This paper attempts to utilise clinical scenarios where ethical issues are embedded and requires appropriate application of the steps of the framework mentioned. A step by step sequential approach is adopted to illustrate how the ‘ethical decision model ‘can be used to resolve ethical problems to arrive at a reasonable conclusion. The UNESCO ethical method of reasoning is used as the framework for decision making. Physicianeducators should be competent to use ethical decision models as well as best available scientific evidence to be able to arrive at the best decision for patient care as well as teach health professional trainees how reasonable treatment decisions can be made within the perimeter of medical law and social justice.
Obstetrics ; Education, Medical

*Education, Medical ; *Education, Medical, Graduate ; *Gynecology ; *Obstetrics

*Abortion, Legal ; *Contraceptives, Oral ; *Education, Medical ; *Gynecology ; *Obstetrics ; *Pregnancy

BACKGROUND: Red blood cell (RBC) transfusion is an essential practice during surgery to accommodate for bleeding. As such, there are efforts being made to allow for a safe and appropriate transfusion due to shortages of blood components and to minimize transfusion-related adverse reactions. However, a conventional transfusion decision with relatively high hemoglobin (Hb) threshold is still performed in clinical setting. In this study, we investigated the threshold of Hblevel and appropriateness of RBC transfusion in patients receiving perioperative RBC transfusion in surgical departments. METHODS: We investigated the pre-transfusion Hb level of 1,379 patients (2,170 episodes) receiving perioperative RBC transfusion in five surgical departments, including cardiothoracic surgery (CS), general surgery (GS), neurosurgery (NS), obstetrics and gynecology (OBGY), and orthopedics (OS), between June 2017 and March 2018. The appropriateness of transfusion was evaluated with two criteria: 1) pretransfusion Hb level ≤10 g/dL and 2) posttransfusion Hb level ≤10 g/dL. RESULTS: The median pretransfusion Hb level was 8.5 g/dL (interquartile range 7.7~9.4); that of each department was as follows: 8.6 g/dL (7.9~9.2) in CS, 7.9 g/dL (7.3~8.6) in GS, 9.1 g/dL (8.5~9.8) in NS, 8.5 g/dL (7.7~9.8) in OBGY, and 8.7 g/dL (7.9~9.7) in OS. With a criteria of pretransfusion of Hb level ≤10 g/dL, 85.4% of total episodes were appropriate. With criteria of post-transfusion of Hb level ≤10 g/dL, 44.7% were appropriate. CONCLUSION: This study presents a fundamental data observing the trend of RBC transfusion in a single institution. A significant proportion of inappropriate RBC transfusion are still being conducted in surgical setting. Continuous and effective education of clinicians and implementation of monitoring systems to assess the appropriateness of RBC transfusion may be necessary.
Education ; Erythrocyte Transfusion ; Erythrocytes ; Gynecology ; Hemorrhage ; Humans ; Neurosurgery ; Obstetrics ; Orthopedics

There are four principles of medical ethics; Beneficence, Respect for autonomy, Non-maleficence, and Justice. It is not easy to apply to principles of medical ethics in the special circumstances of obstetrics and gynecology. Student doctors must learn to be familiar with principles of medical ethics tailored to the special circumstances while the obstetrics and gynecology practice.
Beneficence ; Education, Medical* ; Ethics* ; Ethics, Medical ; Gynecology* ; Humans ; Obstetrics* ; Social Justice

Clinical education is difficult for actual practice of medical students. In particular, the practice in the field of obstetrics is more difficult to many students. Moreover, the education of sub-fields of obstetrics such as birth or abortion needs many materials of women's reproductive organs. However, the ordinary paper-based textbooks have some limitations for clinical education of obstetrics. The electronic textbook system based on multimedia data enables that many student, doctor, and public user overcome these difficulties, as a computer assisted learning. We developed multimedia database system which is connected with web using ODBC(Open DataBase Connectivity)and ASP(Active Server Page)/IDC(Internet DataBase Connection). Many text and multimedia data are gathered in the database. This system serves various multimedia data using internet and intranet in the student's class or home. In conclusion, providing multimedia data of obstetrics using ODBC, ASP/IDC method reduce the limitation of clinical education. This model of the electronic textbook would be a reference to develop multimedia database on the network.
Computer Communication Networks ; Education ; Humans ; Internet ; Learning ; Multimedia* ; Obstetrics ; Parturition ; Students, Medical

