Background: The purpose of this study was to examine the influence of family mealtime and family structure on family functioning and early adolescents’ depression. Methods: A survey was conducted with a sample of 275 middle school students in the Gangdong-gu district, Seoul. APGAR scores and Children’s Depression Inventory (CDI) scale were used to measure family functioning and depression level, respectively, along with six more questions to collect data on family structure, family mealtimes, and adolescents’ reasons for avoiding family meals. Statistical analyses including t-test, one-way ANOVA and twoway ANOVA were employed to examine the influence of family mealtime, family structure and sex on family functioning and depression levels. Results: The analyses revealed that family structure and environmental factors, such as parental presence and educational attainment did not influence family functioning or adolescent depression, while variables related to family mealtime influenced both depression level and family functioning. Results also showed that females were more vulnerable to depression. Conclusion It was concluded that having family time during meals improves family functioning and helps decrease depression levels of adolescent family members. Therefore, parents should take care that they have regular family mealtimes with children, especially female children, during their adolescence.

A systematic educational program evaluation system for continuous quality improvement in undergraduate medical education is essential. Monitoring and evaluation (M&E) are two distinct but complementary processes referred to in an evaluation system that emphasizes formative purpose. Monitoring involves regular data collection for tracking process and results, while evaluation requires periodic judgment for improvement. We have recently completed implementing an educational evaluation using the M&E concept in a medical school. The evaluation system consists of two loops, one at the lesson/course level and the other at the phase/graduation level. We conducted evaluation activities in four stages: planning, monitoring, evaluation, and improvement. In the planning phase, we clarified the purpose of evaluation, formulated a plan to engage stakeholders, determined evaluation criteria and indicators, and developed an evaluation plan. Next, during the monitoring phase, we developed evaluation instruments and methods and then collected data. In the evaluation phase, we analyzed results and evaluated the criteria of the two loops. Finally, we reviewed the evaluation results with stakeholders to make improvements. We have recognized several problems including excessive burden, lack of expertise, insufficient consideration of stakeholders’ evaluation questions, and inefficient data collection. We need to share the value of evaluation and build a system gradually.

Although ‘assessment for learning’ rather than ‘assessment of learning’ has been emphasized recently, student learning before examinations is still unclear. The purpose of this study was to investigate pre-assessment learning activities (PALA) and to find mechanism factors (MF) that influence those activities. Moreover, we compared the PALA and MF of written exams with those of the clinical performance examination/objective structured clinical examination (CPX/OSCE) in third-year (N=121) and fourth-year (N=108) medical students. Through literature review and discussion, questionnaires with a 5-point Likert scale were developed to measure PALA and MF. PALA had the constructs of cognitive and meta-cognitive activities, and MF had sub-components of personal, interpersonal, and environmental factors. Cronbach's α coefficient was used to calculate survey reliability, while the Pearson correlation coefficient and multiple regression analysis were used to investigate the influence of MF on PALA. A paired t-test was applied to compare the PALA and MF of written exams with those of CPX/OSCE in third and fourth year students. The Pearson correlation coefficients between PALA and MF were 0.479 for written exams and 0.508 for CPX/OSCE. MF explained 24.1% of the PALA in written exams and 25.9% of PALA in CPX/OSCE. Both PALA and MF showed significant differences between written exams and CPX/OSCE in third-year students, whereas those in fourth-year students showed no differences. Educators need to consider MFs that influence the PALA to encourage 'assessment for learning'.
Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Learning ; Students, Medical

Pusan National University School of Medicine (PNUSOM) began analyzing the cohort of pre-medical students admitted in 2015 and has been conducting purposeful analyses for the past 3 years. The aim of this paper is to introduce the process of cohort establishment, cohort composition, and the utilization of cohort analysis results. PNUSOM did not initially form a cohort with a purpose or through a systematic process, but was able to collect longitudinal data on students through the establishment of a Medical Education Information System and an organization that supports medical education. Cohort construction at our university is different in terms of a clear orientation toward research questions, flexibility in cohort composition, and subsequent guideline supplementation. We investigated the relevance of admission factors, performance improvements, satisfaction with the educational environment, and promotion and failure rate in undergraduate students, as well as performance levels and career paths in graduates. The results were presented to the Admissions Committee, Curriculum Committee, Learning Outcomes Committee, and Student Guidance Committee to be used as a basis for innovations and improvements in education. Since cohort studies require long-term efforts, it is necessary to ensure the efficiency of data collection for graduate cohorts, as well as the validity and ethics of the study.

BACKGROUND: This study evaluated the effects of family type and sociodemographic factors on medical treatment, health behavior, and subjective health status in Koreans 60 years and older. METHODS: This study was based on data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES), a nationwide health interview survey using a rolling sampling design involving complex, stratified, multistage, probability cluster. Our subjects included those > or =60 years of age (n=1,946) participating in the KNHANES 2010. Family type was categorized into 7 groups according to cohabitation: alone, couple cohabitation (living with a spouse), parent(s) cohabitation (couple living with parent(s)), offspring cohabitation (no spouse, living with offspring), couple offspring cohabitation (couple living with offspring), couple offspring parents cohabitation (couple living with parent(s) and offspring), and others. Logistic regression analyses were used to examine the association of family type and sociodemographic factors with health care. RESULTS: The most common family type was couple cohabitation (38.26+/-1.8%). In this group, the percentage of non-receipt of needed medical care (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.42 to 0.87) and current smoking rate (OR, 0.32; 95% CI, 0.20 to 0.50) were significantly lower than those living alone. Among the sociodemographic charicteristics, male gender, apartment dwelling, high middle household income, 2 member family, education higher than middle school, and possessing own house were associated with good health care behavior. CONCLUSION: This study shows that couples have better health care behavior than other family types, in particular, limited smoking, appropriate medical treatment, and positive subjective health status. Those living alone visit medical clinics less often and have a negative subjective health status.
Delivery of Health Care ; Family Characteristics ; Health Behavior ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Parents ; Smoke ; Smoking ; Spouses

