Child ; Humans ; Neuropsychological Tests ; Psychology, Clinical

PURPOSE: This study analyzed the correlation between grade point average (GPA) of medical school and the score of Korean Medical Licensing Examination (KMLE). METHODS: This study based on the results of 67th KMLE applicants who graduated from a college of medicine in 2003. We also gathered data of these applicants from the college of medicine: gender, age, type of entrance, GPA of basic medicine, clinical medicine, clinical clerkships and final test scores. We analyzed whether there was discrimination between achievement of KMLE passed and that of KMLE failed, which of variables affected the results of KMLE. RESULTS: 173 applicants passed KMLE among 189. There were significant correlations between basic medicine, clinical medicine, final test score and the score of KMLE (respective p-value; < 0.0001). There were also significant differences of GPA between KMLE passed applicants and failed. Final test scores were the most correlated with those of KMLE. If the GPA of 2nd grade was below 2.5 and the GPA of 3rd year grade was below 2.3, they was a high-risk group for failing KMLE (sensitivity 100%, specificity 90%). CONCLUSION: There were significant correlations between the GPA of medical school and the score of KMLE, and significant differences between KMLE passed applicants and failed. A high-risk group of failing KMLE was the students that the GPA of 2nd grade was below 2.5 and the GPA of 3rd grade was below 2.3.
Clinical Medicine ; Discrimination (Psychology) ; Humans ; Licensure* ; Schools, Medical* ; Sensitivity and Specificity

PURPOSE: Even though many studies have indicated that the personality of medical students affects learning style and academic achievement, the effect of personality types on the performance skill tests has not been well known in the medical field due to the rarity of published papers. Thus, the aim of this study was to reveal the effect of personal traits on clinical skill performance tests. METHODS: Fifty-seven fourth-grade medical students were enrolled in this study. They had all completed clinical performance tests. To assess personality types, we used the Korean version of the Myers-Briggs Type Indicator (MBTI). RESULTS: Fifty-five of 57 senior medical students responded completely to the MBTI questionnaire. The proportion of four paired MBTI dimensions was Introversion (I)-Extroversion (E) (67.3% vs. 32.7%), Sensing (S)-Intuition (I) (76.4% vs. 23.6%), Thinking (T)-Feeling (F) (61.8% vs. 38.2%), and Judging (J)-Perception (P) (56.4% vs. 43.6%). The dominant personality types were ISTJ (23.6%), ESTJ (14.5%), and ISTP (10.9%). The first objective structured clinical examination (OSCE) test showed higher scores in Extraversion, Judging, and Sensing-Judging types compared to the counterparts (p<0.05), but this effect was not observed in the second OSCE test. On the clinical performance examination, Extraversion, Sensing, and Judging types had a higher score, as measured by standardized patients. CONCLUSION: Specific personal traits affect the test scores of the clinical performance skill examinations. So, personality measurement might be a useful tool for understanding a student who has difficulty in performance tests. We hope this study will give valuable information to examiners when they instruct and counsel students about clinical performance tests.
Achievement ; Clinical Competence ; Extraversion (Psychology) ; Humans ; Introversion (Psychology) ; Learning ; Personality Inventory ; Students, Medical ; Thinking ; Surveys and Questionnaires

Differences and relations between effects of acupuncture therapy and sham acupuncture are systematically analyzed in this article through the influential factors of acupuncture effect. And it is held that sham acupuncture effect is not exactly equal to placebo effect. The effects of both acupuncture and sham acupuncture are composed by specific effects and non-specific effects, and the differences of non-specific effects between acupunc ture and sham acupuncture can be minimized furthest with blinding and randomized method. Therefore, the difference of acupuncture and sham acupuncture treatment rests with the degree of differences of the specific effects. Only when both of the specific effect of acupuncture and the effect of acupuncture are minimized, can it be applied as the ideal placebo control. Consequently when placebo acupunture are setted up, factors such as the body condition, site of stimulation and stimulation parameters which can influence the specific effect of acupuncture should be taken into consideration to produce the relatively minimum specific effect.
Acupuncture Therapy ; psychology ; Controlled Clinical Trials as Topic ; methods ; psychology ; Humans ; Placebo Effect ; Research Design ; Treatment Outcome

