Purpose: The purpose of this study is to identify the educational needs of a severe trauma treatment simulation program based on mixed reality which combines element of both virtual reality and augmented reality. Methods: Focus group interviews were conducted with ten military hospital nurses on February 4 and 5, 2021. The collected data were analyzed using a qualitative content analysis. As a framework for data analysis, the educational needs were clustered into the following four categories: teaching contents, teaching methods, teaching evaluation, and teaching environment. Results: The educational needs for each category that emerged were as follows: three subcategories including “realistic education reflecting actual clinical practice” and “motivating education” for teaching contents; five subcategories including “team-based education,” “repeated education that acts as embodied learning,” and “stepwise education” for teaching methods; six subcategories including “debriefing through video conferences,” “team evaluation and evaluator in charge of the team,” “combination of knowledge and practice evaluation” for teaching evaluation; six subcategories including “securing safety,” “similar settings to real clinical environments,” “securing of convenience and accessibility for learners,” and “operating as continuing education” for teaching environment. Conclusion The findings of this study can provide a guide for the development and operation of a severe trauma treatment simulation program based on mixed reality. Moreover, it suggests that research to identify the educational needs of various learners should be conducted.

PURPOSE: This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. METHODS: A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. RESULTS: The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. CONCLUSION: Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.
Costs and Cost Analysis ; Female ; Humans ; Insurance, Health, Reimbursement/*economics ; Korea ; National Health Programs/*economics ; Nurse Midwives/*economics ; Pregnancy ; *Relative Value Scales

Purpose: This study aimed to identify nursing students’ experience with the Nursing Management Practicum based on the service design concept to provide a basis for an ideal subject design. Methods: This study was a qualitative research that analyzed the experience of students and their clinical instructors based on the blueprint of Nursing Management Practicum. Focus group interviews were conducted with 13 graduates from two nursing schools and 11 clinical instructors from three hospitals. Results: The students went through six stages during the practicum. They met clinical instructors during the ward orientation and learning activities in wards and met school instructors during the general orientation and conference. The students perceived the learning activities and teaching from the clinical instructors in wards as the most important practicum factors. Conclusion This study provided information which helped us to understand nursing students’ experience with the Nursing Management Practicum as the time passed by. This information can be used to improve students’ experience with the practicum and convert the subject into a more learner-centered education.

OBJECTIVE: The purpose of this study was to develop a quality assessment domain and to determine its priority in Korea's Occupational Health Services. METHODS: We designed the study in a 3 phase approach. The first phase of the process encompasses making a list of measures for quality assessments by a thorough review of the literature. The second phase emcompassed the development of inclusion and priority criteria. The third phase of survey development was conducted during August 2008 and a questionnaire was administered to occupational health physicians covering 58 subjects. RESULTS: Finally we investigated 40 quality assessment measures, including 2 for structural domain, 17 for process domain, 21 for result domain in occupational health service. The 40 quality assessment measures divided into 2 parts. The early quality assessment part was 14 measures that including 8 measures for process domains and 5 measures for result domains. CONCLUSION: We investigate a quality assessment domain and determined the priorities of the occupational health service in Korea.
Humans ; Korea ; Occupational Health ; Occupational Health Physicians ; Occupational Health Services ; Questionnaires

OBJECTIVE: We investigated the differences among the patients who were diagnosed with carpal tunnel syndrome according to the frequency of exposure to wrist-burdening work by using carpal tunnel syndrome surveillance system. METHODS: The study subjects were a total of 855 patients from 1,017 patients who were diagnosed with carpal tunnel syndrome in 9 university hospitals from May, 2001 to October, 2004, and we excluded 161 patients who had no clear information for their occupational status. The subjects were classified into three groups according to four types of wrist-burdening work: 1) repetitive use of wrists, 2) inappropriate posture of the hand, 3) use of vibrating tools, and 4) overpressure work on the hand or palm, - as defined in the operational definition by the National Institute for Occupational Safety and Health (NIOSH). The subjects with two or more types of wrist-burdening work were classified as 'high risk group', the subjects with one type of wrist-burdening work were classified as 'intermediate risk group', and the subjects with none of the types of wrist-burdening work were classified as 'low risk group'. We used chi-square test, Fisher's exact test and ANOVA for comparing the characteristics according to the 3 subgroup. RESULTS: The mean age in the high risk group was the lowest(53 years), and there was a significant difference among the groups for the mean age(p<0.05). The high risk group included the most males with 39(22.0%). The subjects in the high risk group had significantly more jobs in agriculture.forestry.fisheries, factory work, and simple labor and less comorbidities, including diabetes and rheumatoid arthritis(p<0.05). The subjects in the intermediate risk group had a higher proportion of service workers. There were significant differences for the symptoms of carpal tunnel syndrome according to the frequency of exposure to wrist-burdening work. The subjects in the high risk group showed the highest proportion of work-related aggravation of symptoms with 88(76.5%) and the highest mean number of days absent from work(6 days) as related to carpal tunnel syndrome. CONCLUSION: Worker in agriculture.forestry.fisheries, factory work, and simple labor showed significantly more frequent carpal tunnel syndrome, and so management strategies are needed to prevent them from developing carpal tunnel syndrome.
Carpal Tunnel Syndrome ; Comorbidity ; Employment ; Hand ; Hospitals, University ; Humans ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Occupations ; Posture ; Wrist

