained from the responses of 3rd-year medical students during examinations in 2020 at Hallym University College of Medicine. Simulated data were generated using estimated parameters from a real item bank in R. Outcome variables included the number of examinees’ passing or failing with SEM values of 0.25 and 0.30, the number of items administered, and the correlation. The consistency of real CAT result was evaluated by examining consistency of pass or fail based on a cut score of 0.0. The efficiency of all CAT designs was assessed by comparing the average number of items administered under both stopping rules. Results: Both SEM 0.25 and SEM 0.30 provided a good balance between accuracy and efficiency in CAT. The real data showed minimal differences in pass/fail outcomes between the 2 SEM conditions, with a high correlation (r=0.99) between ability estimates. The simulation results confirmed these findings, indicating similar average item numbers between real and simulated data. Conclusion The findings suggest that both SEM 0.25 and 0.30 are effective termination criteria in the context of the Rasch model, balancing accuracy and efficiency in CAT.

Purpose: This study aimed to compare and evaluate the efficiency and accuracy of computerized adaptive testing (CAT) under 2 stopping rules (standard error of measurement [SEM]=0.3 and 0.25) using both real and simulated data in medical examinations in Korea. Methods: This study employed post-hoc simulation and real data analysis to explore the optimal stopping rule for CAT in medical examinations. The real data were obtained from the responses of 3rd-year medical students during examinations in 2020 at Hallym University College of Medicine. Simulated data were generated using estimated parameters from a real item bank in R. Outcome variables included the number of examinees’ passing or failing with SEM values of 0.25 and 0.30, the number of items administered, and the correlation. The consistency of real CAT result was evaluated by examining consistency of pass or fail based on a cut score of 0.0. The efficiency of all CAT designs was assessed by comparing the average number of items administered under both stopping rules. Results: Both SEM 0.25 and SEM 0.30 provided a good balance between accuracy and efficiency in CAT. The real data showed minimal differences in pass/fail outcomes between the 2 SEM conditions, with a high correlation (r=0.99) between ability estimates. The simulation results confirmed these findings, indicating similar average item numbers between real and simulated data. Conclusion The findings suggest that both SEM 0.25 and 0.30 are effective termination criteria in the context of the Rasch model, balancing accuracy and efficiency in CAT.

Purpose: This study aimed to compare and evaluate the efficiency and accuracy of computerized adaptive testing (CAT) under 2 stopping rules (standard error of measurement [SEM]=0.3 and 0.25) using both real and simulated data in medical examinations in Korea. Methods: This study employed post-hoc simulation and real data analysis to explore the optimal stopping rule for CAT in medical examinations. The real data were obtained from the responses of 3rd-year medical students during examinations in 2020 at Hallym University College of Medicine. Simulated data were generated using estimated parameters from a real item bank in R. Outcome variables included the number of examinees’ passing or failing with SEM values of 0.25 and 0.30, the number of items administered, and the correlation. The consistency of real CAT result was evaluated by examining consistency of pass or fail based on a cut score of 0.0. The efficiency of all CAT designs was assessed by comparing the average number of items administered under both stopping rules. Results: Both SEM 0.25 and SEM 0.30 provided a good balance between accuracy and efficiency in CAT. The real data showed minimal differences in pass/fail outcomes between the 2 SEM conditions, with a high correlation (r=0.99) between ability estimates. The simulation results confirmed these findings, indicating similar average item numbers between real and simulated data. Conclusion The findings suggest that both SEM 0.25 and 0.30 are effective termination criteria in the context of the Rasch model, balancing accuracy and efficiency in CAT.

Decompression sickness is a self contained underwater breath apparatus (SCUBA)-related injury with various symptoms and is considered an extreme emergency condition. This is a case of pulmonary involvement in decompression sickness in a 26-year-old SCUBA diver. Although pulmonary involvement in decompression sickness is a potentially severe condition that requires immediate treatment, this condition can be under- or misdiagnosed, and evaluation of this disease by imaging findings is not clearly understood. We experienced a case of pulmonary involvement in decompression sickness and herein present the chest computed tomography and simple radiograph findings associated with this condition.
Decompression ; Decompression Sickness ; Dyspnea ; Emergencies ; Thorax

PURPOSE: This research used quantitative research to identify differences in death consciousness between pre and post education. The study was also designed to further understanding of the effects of nursing education by using a qualitative analysis to examine hospice education experience. METHOD: This study a one group pre-post test design. RESULTS: 1. The mean score for the students' death consciousness before the hospice education averaged 2.15+/- .33, a medium level for death consciousness. The score after education was 2.25+/- .36, that is, there was higher score for death consciousness after education. 2. The result of classification, giving their names and categorizing the experience of being in a coffin shown to be self-reflection, regret, recognition to death, death as discontinuation of life, the last closing from everything, death as a sad and cruel event, death as another world, specialist intuition of nursing. CONCLUSION: This research provided an opportunity for nursing students to consider death earnestly and realistically through hospice nursing education. We also discovered affirmative changes in the students' viewpoint of death, students who in future clinical practice may work with elders. We also found increases in motives to develop ability to present effective aid to dying patients.
Classification ; Consciousness ; Education* ; Education, Nursing ; Evaluation Studies as Topic ; Hospice and Palliative Care Nursing ; Hospices* ; Humans ; Intuition ; Nursing ; Specialization ; Students, Nursing

Noroviruses (NoV) are the major viral pathogen causing epidemic acute gastroenteritis and outbreaks of foodborne and waterborne illness. During the local festival in Chungnam province, group food poisoning occurred outbreak by NoV infections in Jan 2019. In this study, epidemiological analysis and molecular characterization were conducted such as genotyping, phylogeny. The prevalent genotypes of food poisoning events were NoV GII.3 and GII.17, and NoV GII.3 and GII.17 isolates of this study were completely matched in nucleotide sequence comparison of capsid gene region, respectively. In underground water and stream water, various multiple genotypes of noroviruses were detected including NoV GII.3, GII.8 and GI.4 in aquatic environment of the local festival site. Among 32 worker samples, various NoVs of five genotypes (GI.7, GI.8, GII.3, GII.8, GII.17) were detected in 12 samples and expected to causing NoV contaminated by exposure to groundwater. NoV genotype GII.3, which was detected from groundwater 2, was completely consistent with that of patients and workers. Therefore, groundwater within the local festival site could be main cause of food poisoning event. Because NoV outbreaks are caused by fecal to oral transmission, proper management of sewage purification facilities, groundwater and sanitary toilets is required for many visitors, and efforts are needed to maintain clean environment.
Base Sequence ; Capsid ; Chungcheongnam-do ; Disease Outbreaks ; Epidemiologic Studies ; Foodborne Diseases ; Gastroenteritis ; Genotype ; Groundwater ; Holidays ; Humans ; Korea ; Norovirus ; Phylogeny ; Rivers ; Sewage ; Water