1.Transforming nursing education to enhance integrated nursing competency: a Delphi-based methodological study on symptom-based clinical reasoning
Jeung-Im KIM ; Soyoung YU ; Jin-Hee PARK ; Ju-Eun SONG ; Eunjung RYU ; JuHee LEE ; YeoJin IM
Journal of Korean Academy of Nursing 2026;56(1):39-50
Purpose:
This study aimed to address the shift toward competency-based education and the planned 2028 “Integrated Nursing” National Licensing Examination (NLE), this study aimed to establish structural alignment among NLE domains, the seven integrated nursing competencies (INCs), and curriculum goals, with a particular focus on implementing symptom-based clinical reasoning (SBCR).
Methods:
This Delphi-based methodological study included seven content experts for content validity index (CVI) assessment and 24 nursing education experts who participated in a consensus workshop. The item-level CVI and the scale-level CVI/average were calculated to confirm the linkage between INCs and NLE domains. In addition, qualitative analysis of workshop materials and meeting records was conducted to derive 10 integrated learning topics and to develop an SBCR educational model for the key symptom of headache, grounded in Miller’s Clinical Competence Pyramid (levels 2–4).
Results:
The analysis confirmed the validity of integrating the INCs within the overall curriculum structure. The resulting framework delineates staged learning objectives and core clinical questions designed to systematically enhance clinical reasoning, promote safe nursing practice, and support professional reflection within a unified curriculum.
Conclusion
This study provides a practical foundation for nursing curriculum redesign by facilitating a transition from fragmented, subject-based instruction to a holistic, patient-centered SBCR model. This approach aligns with the requirements of the integrated NLE and is expected to contribute to meaningful improvements in actual clinical competency.
2.Effect of intraoperative music on quality of recovery after arthroscopic knee surgery: a prospective, double-blind, randomized controlled trial
Ji yong YEOM ; Soomin KIM ; Hyeon Seung YI ; Juhee MIN ; Eun Kyung CHOI
Journal of Yeungnam Medical Science 2026;43(1):29-
Background:
Various perioperative therapeutic strategies have been used to minimize postoperative complications and enhance recovery. Music intervention has attracted increasing attention as a safe, noninvasive, and cost-effective approach with potential benefits for patient-centered postoperative outcomes. Accordingly, this study investigated the effect of intraoperative music on postoperative recovery quality, as assessed using the Quality of Recovery-40 (QoR-40) questionnaire, as well as its potential analgesic and antiemetic effects in patients undergoing arthroscopic knee surgery.
Methods:
Eighty-two patients were enrolled and allocated to either the music or control group. In the music group, patient-selected tracks were delivered intraoperatively via headphones. Postoperative recovery quality was assessed using the QoR-40 at 24 hours. Pain was evaluated 30 minutes, 2 hours, and 24 hours after arrival in the post-anesthesia care unit. The incidence of postoperative nausea and vomiting (PONV) was recorded at all time points.
Results:
Although the total QoR-40 scores did not differ between the groups, the music group demonstrated significantly higher physical comfort scores (p=0.006). The incidence of PONV at 24 hours was lower in the music group (p=0.048), whereas the postoperative pain scores and rescue analgesic requirements showed no significant differences at any assessment point.
Conclusion
In patients undergoing arthroscopic surgery, intraoperative music was associated with improvements in physical comfort and PONV, despite no significant difference in the total QoR-40 score.
3.The Clinical Utility of the Cognitive Impairment Screening Test (CIST)
Hyeseon HAN ; Soyeon LIM ; Suah KIM ; Byung Hwa LEE ; Hee Jin KIM ; Juhee CHIN
Dementia and Neurocognitive Disorders 2026;25(1):42-53
Background:
and Purpose: The Cognitive Impairment Screening Test (CIST) was developed for use at the Community Dementia Reassurance Center in South Korea. This study evaluated convergent and discriminant validity of CIST, as well as its clinical utility in identifying cognitive impairment and differentiating amyloid deposition.
Methods:
We enrolled 252 participants from a hospital memory clinic (47 cognitively unimpaired [CU], 116 amnestic mild cognitive impairment, and 89 dementia). Participants completed CIST, K-MMSE-2, the Seoul Neuropsychological Screening Battery, 2nd edition (SNSB-II), and underwent amyloid positron emission tomography. To evaluate the convergent and discriminant validity of CIST, we conducted correlation analyses with SNSBII. Receiver operating characteristic analyses were used to evaluate the ability to discriminate cognitive impairment and to distinguish amyloid positivity. Areas under the curve (AUCs) for CIST and K-MMSE-2 were compared using DeLong’s test.