The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs' attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the "GP Attitudes and Competencies Towards Dementia" questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n=296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed that early recognition of dementia served the welfare of the patients (n=385; 96%) and their relatives (n=387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of questionnaire revealed 4 factors representing "benefits of early diagnosis and treatment of patients with dementia", "confidence in dealing with patients and caregiver of dementia", "negative perceptions towards dementia care" and "training needs". GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs' knowledge, confidence and comfort in managing patients with dementia.
Attitude of Health Personnel ; Caregivers ; psychology ; Clinical Competence ; Dementia ; diagnosis ; therapy ; General Practitioners ; psychology ; Humans ; Self Efficacy ; Singapore ; Surveys and Questionnaires

A prescriptive model approach in decision making could help achieve better diagnostic accuracy in clinical practice through methods that are less reliant on probabilistic assessments. Various prescriptive measures aimed at regulating factors that influence heuristics and clinical reasoning could support clinical decision-making process. Clinicians could avoid time-consuming decision-making methods that require probabilistic calculations. Intuitively, they could rely on heuristics to obtain an accurate diagnosis in a given clinical setting. An extensive literature review of cognitive psychology and medical decision-making theory was performed to illustrate how heuristics could be effectively utilized in daily practice. Since physicians often rely on heuristics in realistic situations, probabilistic estimation might not be a useful tool in everyday clinical practice. Improvements in the descriptive model of decision making (heuristics) may allow for greater diagnostic accuracy.
Clinical Decision-Making ; Decision Making ; Diagnosis ; Heuristics ; Problem Solving ; Psychology ; Thinking*

PURPOSE: This study was designed to investigate the effects of information sharing between students on results of clinical performance examination (CPX). METHODS: 143 third-year students, who completed their core clinical clerkship, were randomly assigned to one day of a 3-day, 6 station CPX. Station checklists, scored by the SP(s), consisted of history taking, physical examination, information sharing, clinical courtesy and patient-physician interaction. We compared the CPX station scores, CPX domain scores, self assessment scores and GPA of the three groups tested on different days with ANOVA, and analyzed the differences in CPX scores, after controlling for GPA, with ANCOVA. The correlations among the CPX total and domain scores, self assessment and the GPA of the 3rd year students were calculated. Data regarding information sharing between students and self-assessment were obtained through student questionnaires. RESULTS: CPX total scores, self assessment scores and GPA of 3rd year students from day-2 were significantly higher than scores from day-1 or day-3. Checklist analysis showed that PE, CC and PPI scores were significantly higher on day-2, but Hx and IS scores were not significantly different. Results from questionnaires showed that 43% of students shared evaluation information. And CPX total scores had little correlation with self assessment scores. GPA of 3rd year students showed a similar pattern with the CPX totalscore. CONCLUSION: There is information sharing occurring between students during clinical performance examinations. Although there are significant differences in CPXscores for the treatment group, it seemed that CPX scores are not affected by information sharing between students. Reliability of information sharing from other students is low. The generalization of this study should be interpreted carefully.
Checklist ; Clinical Clerkship ; Generalization (Psychology) ; Humans ; Information Dissemination* ; Physical Examination ; Self-Assessment ; Surveys and Questionnaires

