The origin of the periodic health examination can be traced to Horace Dobell, a British physician. The periodic health examination became popular in the early 20th century with many advocates such as the life insurance companies, private corporate industry, medical professionals, and the prepaid health care in North America. The contents and legitimacy of periodic health examination has changed markedly over time according to the objectives. There were various objectives of the periodic health examination according to the advocates: reduction of morbidity and mortality, scientific knowledge, economic savings, professional empowerment, the patient-physician relationship, satisfaction of patient demand, and efficient administration. Recent remarkable changes led by Canadian Task Force and U.S. Preventive Services Task Force were the emphasis of reduction of disease-specific morbidity and mortality, risk adjusted application, and the inclusion of counseling, immunization, and chemoprophylaxis. Health screening has become a promising medical practice in Korea. The main environment of the periodic health examination in Korea is fee-for-service system, the national medical insurance system, and Korean cultural background. However, the consensus of Korean government and society for controlling medical cost will limit the irrational prosperity of periodic health examination in near future.
English Abstract ; History of Medicine, 20th Cent. ; Patient Education/*history ; Preventive Health Services/*history

China ; Cleft Lip ; epidemiology ; Cleft Palate ; epidemiology ; Dentist-Patient Relations ; Health Services Needs and Demand ; History, 20th Century ; History, Ancient ; History, Medieval ; Humans ; Malocclusion ; epidemiology ; Mouth Neoplasms ; epidemiology ; Prevalence ; Surgery, Oral ; education ; history ; organization & administration ; trends

PURPOSE: Nonverbal communication (NVC) may be a crucial factor affecting effective communication between patients and medical students during the objective structured clinical examination (OSCE), but it has not been intensively studied. We examined NVC and its correlation with patient-physician interaction (PPI) in the OSCE. METHODS: A total of 68 video recordings of routine check-up OSCEs were included. A checklist for NVC was developed that included seven nonverbal factors in a mute state (NVM) and four nonverbal factors in speech (NVS), and one point was assigned to each factor. The scores for history taking, PPI, NVM, and NVS were compared, and correlations of each score were evaluated. RESULTS: Students with adequate facial expressions, accorded speech rate and voice volume, adequately matched voice tone, and few or no moments of unnecessary silence showed better PPI scores. The PPI score was correlated with history taking and the NVS score, but not the NVM score. CONCLUSION: Our results suggest that NVS may be more influential to PPI during OSCEs than NVM. Communication teachers should help students to be better prepared to use both NVS and NVM properly.
Checklist ; Education, Medical ; Facial Expression ; Humans ; Medical History Taking ; Nonverbal Communication* ; Patient Satisfaction ; Students, Medical* ; Video Recording ; Voice

INTRODUCTIONPlanning a high-stake clinical examination requires the evaluation of several psychometric and logistical variables. The authors conducted generalisability and decision studies to answer the following research questions in the context of the surgical long case: (1) Does the addition of a third examiner have any added benefit, vis-à-vis reliability, to the examination? (2) Is global marking more reliable than an itemised marking template? (3) What would be the impact on reliability if there was a reduction in the number of examinees that each panel of examiners is required to assess?

METHODSA third examiner and global marking were introduced. Separate generalisability and decision studies were carried out for both the two- and three-examiner models as well as for itemised and global scores.

RESULTSThe introduction of a third examiner resulted in a modest gain of reliability by 0.05-0.07. Gain in reliability was higher when each candidate was allowed to undertake a higher number of clinical cases. Both the global and itemised scores provided equivalent reliability (generalisability coefficient 0.74-0.89).

CONCLUSIONOur results showed that only a modest improvement in reliability of the surgical long case is achieved through the introduction of an additional examiner. Although the reliability of global scoring and the itemised marking template was comparable, the latter may provide opportunities for individualised feedback to examinees.

Clinical Competence ; Education, Medical, Undergraduate ; methods ; standards ; Educational Measurement ; methods ; Humans ; Medical History Taking ; methods ; Observation ; Professional-Patient Relations ; Psychometrics ; methods ; Reproducibility of Results ; Schools, Medical ; Singapore

This study was conducted to explore the status of nursing information systems implementation in Korean hospitals. Structured questionnaires were mailed to the 411 hospitals with more than 80 beds. Data were tabulated using descriptive procedure. Out of 411 hospitals, 116 hospitals replied. Out of 116 replied hospitals 114 hospitals indicated that they have some kind of hospital information system implemented. 86 hospitals have computerized their outpatient care management system and 84 hospitals have computerized their inpatient care management system. And 70 hospitals replied that they have some form of nursing information systems. Most components in the nursing information system are the ones related to other department with only a few nursing specific tasks being computerized. Order communication system was ranked the first as a task to be computerized with nursing history. nursing record. nursing care plan, daily report following. Nursing department of the sixty hospitals reflect their input in nursing information system development by participating a hospital wide adhoc committee. And 32 hospitals have their own committee to discuss issues related to nursing information system development. Eleven hospitals reported that they have nurse information and 17 hospitals have dispatched nurses to the information department. And 25 hospitals said that they are not involved at all in nursing information system development. Sixty-two hospitals indicated that the N have some form of computer education programs for nurses: 28 have regular in-service education programs 34 have irregular in-service education programs: and 29 have education programs for the newly employed.
Ambulatory Care ; Education ; History of Nursing ; Hospital Information Systems ; Humans ; Information Systems* ; Inpatients ; Nursing Informatics ; Nursing Records ; Nursing* ; Patient Care Planning ; Postal Service ; Surveys and Questionnaires

