Purpose: This study aimed to analyze the research trends of the Korean Journal of Medical Education (KJME) since it became an English-language journal. Methods: A total of 274 articles published in KJME from 2016 to 2023 were analyzed. All article types were included in the analysis. NetMiner ver. 4.0 (Cyram Inc., Korea) was used for the main keyword and topic modeling analysis. Results: Of the 274 articles, 170 (62%) and 104 (38%) were by domestic and international authors, respectively. The main keywords with high frequency were “students,” “learning,” “experience,” “pandemic,” and “perception.” Three topics were derived using topic matching analysis: “residents’ perception and attitude of the pandemic,” “assessment of learning and achievement,” and “learning experiences in the pandemic.” Conclusion Since the shift to English-language journals, medical education research has witnessed an increase in the number of articles published by international authors. Research on postgraduate education has increased. Research topics are relevant to situations such as the coronavirus disease 2019 pandemic. These findings can help researchers select research topics and encourage them to submit their research to the journal.

Purpose: : The effectiveness of the interprofessional education(IPE) program has been evaluated with quantitative data. The purpose of this study is to analyze the effectiveness of IPE using topic modeling technique in text network analysis tool as one of the qualitative data analysis methods. Methods: : In this study, 58 fourth-year students from medical, pharmacy, and nursing school participated in the IPE program. The IPE was conducted as a half day program centered on student activities of small group activities and role play. The role play scenario is about medical errors caused by health professional’s negligence. Fifty-eight reflective essays were analyzed as qualitative data. topic modeling technique was used for the analysis. Results: : Four topics were derived from this study: experience of the importance of collaboration among healthcare professionals (Topic 1), conflict situations and resolution among healthcare professionals in hospitals (Topic 2), empathize with the difficulties experienced by healthcare professionals through role play (Topic 3), and recognition of doctors’ responsibilities in emergency situations (Topic 4). Topic 3 had the highest share of topics at 33.3%. Conclusion : We found that IPE was an effective educational strategy for interprofessional collaboration. In addition, qualitative data such as reflective essays can be utilized to analyze the effectiveness of IPE.

Objective: The shared epitope (SE) and anti-citrullinated peptide antibody (ACPA) are involved in the pathogenesis of rheumatoid arthritis (RA). This study evaluated the clinical implications of SE and ACPA in terms of disease manifestation and response to biologic disease modifying anti-rheumatic drugs (DMARDs). Methods: Patients with identified human leukocyte antigen (HLA)-DRB1 alleles were included to compare the clinical characteristics and drug survival rate of tumor necrosis factor (TNF) inhibitors or abatacept based on the presence of SE and ACPA. Results: Of the 533 patients with identified HLA-DRB1 alleles, 329 patients (61.7%) with SE alleles showed higher disease activity and erosive changes compared to patients without SE alleles. SE-positive patients were more likely to start biologic (b-) or targeted synthetic DMARDs (tsDMARDs) within the first 5 years (p=0.020). The presence of SE, smoking, dyslipidemia, and higher erythrocyte sedimentation rate were independently associated with the initiation of b- or tsDMARDs (p=0.016, 0.028, 0.031, and 0.001, respectively). The presence of SE and ACPA did not affect the drug survival rate of TNF inhibitors, whereas the abatacept retention rate was higher in ACPA-positive patients (p=0.024). Conclusion The presence of SE affected disease characteristics and prognosis in Korean patients with RA without a significant impact on drug survival rate of TNF inhibitors and abatacept. ACPA positivity was associated with abatacept drug retention, suggesting that abatacept may be helpful in ACPA-positive patients than in ACPA-negative patients.

The purpose of this study is to investigate domestic and international research trends in studies of medical students' characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.
Cross-Sectional Studies ; Humans ; Korea ; Longitudinal Studies ; Mental Health ; Research Design ; Research Subjects ; Schools, Medical ; Sociological Factors ; Students, Medical

Purpose: Today's students have distinctive generational characteristics and increased psychopathology and generational tension. The authors investigated the negative experiences of Late Millennial students in medical school to draw implications for student support. Methods: The authors explored medical students’ negative experiences using the critical incident technique. The authors conducted semi-structured in-depth interviews with 13 medical students, between February and May 2016. The authors focused on occurrences that significantly influenced medical students’ school lives negatively from the students’ perspective. All interviews were recorded and transcribed. The authors classified incidents into frames of reference for the use of faculty development for student support. Results: The authors extracted 22 themes from a total 334 codes and classified them into eight subcategories. Finally, four categories emerged from frames of reference. Students manipulate relationships and colluding for better specialty choice. They experience uncontrolled rifts in interpersonal relationships between peers including lawsuits, sexual assaults, and social network service conflicts. Today’s students feel resentment towards dependent hierarchical relationships with seniors. They struggle with gender discrimination but perpetuate outdated gender role toward the opposite gender. Conclusion Faculty members should understand today’s students’ level of career stress and desire for work life balance. They should motivate students’ professional identity, promote assertiveness against unfair authorities, and focus on mental health, teamwork, and relationship building. All generations need to understand other generations and develop appropriate leadership and gender sensitivity.