PURPOSE: This study aims to determine obstetrics nurses knowledge, attitude, and practice about breast cancer and breast self-examination (BSE), and to contribute to the early detection of breast cancer during breastfeeding periods. METHODS: For the survey, 163 individuals (obstetric nurses) were chosen by convenience sampling and agreed to participate in the study. Their knowledge, attitude, and practice about breast cancer and BSE. RESULTS: Knowledge and attitude averaged 70.45+/-10.90 (of 100) and 3.64+/-0.27 (of 5), respectively. While most nurses (99%) recognized the importance of BSE, only 58.9% experienced BSE. BSE practice level averaged 8.35+/-1.96 (of 12). Only 20.2% had recommended BSE to their clients. Practice level varied significantly for different marital status, breastfeeding experience, and education, while knowledge and attitude remained independent. Nurses who had experienced mammogram or breast ultrasonogram themselves scored higher in knowledge. Attitude was higher for nurses who received recommendation for BSE, performed BSE, received BSE education, or recommended BSE to clients. Practice level was higher for nurses who received BSE education or willing to perform BSE in future. Practice level had a positive correlation with attitude but no correlation to knowledge. CONCLUSION: Obstetric nurses need continuing education for practicing BSE. Practical BSE education can not only promote preventive behavior of nurses, but it can also improve the breast health management of obstetrical clients.
Breast ; Breast Feeding ; Breast Neoplasms ; Breast Self-Examination ; Education, Continuing ; Marital Status ; Obstetrics

COVID-19 ; Child ; Humans ; Internship and Residency ; Obstetrics/education* ; SARS-CoV-2 ; Singapore

INTRODUCTIONThis study aimed to develop a realistic and lifelike uterine model for the training of hysteroscopy skills.

MATERIALS AND METHODSA lifelike "uterine" model was constructed using female pig bladder. The pig bladder was enclosed within a malleable mould, with both ureters blocked by pins. Both rigid and flexible hysteroscopes were used in this study.

RESULTSBasic diagnostic hysteroscopy can be performed in the usual fashion using this lifelike model. The cost of each learning station is minimal. Pig bladder accurately simulates the human uterus with its realistic tactile feel, and conditions in the surgical environment, including obscuration of vision by debris, uterine "folds", realistic "ostia", incomplete shearing of tissue, "uterine" perforation, etc.

CONCLUSIONThis low-cost novel model provides realistic tissue resistance and yields an almost anatomically accurate hysteroscopic training tool, thereby allowing trainees to effectively acquire both diagnostic and therapeutic hysteroscopic skills.

Animals ; Education, Medical, Graduate ; methods ; Female ; Gynecology ; education ; Hysteroscopes ; Hysteroscopy ; education ; instrumentation ; Models, Anatomic ; Obstetrics ; education ; Singapore ; Swine ; Urinary Bladder ; Uterus

Yun Ti Wang studied medicine in England, different from other Korean medical doctors in early days. Yun, who entered medical school at Glasgow University in England in March 1919, graduated with a Bachelor of Medicine in October 1925, along with an England medical license. Yun began working as an instructor at Severance Medical College from November 1927, and received Doctor of Medicine from the College of Obstetricians and Gynecologists at Kyoto Imperial University in August 1936. After the Liberation, Yun began working as a faculty member at the medical school at Seoul University, and he also worked as a Chief of the Second Medical Clinic of the school from 1946. Yun made a great effort in order to build an integrated committee, eventually contributing to the launching of Joseon Medical Associates in 1947. He was also elected as a first president at Joseon Obstetrics and Gynecology Associates, which was organized at the same year as the Joseon Medical Associates. Yun entered military as an army surgeon in April 1949 and has worked there until he was appointed as a principal at the Army Medical School in September 1953. His contributions to the development of military medical services include the following: expansion of medical facilities in army, stable system of workforce in military medical service, launching of Medical Aid and establishment of Department of Medical Care, and introduction of new medical technologies in anesthesiology and neurosurgery, etc. The career of Yun can be largely divided into the field of gynecology and military medical services. In the gynecological field, Yun contributed to the settlement of obstetrics in Korea, by taking in charge of the obstetrics class at Severance following medical missionaries. As for the military medical services, he has contributed to the establishment of military medical system as well as to the opening of new academic areas. The impact of his activities on the establishment of military medical services is especially significant, since it was a field that no Korean citizens had access to during the colonization era.
Education, Medical/history ; England ; Gynecology/history ; History, 20th Century ; Korea ; Military Medicine/*history ; Obstetrics/*history ; Societies, Medical/history