In order to compare a group of examinees to other group, the tests taken by two groups of examinees should be equivalent. The first step of the equating the test is to make anchor items. In medical schools, the students prepare the examination through the thorough review of the test items of previous year. So it is said that the reuse of the same items could be undesirable. The purpose of this study is to find out response variations to the same items between two consecutive grades when the items are reused. The senior classes of a medical school are sampled and the test items of graduation examination was analysed. On the basis of item difficulty(item's p-value) and discrimination index, we selected 35 items. Next year, we reused those items to the same examination to the senior class of that year, and the result was analysed. Among those 35 items, 14 items were modified slightly. The averages of the item difficulty and discrimination index on the previous examination were 0.49 and 0.20 which were in the desirable ranges. But at the next year these data were worsened to 0.84 and 0.10 respectively. This trends were not different in the slightly modified items. And there was no significant differences among the item groups classified on the basis of the level of knowledge. We could ascertain that if a previously used item used again to a test, the item difficulty will increase(become easy) and discrimination index will decrease even though minor modification is done.
Discrimination (Psychology) ; Humans ; Schools, Medical*

Career Choice ; Humans ; Students, Medical ; psychology ; Surveys and Questionnaires ; Violence ; psychology

The passing rate of the Medical Licensing Examination has been variable, which probably originated from the difference in the difficulty of items and/or difference in the ability level of examinees. We tried to explain the origin of the difference using the test equating method based on the item response theory. The number of items and examinees were 500, 3,647 in 2003 and 550, 3,879 in 2004. Common item nonequivalent group design was used for 30 common items. Item and ability parameters were calculated by three parametric logistic models using ICL. Scale transformation and true score equating were executed using ST and PIE. The mean of difficulty index of the year 2003 was -0.957 (SD 2.628) and that of 2004 after equating was -1.456 (SD 3.399). The mean of discrimination index of year 2003 was 0.487 (SD 0.242) and that of 2004 was 0.363 (SD 0.193). The mean of ability parameter of year 2003 was 0.00617 (SD 0.96605) and that of year 2004 was 0.94636 (SD 1.32960). The difference of the equated true score at the same ability level was high at the range of score of 200-350. The reason for the difference in passing rates over two consecutive years was due to the fact that the Examination in 2004 was easier and the abilities of the examinees in 2004 were higher. In addition, the passing rates of examinees with score of 270-294 in 2003, and those with 322-343 in 2004, were affected by the examination year.
Discrimination (Psychology) ; Education, Medical ; Licensure* ; Logistic Models

PURPOSE: The reliability of test is determined by each items' characteristics. Item analysis is achieved by classical test theory and item response theory. The purpose of the study was to compare the discrimination indices with item response theory using the Rasch model. METHODS: Thirty-one 4th-year medical school students participated in the clinical course written examination, which included 22 A-type items and 3 R-type items. Point biserial correlation coefficient (C(pbs)) was compared to method of extreme group (D), biserial correlation coefficient (C(bs)), item-total correlation coefficient (C(it)), and corrected item-total correlation coeffcient (C(cit)). Rasch model was applied to estimate item difficulty and examinee's ability and to calculate item fit statistics using joint maximum likelihood. RESULTS: Explanatory power (r2) of Cpbs is decreased in the following order: C(cit) (1.00), C(it) (0.99), C(bs) (0.94), and D (0.45). The ranges of difficulty logit and standard error and ability logit and standard error were -0.82 to 0.80 and 0.37 to 0.76, -3.69 to 3.19 and 0.45 to 1.03, respectively. Item 9 and 23 have outfit > or =1.3. Student 1, 5, 7, 18, 26, 30, and 32 have fit > or =1.3. CONCLUSION: C(pbs), C(cit), and C(it) are good discrimination parameters. Rasch model can estimate item difficulty parameter and examinee's ability parameter with standard error. The fit statistics can identify bad items and unpredictable examinee's responses.
Discrimination (Psychology) ; Humans ; Joints ; Schools, Medical

PURPOSE: In 2002, extended-matching type (R-type) items were introduced to the Korean Medical Licensing Examination. To evaluate the usability of R-type items, the results of the Korean Medical Licensing Examination in 2002 and 2003 were analyzed based on item types and knowledge levels. METHODS: Item parameters, such as difficulty and discrimination indexes, were calculated using the classical test theory. The item parameters were compared across three item types and three knowledge levels. RESULTS: The values of R-type item parameters were higher than those of A- or K-type items. There was no significant difference in item parameters according to knowledge level, including recall, interpretation, and problem solving. The reliability of R-type items exceeded 0.99. With the R-type, an increasing number in correct answers was associated with a decreasing difficulty index. CONCLUSION: The introduction of R-type items is favorable from the perspective of item parameters. However, an increase in the number of correct answers in pick 'n'-type questions results in the items being more difficult to solve.
Discrimination (Psychology) ; Education, Medical ; Licensure* ; Problem Solving