BACKGROUND: This study investigated the handwashing in clinical nurses for prevention and control of nosocomial infection. METHODS: The subjects were 192 nurses at a university hospital in Busan. The data were collected using questionnaires, which included items to measure the method, application time, and frequency of handwashing related to nursing intervention activities, and were analyzed using the mean score, frequency and percentage. RESULTS: Each day, the nurses had an average of 10.5 times of hand washing. 34.9% of nurses had evaluated "not enough" concerning their handwashing performance. Nurses indicated that the performance of handwashing had interrupted by overwork, lack of facilities, skin irritation with itching, etc. 19.4% of nurses had not received education program about handwashing. Some nurses did not strictly follow a handwashing protocol allowing potential chances of nosocomial infection to occur. The rate of handwashing performance increased after the activities of nursing intervention than before activities related to respiration, nutrition, elimination, hygiene, medication, etc. CONCLUSION: These findings suggest that hospital administrators must develop education programs and policies for the prevention of nosocomial infection. We recommend that nurses participate in education to search for practical methods to improve the management of nosocomial infection such as handwashing performance.
Busan ; Cross Infection ; Education ; Hand Disinfection* ; Hospital Administrators ; Humans ; Hygiene ; Nursing ; Pruritus ; Respiration ; Skin ; Surveys and Questionnaires

PURPOSE: The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. METHODS: Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. RESULTS: Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. CONCLUSION: A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.
Counseling ; Humans ; Informed Consent ; Students, Medical

PURPOSE: Problem-based learning (PBL) is an educational approach in which complex authentic problems serve as the context and stimulus for learning. PBL is designed to encourage active participation during learning. The goal of this study was to study the effects of PBL on academic motivation and self-directed learning readiness in medical school students. METHODS: The subjects of this study were 190 students in the 1st and 2nd grade of medical school. The period of the PBL course was two weeks for Year 1 and five weeks for Year 2 students. Students completed one module over one week. Academic motivation tests and self-directed learning readiness tests were performed before and after the PBL course. The differences between the two groups were analyzed using paired t-test and repeated measures MANCOVA. RESULTS: PBL had positive effects on academic self-efficacy (self-control efficacy, task-level preference) and academic failure tolerance (behavior, task-difficulty preference) as academic motivation. PBL had a mildly positive effect on self-directed learning readiness. In addition, the five-week PBL course had greater positive effects on academic motivation than the two-week course but not with regard to self-directed learning readiness. CONCLUSION: Medical students engage in academic motivation and self-directed learning readiness during PBL, suggesting that the five-week PBL course has greater positive effects than the two-week course. Future studies are needed to confirm the most effective periods of PBL.
Humans ; Learning ; Motivation ; Problem-Based Learning ; Program Evaluation ; Schools, Medical ; Students, Medical

Students must be familiar with clinical skills before starting clinical practice to ensure patients’ safety and enable efficient learning. However, performance is mainly tested in the third or fourth years of medical school, and studies using the validity framework have not been reported in Korea. We analyzed the validity of a performance test conducted among second-year students classified into content, response process, internal structure, relationships with other variables, and consequences according to Messick’s framework.As results of the analysis, content validity was secured by developing cases according to a pre-determined blueprint. The quality of the response process was controlled by training and calibrating raters. The internal structure showed that (1) reliability by generalizability theory was acceptable (coefficients of 0.724 and 0.786, respectively, for day 1 and day 2), and (2) the relevant domains had proper correlations, while the clinical performance examination (CPX) and objective structured clinical examination (OSCE) showed weaker relationships. OSCE/CPX scores were correlated with other variables, especially grade point average and oral structured exam scores. The consequences of this assessment were (1) making students learn clinical skills and study themselves, while causing too much stress for students due to lack of motivation; (2) reminding educators of the need to apply practical teaching methods and to give feedback on the test results; and (3) providing an opportunity for faculty to consider developing support programs. It is necessary to develop the blueprint more precisely according to students’ level and to verify the validity of the response process with statistical methods.

BACKGROUND: Many studies have shown that obesity is associated with sexual dysfunction and causes erectile dysfunction particularly, but these studies are mainly about chronic diseases caused by obesity. Therefore, we conducted a study to evaluate the association of obesity in itself with erectile dysfunction. METHODS: The study sample consisted of men, aged over 20 who visited in a university hospital in Pusan from December 1999 to March 2000, who responded to the Korean version of the international index of erectile function(IIEF). The patients having obesity related diseases were excluded from the subject group. The subjects were classified into 'obese', 'normal' group according to body mass index(BMI) and erectile function was classified into 'erectile dysfunction', 'normal' according to IIEF 5 score. Chi square test and Fisher's exact test were performed for statistic analysis. RESULTS: The mean age was 42.1. In total 160 subjects, 109 men(68.1%) belonged to the normal group and 51(31.9%) to the obese group, and 100 men(62.5) had erectile dysfunction. In normal group, 43(39.4%) had normal erectile function and 66(60.6%) had erectile dysfunction. In obese group, 17(33.3%) were normal and 34(66.7%) had erectile dysfunction. No significant difference between two groups was noted in erectile function (P> 0.05). CONCLUSION: There was no significant association of obesity in itself with erectile dysfunction in this study after excluding effects of other obesity related problems.
Busan ; Chronic Disease ; Erectile Dysfunction* ; Humans ; Male ; Obesity*