PURPOSE: Standardized patients participate in clinical performance examinations not only to simulate case scenarios but also to evaluate the performance of students using a checklist. The accuracy in checking off checklist items is one of the most important factors determining the reliability of this examination. The purposes of this study were to determine the SP' s overall accuracy in recording checklist items, and whether their accuracy was affected by certain characteristics of checklist items. METHODS: Three professors, who have been fully involved in scenario development and SP training, reviewed videotapes of the examination and evaluated the performance of the students using the same checklist. SP' s checklists were marked on this 'correct checklist'. The checklists and checklist guidelines of the items marked under the score of 50 out of 100 were analyzed. RESULTS: Results showed that the accuracy of the SP' s in recording checklist items was 86.9% and was affected by certain characteristics, such as complexity or ambiguity of checklists and checklist guidelines. CONCLUSION: In this study, the SP' s accuracy in recording checklist items was good to very good, and the result suggested that the accuracy could be improved by the elaboration of checklists and checklist guidelines.
Checklist* ; Educational Measurement ; Humans ; Observer Variation ; Videotape Recording

PURPOSE: To adapt to rapid and turbulent changes in the field of medicine, education, and society, medical school faculties need appropriate leadership. To develop leadership competencies through education, coaching, and mentoring, we need a leadership competency model. The purpose of this study was to develop a new leadership competency model that is suitable for medical school faculties in Korea. METHODS: To collect behavioral episodes with regard to leadership, we interviewed 54 subjects (faculties, residents, nurses) and surveyed 41 faculties with open-ended questionnaires. We classified the behavioral episodes based on Quinn and Cameron's leadership competency model and developed a Likert scale questionnaire to perform a confirmatory factor analysis. Two hundred seven medical school faculties responded to the questionnaire. RESULTS: The competency clusters that were identified by factor analysis were professionalism, citizenship, leadership, and membership to an organization. Accordingly, each cluster was linked with a dimension: self, society, team (that he/she is leading), and organization (to which he/she belongs). The clusters of competencies were: professional ability, ethics/morality, self-management, self-development, and passion; public interest, networking, social participation, and active service; motivating, caring, promoting teamwork, nurturing, conflict management, directing, performance management, and systems thinking; organizational orientation, collaboration, voluntary participation, and cost-benefit orientation. CONCLUSION: This competency model that fits medical school faculties in Korea can be used to design and develop selection plans, education programs, feedback tools, diagnostic evaluation tools, and career plan support programs.
Cooperative Behavior ; Humans ; Korea ; Leadership ; Mentors ; Orientation ; Schools, Medical ; Self Care ; Social Networking ; Societies, Medical ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to find a strategy for reintroducing the core-selective clinical clerkship system to the Seoul National University College of Medicine's clerkship curriculum, which has an unsuccessful history with this system ('86-'90). METHODS: Authors conducted a literature review to identify problems recognized from the past experience and a focus group interview with related personnel to prioritize the problems. From 5 domains of problems identified, interviewees focused on 2 problems- problems in the definition of 'what are the core (compulsory) and the selective (optional) rotations' and the tendency of students to crowd in popular subjects. Therefore, to redetermine what is core clerkship subjects and to predict the selection tendency of students, we conducted questionnaire surveys from students (N=171), residents (N=84), and practitioners (N=78). As for should-be core clerkship rotations, students and residents included radiology and neurology and practitioners included emergency medicine, radiology and orthopedics. We concluded that these 4 rotations should be added to the predetermined 5 core rotations (internal medicine, general surgery, pediatrics, obstetrics & gynecology, and psychiatrics). Students selection ratio varied from very high (69%) to very low (32%), and selected rotations by individual students showed statistically significant correlations. The students were classified, according to rotation selection tendency, into 4 clusters. RESULTS: As for should-be core clerkship rotations, students and residents included radiology and neurology and practitioners included emergency medicine, radiology and orthopedics. We concluded that these 4 rotations should be added to the predetermined 5 core rotations (internal medicine, general surgery, pediatrics, obstetrics & gynecology, and psychiatrics). Students selection ratio varied from very high (69%) to very low (32%), and selected rotations by individual students showed statistically significant correlations. The students were classified, according to rotation selection tendency, into 4 clusters. CONCLUSION: Integrating the analysis of the selection ratio and that of selection tendency of individual students, we built a scenario that could prevent the crowding of students in popular specialty clerkships, and at the same time, could avoid neglecting students right to select rotations that interest them.
Clinical Clerkship* ; Crowding ; Curriculum ; Emergency Medicine ; Focus Groups ; Gynecology ; Humans ; Neurology ; Obstetrics ; Orthopedics ; Pediatrics ; Schools, Medical* ; Seoul ; Surveys and Questionnaires

BACKGROUND: The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. MATERIALS AND METHODS: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. RESULTS: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. CONCLUSION: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.
Classification ; Humans ; Knee Joint ; Soft Tissue Injuries ; Tibia

A totally implanted venous access system was inserted in 19 children with cancer. The devices were utilized for the administration of antineoplastic drugs, parenteral fluids, antibiotics, and blood products. Total duration of implantation was 4,046 days for 23 implanted system (range 7-445 days). Complications included cather infection (0.247/100 catheter days), occlusion (0.692/100 catheter days), and dislodgement of needle (0.643/100 catheter days). There were major complications that necessitated removal of catheters, including systemic infections (0.09/100 catheter days) and complete occlusions (0.09/100 catheter days). The system was thought to be safe and convenient in chemotherapy, and permitted full physical activity.
Anti-Bacterial Agents ; Antineoplastic Agents ; Catheters ; Child* ; Drug Therapy ; Humans ; Motor Activity ; Needles ; Prospective Studies*

Thrombosis at the left ventricular outflow tract occurs without any detectable heart disease or predisposing factors only extremely rarely. A 48-year-old male visited Konkuk University Medical Center with loss of consciousness one month prior to presentation. Before he visited our hospital, he had been diagnosed with a cardiac tumor, which was located between the left atrium and posterior aortic root, and which was adjacent to both the aortic and mitral valves. Cardiac transplantation was recommended at the other hospital because of the high risk of cardiac dysfunction induced by both aortic and mitral valvular dysfunction after surgical resection. Based on preoperative transthoracic echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and intra-operative transesophageal echocardiography, we considered it to be a benign tumor. Complete resection was achieved and the pathology confirmed organizing thrombus. We report a case of organizing thrombus mimicking a cardiac tumor, which was located at the mitral-aortic intervalvular fibrosa of the left ventricular outflow tract without any heart disease.
Academic Medical Centers ; Aneurysm, False ; Causality ; Echocardiography ; Echocardiography, Transesophageal ; Heart Atria ; Heart Diseases ; Heart Neoplasms* ; Heart Transplantation ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mitral Valve ; Pathology ; Thrombosis* ; Unconsciousness