Stress-related mucosal damages (SRMDs) usually happen in victims of natural or man-made disasters. Because of unexpected factors, it causes psychological, mental, and endocrine exciting. In addition to direct damages, stress damages cause ‘positive resonance’ result in more severe injury. The signs of disaster-related stress must be found in emergency treatment in order to provide prognostic treatments such as calming down, pain relief, treating of SRMDs and gastrointestinal bleeding due to SRMDs. After discharge, patients must be stabilized moral
Medical Waste ; Psychology ; Gastrointestinal Diseases ; Stress

China ; History, 20th Century ; Psychology, Medical ; history

INTRODUCTIONThis paper aimed to ascertain if hospital policy on medical futility helps in conflict resolution, and in ensuring good end-of-life care.

MATERIALS AND METHODSLiterature on the subject published in the last 5 years was identified through Pubmed, and those with empirical data pertaining to the outcomes of interest were examined. A systematic analysis was not possible as papers varied greatly in aims, designs, outcomes and their measures. Instead, the outcomes of representative papers were described and discussed.

RESULTSThere is a widespread use of policies and guidelines based on the concept of medical futility. Conflicts are rare and appear to arise primarily from the manner in which policies are implemented. End-of-life care appears to be improving as evidenced by a significant number of deaths occurring following: (i) discussions involving patient, family, healthcare team members; (ii) cessation of intensive care and (iii) cessation of institution of palliative care. Deaths are increasingly taking place in the presence of family and outside the intensive care wards. Finally, post mortem audit of processes and practices indicate (i) compliance but in a limited manner with policies and recommended guidelines, (ii) family satisfaction and (iii) identify areas where improvement in end-of-life (EOL) care can be effected. Key areas are in improving education of, communication with, and documentation by all stakeholders.

CONCLUSIONHospital policies on medical futility have helped to resolve conflicts and improve end-of-life care. Prospective, multicentre and controlled trials will be useful in determining the value of specific interventions, obtaining generalisable data and facilitating implementation of better end-of-life care models.

Conflict (Psychology) ; Ethics, Medical ; Humans ; Medical Futility ; ethics ; psychology ; Organizational Policy ; Palliative Care ; ethics ; methods ; standards

PURPOSE: The purpose of this study was to identify the causal relationship between emotional intelligence, ego-resilience, coping efficacy, and academic stress. METHODS: Participants were 424 medical students from four medical schools in Korea. We examined their emotional intelligence, ego-resilience, coping efficacy, and academic stress using a t-test, an analysis of variance, correlational analysis, and path analysis. RESULTS: First- and second-year students scored higher on academic stress than did those from third- and fourth-year students. Further, coping efficacy mediated the relationships between emotional intelligence, ego-resilience, and academic stress. Academic stress was directly influenced by coping efficacy, and indirectly by emotional intelligence and ego-resilience. This showed that coping efficacy play an important role in academic stress. CONCLUSION: Our findings may help medical schools design educational programs to improve coping efficacy in students, and to reduce their academic stress.
*Adaptation, Psychological ; *Education, Medical ; *Emotional Intelligence ; Humans ; Republic of Korea ; *Schools, Medical ; *Stress, Psychological ; Students, Medical/*psychology

PURPOSE: This study was performed to compare the characteristics and perceptions of medical school students and professional graduate medical school students. METHODS: Study subjects were 131 medical students from a national university and 113 applicants of a professional graduate medical school. We developed a self-reported questionnaire asking about socio-demographic characteristics; the level of satisfaction of educational environment; perception of missions of medical education and career plan and student activities during school. RESULTS: Students from the professional graduate medical school were significantly different from medical students in socio-demographic characteristics. They also showed higher satisfaction with their education, were more supportive of student union activities and were more anxious about economic and health problems than medical students. However, there was no difference between the two groups regarding perception of missions of medical education and career plan after graduation. CONCLUSION: Based on the above results, it is necessary to consider the characteristics and perceptions of professional graduate medical students when developing educational policies for these older students. The limitation of this study includes a restricted sample, and generalization of results should be done carefully. Thus, more extensive, wide-ranging studies would be useful.
Education ; Education, Medical ; Generalization (Psychology) ; Humans ; Missions and Missionaries ; Schools, Medical* ; Students, Medical ; Surveys and Questionnaires