Purpose: This study conducted a systematic review and meta-analysis to identify trends in nursing ethics education research for Korean nursing students and nurses. Methods: The data search was conducted in July 2020; domestic and foreign academic journals were targeted for the search. A combination of search terms was entered into major databases, and the year of publishing was limited to the last 10 years (2010~2020). Results: The systematic review analyzed 25 experimental and 13 non-experimental studies, and education methods included lectures, discussions, role play, film-use classes related to nursing ethics, action learning, and case-based learning. The meta-analysis of 12 studies revealed that ethical education has significant differences in effect size of biomedical ethics, critical thinking, moral judgment, and moral sensitivity. A subgroup analysis of education methods showed that in addition to traditional lecture and discussion education methods, there were significant differences in the effect size of sense of biomedical ethics between the following two methods: lecture and discussion including additional methods and lecture and discussion only. Conclusion Ethics education for nursing students and nurses has been found to be effective in improving ethics-related competencies, and various teaching methods other than lectures and discussions must be utilized.

Purpose: This study aims to analyze the financial performance research trends in medical institutions and to suggest the necessity and future research direction for financial management from the perspective of nursing organizations. Methods: Financial performance research in medical institutions was extracted by combining the keywords ‘finance’, ‘nursing’, ‘medical’, and ‘hospital’ in three domestic and foreign online databases. 55 studies were finally extracted. Results: Of the 55 studies selected, 41.8% have been published after 2010, and 79.6% have been published in Korea. 83.6% of the studies used financial statements, and 74.5% used the financial ratio. Among the studies on the use of financial statements, 40 balance sheets and 41 profit and loss statements were used. Conclusion There were some limitations in deriving implications for financial performance management at the level of nursing organization. When establishing strategies for future financial performance improvement, it is recommended to prioritize nursing cost optimization and profitability enhancement at the nursing organization level.

Purpose: This study was to identify how a nursing management practicum was operated during the COVID-19 pandemic in Korea. Methods: This study surveyed instructors teaching the nursing management practicum with a questionnaire covering five domains and 42 items. The data were analyzed using descriptive statistics and content analysis. Results: The practicum was performed mainly by mixed methods (40.8% and 38.5%), in hospitals only (30.8% and 60.4%), online only (19.8% and 1.1%) in 2020 and 2021, respectively. The mixed methods were most frequently used for instructor teaching and conferences (43.9% and 58.3%). and the average teaching time per week was 9.40 and 8.69 hours per week, respectively. Taking charge in one to three core nursing skill items, 87.8% and 90.1% of the respondents each year performed face to face evaluation for the skills. Four to six out of 12 POs were covered by 58.2% and 54.9% of the participants, respectively, in 2020 and 2021. The greatest difficulty under the pandemic was securing students’ hospital assignments. Conclusion The nursing management practicum needs to adopt various digital technologies, and create new education models including hybrid ones combining both contact and untact methods to improve the educational effect for the post COVID-19 era.

PURPOSE: This study was done to estimate supply and demand for nursing workforce to provide community-based primary healthcare in the North Korean region to cost-efficiently narrow the health gap between the two Koreas in case of a Korean reunification. METHODS: To understand the nursing education system and current state of nursing workforce in North Korea, the authors interviewed six North Korean defectors who had worked as nurses in North Korea. Based on the interview results and literature review, the supply and demand for the primary healthcare nursing workforce that would be needed after Korean reunification were estimated RESULTS: Currently, a total of 2,100 to 2,700 North Korean nurses were estimated to have graduated from nursing schools with a 2 year curriculum or completed 6-month military nurse training courses every year. The projected number of nurses in demand to provide primary health care ranged from 84,160 to 105,200 and the shortage would be between 31,586 and 52,626. CONCLUSION: An active utilization of the North Korean nursing workforce to improve the health of North Koreans after reunification will be the best way to reduce the reunification cost which will be inflicted mainly on South Korea.
Curriculum ; Democratic People's Republic of Korea ; Education, Nursing ; Humans ; Korea ; Military Personnel ; Nursing ; Primary Health Care ; Schools, Nursing

Deficiency of hypoxanthine-guanine phosphoribosyltransferase is a purine nucleotide disorder and is the most common genetic cause of uric acid overproduction. This disease has a wide range of spectrum with regard to neurological features depending on the extent of the enzymatic deficiency. Complete deficiency of hypoxanthine-guanine phosphoribosyltransferase, called Lesch-Nyhan syndrome, is presented with hyperuricemia and characteristic neurological manifestation and self-mutilation. Partial hypoxanthine-guanine phosphoribosyltransferase--deficient patients are presented with a various intensities of the aforementioned symptoms, from almost normal neurologic manifestation to a severe form along with hyperuricemia. We report a twenty-year-old man with complete hypoxanthine-guanine phosphoribosyltransferase mutation and Lesch-Nyhan sydrome, who manifested gouty arthritis without neurologic symptom.
Arthritis, Gouty* ; Humans ; Hyperuricemia ; Hypoxanthine Phosphoribosyltransferase ; Lesch-Nyhan Syndrome* ; Neurologic Manifestations* ; Uric Acid