Objective: There is no recommendation for the use of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) who developed cancer. We examined changes in the DMARDs prescription patterns associated with cancer diagnosis in RA patients. Methods: We reviewed the medical records of 2,161 RA patients who visited rheumatology clinic between January 2008 and February 2017 and found 40 patients who developed cancer during RA treatment. In these patients, we examined DMARDs prescription patterns before and right after cancer diagnosis and at recent outpatient clinic visits. Results: Before cancer diagnosis, methotrexate (MTX)-combined conventional synthetic DMARDs (csDMARDs) were most commonly prescribed (22, 55.0%) and biological DMARDs (biologics) in nine patients (22.5%). For cancer treatment, 19 patients received chemotherapy (including adjuvant chemotherapy) and 21 patients had surgery only. Right after cancer diagnosis, changes in the DMARDs prescription patterns were similar in discontinuation (13, 32.5%), switching (14, 35.0%), and maintenance (13, 32.5%). DMARDs were discontinued more frequently in the chemotherapy group (9/19, 47.4%) than the surgery only group (4/2, 19.0%) (p<0.05). Among the 13 patients who discontinued DMARDs, nine (69.2%) resumed DMARDs after a median of 5.5 months (interquartile range [IQR] 2.9, 18.3) due to arthritis flare. At a median of 4.6 years (IQR 3.3, 6.7) after cancer diagnosis, 25 patients were evaluated at recent outpatient clinic visits. Four patients received no DMARD, three MTX monotherapies, 11 csDMARDs combination therapies, and seven biologics. Conclusion A significant number of RA patients who developed cancer during RA treatment were still receiving DMARDs including biologics after cancer diagnosis.

Purpose: The decision to enroll in medical school is largely influenced by extrinsic motivation factors. It is necessary to explore the factors that affect pre-med students’ motivation to enter medical school and their college adjustment, and to develop measures to help them adjust. Methods: A total of 407 pre-med students were surveyed regarding their motivation to enter medical school, fear of failure, and college adjustment. We analyzed the latent profiles of extrinsic motivation factors using latent profile analysis. One-way analysis of variance was conducted to examine the differences in fear of failure and adaptation to university life according to the latent groups. Results: After analyzing the latent profiles of entrance motivation, three latent profiles were selected. They were divided into high, medium, and low extrinsic motivation groups. Three profiles scored the highest on job security, followed by good grades and social status. Sophomores were more likely to be high extrinsic motivators than freshmen were. Fear of failure was high in the group with high extrinsic motivation, and adaptation to college life was highest in the group with low extrinsic motivation. Conclusion Job security was the most important extrinsic motivator for entering medical school, and extrinsic entrance motivation influenced fear of failure and college adjustment. Given the high level of extrinsic motivation among medical students, it is meaningful to analyze the extrinsic motivation profile of entering medical students and how it affects failure motivation and college adjustment.

Purpose: The purpose of this study was to examine perceptions of global health education (GHE) among medical students and their involvement in global health activities and identify priorities of educational needs for developing GHE programs. Methods: This study was cross-sectional and conducted through an online survey for medical students. The participants were students attending medical schools nationwide, and the final analysis target was 678. The survey developed questionnaires necessary for research purposes regarding global health-related experiences and perceptions, level of awareness of global health competencies (GHC), and needs assessments. The data were analyzed using the frequency analysis, chi-square test, independent t-test, Borich Needs Assessment Model, and the Locus for Focus Model. Results: In total, 60.6% (411/678) agreed on the need for GHE, whereas 12.1% (82/678) agreed on the appropriateness of GHE in the current medical school curriculum, indicating a perception gap between the necessity and the status. At the current level of awareness of global health and GHC, we identified statistically significant differences according to gender, participation in global health activities, and GHE. In the analysis of the educational needs of GHC, all items of GHC had statistically significant differences between the importance level and the current level, and priorities were derived. The competency with the highest priority was domain A (Global Burden of Disease). Conclusion We expect the findings of this study to be used in Korean medical education as fundamental data to prepare a hereafter research foundation for GHE and discuss systematic GHE based on GHC.

Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory disease found in many organs including biliary tract, salivary gland, kidney, and lung. Tubulointerstitial nephritis is the most common renal manifestation, but hematologic involvement of IgG4-RD is rare. Here, we report on a case of a 57-year-old male with IgG4-related interstitial nephritis with bicytopenia, which was initially thought to be systemic lupus erythematosus. He presented with proteinuria, anemia, thrombocytopenia, and low complement levels. Histological findings showed an increased number of IgG4-positive plasma cells (>200/high power field), and an elevated IgG4/IgG ratio (>90%). Serum levels of IgG and IgG4 were also increased. This case emphasized the importance of differential diagnosis of IgG4-RD and immune complex glomerulonephritis.
Anemia ; Antigen-Antibody Complex ; Biliary Tract ; Complement System Proteins ; Diagnosis, Differential ; Glomerulonephritis ; Humans ; Immunoglobulin G ; Immunoglobulins* ; Kidney ; Lung ; Lupus Erythematosus, Systemic ; Male ; Middle Aged ; Nephritis, Interstitial* ; Plasma Cells ; Proteinuria ; Salivary Glands ; Thrombocytopenia

Although rheumatoid arthritis (RA) is the most common chronic inflammatory autoimmune disease, diagnosis of RA is currently based on clinical manifestations, and there is no simple, practical assessment tool in the clinical field to assess disease activity and severity. Recently, there has been increasing interest in the discovery of new diagnostic RA biomarkers that can assist in evaluating disease activity, severity, and treatment response. Proteomics, the large-scale study of the proteome, has emerged as a powerful technique for protein identification and characterization. For the past 10 years, proteomic techniques have been applied to different biological samples (synovial tissue/fluid, blood, and urine) from RA patients and experimental animal models. In this review, we summarize the current state of the application of proteomics in RA and its importance in identifying biomarkers and treatment targets.
Arthritis, Rheumatoid* ; Autoimmune Diseases ; Biomarkers ; Diagnosis ; Humans ; Models, Animal ; Proteome ; Proteomics*