PURPOSE: Identifying patients' agendas is important; however, the extent of Korean medical students' agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students' agenda solicitation. METHODS: A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients' reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient's initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined. RESULTS: The medical students did not explore the patients' concerns and did not negotiate an agenda. Interruption of the patient's opening statement occurred in 4.62+/-2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions. CONCLUSION: Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students' ability to set an agenda.
Adult ; Checklist ; *Clinical Competence ; *Communication ; Curriculum ; *Education, Medical, Undergraduate ; Female ; Humans ; Male ; *Medical History Taking ; *Physician-Patient Relations ; Republic of Korea ; *Students, Medical ; Universities ; Video Recording ; Young Adult

PURPOSE: The purpose of this study is to investigate the reliability and validity of new clinical performance examination (CPX) for assessing clinical reasoning skills and evaluating clinical reasoning ability of the students. METHODS: Third-year medical school students (n=313) in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP) note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey. RESULTS: The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students' performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5%) identified essential problem early and only 58 (18.5%) performed systematic history taking and physical examination. One hundred seventy-three of them (55.3%) communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes. CONCLUSION: To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.
Checklist ; *Clinical Competence ; Communication ; Comprehension ; *Education, Medical, Undergraduate ; Educational Measurement/*standards ; Humans ; Medical History Taking ; Medical Records ; Observer Variation ; Physical Examination ; Physician-Patient Relations ; *Problem-Based Learning ; Reproducibility of Results ; Republic of Korea ; *Schools, Medical ; *Students, Medical ; Surveys and Questionnaires ; *Thinking ; Universities

PURPOSE: This study was to explore the relationship between clinical performance examination (CPX) achievement and epistemological beliefs to investigate the potentials of epistemological beliefs in ill-structured medical problem solving tasks. METHODS: We administered the epistemological beliefs questionnaire (EBQ) to fourth-year medical students and correlated the results with their CPX scores. The EBQ comprised 61 items reflecting five belief systems: certainty of knowledge, source of knowledge, rigidity of learning, ability to learn, and speed of knowledge acquisition. The CPX included scores for history taking, physical examination, and patient-physician interaction. RESULTS: The higher epistemological beliefs group obtained significantly higher scores on the CPX with regard to history taking and patient-physician interaction. The epistemological beliefs scores on certainty of knowledge and source of knowledge were significantly positively correlated with patient-physician interaction. The epistemological beliefs scores for ability to learn were significantly positively correlated with those for history taking, physical examination, and patient-physician interaction. CONCLUSION: Students with more sophisticated and advanced epistemological beliefs stances used more comprehensive and varied approaches in the patient-physician interaction. Therefore, educational efforts that encourage discussions pertaining to epistemological views should be considered to improve clinical reasoning and problem-solving competence in the clinic setting.
*Achievement ; Adult ; *Attitude ; *Clinical Competence ; *Culture ; *Education, Medical, Undergraduate ; Educational Measurement ; Female ; Humans ; *Knowledge ; Male ; Medical History Taking ; Physical Examination ; Physician-Patient Relations ; Problem-Based Learning ; Republic of Korea ; Schools, Medical ; *Students, Medical ; Surveys and Questionnaires ; Thinking ; Young Adult

Stroke is a significant cause of death and disability in Singapore; in 2014, it was the fourth most common cause of death. Transient ischaemic attack (TIA) is defined as a transient episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia without evidence of acute infarction. The diagnosis of TIA/acute stroke needs to be considered in all patients who present with sudden focal neurological dysfunction. Prompt referral for assessment, neuroimaging and intervention provides the best chance for neurological recovery and/or minimising further neurological damage. Primary care physicians have a crucial role in TIA/stroke prevention and management. This includes referring patients with suspected acute TIA/stroke to hospitals with stroke treatment facilities immediately; managing the modifiable risk factors of cerebral ischaemia; continuing prescription of antiplatelet agents and/or anticoagulation where indicated; and teaching patients to recognise and respond to suspected cerebral ischaemia using the FAST (face, arm, speech, time) acronym.
Clinical Competence ; Humans ; Ischemic Attack, Transient ; diagnosis ; drug therapy ; Medical History Taking ; Outpatients ; Patient Education as Topic ; Plasminogen Activators ; therapeutic use ; Referral and Consultation ; Risk Factors ; Singapore ; Stroke ; diagnosis ; drug therapy