PURPOSE: The objective of this systematic review was to assess the effects of family support programs on caregiving burden, depression, and stress in family caregivers of people with dementia. METHODS: A literature search was conducted of electronic databases to identify randomized controlled studies with family support programs done between 2000 and 2014. Studies published in English and/or Korean were included for the analysis with search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. Studies were rated for quality assessment by two independent reviewers using the appraisal checklist developed by Cochrane Reviews and Dissemination. Of 8,334 articles identified in the literature search, full texts of 76 articles that met the inclusion criteria were reviewed and 38 were found to include relevant outcomes. RESULTS: Results from selected studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed using the Chisquare test. Meta-analysis showed that the effect sizes of family caregiver support programs were small to medium for categories of caregiving burden (Hedge's g= - 0.17, 95% CI= - 0.30~ - 0.04), depression (Hedge's g= - 0.30, 95% CI= - 0.40~ - 0.20), and stress (Hedge's g= - 0.39, 95% CI= - 0.52~ - 0.25). CONCLUSION: The review results indicate that a support programs can assist family caregivers in reducing their psycho-emotional distress.
Caregivers/*psychology ; Clinical Trials as Topic ; Databases, Factual ; Dementia/*pathology ; Depression/*etiology ; Humans ; *Program Evaluation ; *Stress, Psychological

PURPOSE: The third year students at Gyeong-Sang National University College of Medicine were asked to perform objective structured clinical examination (OSCE) at the end of the 2004 academic year. In this article, we analysed the correlation among the scores of OSCE with those of Final Term Examination in Internal Medicine (FTE), Clerkship Performance in Internal Medicine (CP) and Case Conference Examination (CCE), which assess knowledge, skill and attitude, and problem solving ability in medicine, respectively. We also analyzed difficulty and discrimination indexes of the test questions or evaluation criteria, and assessed their objectivity. METHODS: 1) Relevance: the pearson correlation analysis was performed on the scores of 85 students from 6 OSCE stations, FTE, CP and CCE. 2) Analysis on the evaluation criteria: the difficulty and discrimination indexes of the 59 evaluation criteria were calculated. 3) Objectivity: in order to assess objectivity in the scores, the Student t-test was performed on the scores of students from 4 OSCE stations where there was a change in the examiners after the morning sessions and on the students from 2 OSCE stations that had no change of examiners. RESULTS: 1) Relevance: Correlation coefficients between the scores of OSCE and FTE, CP or CCE were 0.335, 0.326 and 0.421, respectively (p < 0.01). 2) Analysis on the evaluation criteria: difficulty indexes of the 59 criteria ranged from 0.15 to 0.98, and 43% of the criteria belonged to the acceptable range. Discrimination indexes ranged from -0.22 to 0.61, and 69% of the criteria were acceptable. 3) Objectivity: The student t-test showed significant differences between the scores of the morning and afternoon sessions in 2 of the 4 stations, where the examiners were changed in the afternoon (p < 0.01). CONCLUSION: Our results suggest that OSCE performed in 2004 may have relevance to a valid tool in assessing clinical competence of medical students in terms of knowledge, skill, attitude and problem solving ability. However, in order to reuse the test materials in the future, evaluation criteria need to be refined further based on difficulty and discrimination indexes, and measures to improve objectivity of examiners should also be studied.
Clinical Competence ; Discrimination (Psychology) ; Humans ; Internal Medicine ; Problem Solving ; Students, Medical

PURPOSE: The purpose of this study was to investigate the factors influencing nurses' clinical decision making focusing on critical thinking disposition. METHODS: The subjects of this study consisted of 505 nurses working at one of the general hospitals located in Seoul. Data was collected by a self-administered questionnaire between December 2006 and January 2007. Data was analyzed by one way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS Win 14.0. RESULTS: The mean scores of critical thinking disposition and clinical decision making were 99.10 and 134.32 respectively. Clinical decision making scores were significantly higher in groups under continuing education, with a master or higher degree, with clinical experience more than 5 years, or with experts. Critical thinking disposition and its subscales have a significant correlation with clinical decision making. Intellectual eagerness/curiosity, prudence, clinical experience, intellectual honesty, self-confidence, and healthy skepticism were important factors influencing clinical decision making(adjusted R2=33%). CONCLUSION: Results of this study suggest that various strategies such as retaining experienced nurses, encouraging them to continue with education and enhancing critical thinking disposition are warranted for development of clinical decision making.
Adult ; Clinical Competence ; *Decision Making ; Female ; Humans ; Male ; Nursing Staff, Hospital/*psychology ; Questionnaires ; Thinking