Results:
The total score of CIST correlated significantly with all SNSB-II subtests, and the domain scores of CIST showed stronger associations with corresponding SNSB-II subtests than with unrelated ones. Both CIST and K-MMSE-2 effectively distinguished cognitively impaired individuals from CU, with CIST demonstrating superior discrimination (AUC=0.926 vs.0.887, p=0.042). In the non-demented group, both CIST and K-MMSE-2 showed acceptable discrimination for amyloid positivity (AUC≈0.73), with high specificity but low sensitivity;however, there were no significant differences between the two tests.
Conclusions
The CIST demonstrated strong validity and discriminatory ability for detecting cognitive impairment. It also showed acceptable discrimination for amyloid positivity in non-demented participants, supporting its utility as a screening tool in both clinical and community settings.
4.Core domains for pre-registered nurses based on program outcomes and licensing competencies
Soyoung YU ; Hye Young KIM ; Jeung-Im KIM ; JuHee LEE ; Ju-Eun SONG ; Hyang Yuol LEE
Journal of Korean Academy of Nursing 2025;55(2):249-268
Purpose:
This study aimed to identify core domains for pre-registered nurses by comparing licensing competencies with program outcomes (POs) in undergraduate nursing education. This was accomplished in preparation for the transition of the Korean Nurse Licensing Examination (KNLE) from a tradition seven-subject format to a newly integrated, competency-based single-subject format that reflects current trends in nursing assessment.
Methods:
A literature review and survey were conducted. From 828 studies retrieved via PubMed, CINAHL, and Google Scholar using keywords such as “newly graduated registered nurses” and “competency OR competence,” 18 were selected according to pre-established inclusion and exclusion criteria. Documents from national and international nursing organizations were included to extract relevant licensing competencies. We also reviewed POs from all undergraduate nursing schools in South Korea to align educational outcomes with the identified core domains.
Results:
The core domains identified were clinical performance and decision-making, professional attitudes and ethics, communication and interpersonal skills, leadership and teamwork, quality improvement and safety, health promotion and prevention, and information technology and digital health. These domains showed strong alignment with POs under the fourth-cycle accreditation standards.
Conclusion
It concludes the seven core domains will be appropriate for evaluating pre-registered nurses in the integrated KNLE. Based on the seven identified core domains, expert consensus should be sought in the next phase to support the development of integrated, competency-based test items grounded in these domains.
5.Core domains for pre-registered nurses based on program outcomes and licensing competencies
Soyoung YU ; Hye Young KIM ; Jeung-Im KIM ; JuHee LEE ; Ju-Eun SONG ; Hyang Yuol LEE
Journal of Korean Academy of Nursing 2025;55(2):249-268
Purpose:
This study aimed to identify core domains for pre-registered nurses by comparing licensing competencies with program outcomes (POs) in undergraduate nursing education. This was accomplished in preparation for the transition of the Korean Nurse Licensing Examination (KNLE) from a tradition seven-subject format to a newly integrated, competency-based single-subject format that reflects current trends in nursing assessment.
Methods:
A literature review and survey were conducted. From 828 studies retrieved via PubMed, CINAHL, and Google Scholar using keywords such as “newly graduated registered nurses” and “competency OR competence,” 18 were selected according to pre-established inclusion and exclusion criteria. Documents from national and international nursing organizations were included to extract relevant licensing competencies. We also reviewed POs from all undergraduate nursing schools in South Korea to align educational outcomes with the identified core domains.
Results:
The core domains identified were clinical performance and decision-making, professional attitudes and ethics, communication and interpersonal skills, leadership and teamwork, quality improvement and safety, health promotion and prevention, and information technology and digital health. These domains showed strong alignment with POs under the fourth-cycle accreditation standards.
Conclusion
It concludes the seven core domains will be appropriate for evaluating pre-registered nurses in the integrated KNLE. Based on the seven identified core domains, expert consensus should be sought in the next phase to support the development of integrated, competency-based test items grounded in these domains.
6.Expert Consensus on Developing Information and Communication Technology-Based Patient Education Guidelines for Rheumatic Diseases in the Korea
Junghee YOON ; Soo-Kyung CHO ; Se Rim CHOI ; Soo-Bin LEE ; Juhee CHO ; Chan Hong JEON ; Geun-Tae KIM ; Jisoo LEE ; Yoon-Kyoung SUNG
Journal of Korean Medical Science 2025;40(1):e67-
Background:
This study aimed to identify key priorities for the development of guidelines for information and communication technology (ICT)-based patient education tailored to the needs of patients with rheumatic diseases (RDs) in the Republic of Korea, based on expert consensus.
Methods:
A two-round modified Delphi study was conducted with 20 rheumatology, patient education, and digital health literacy experts. A total of 35 items covering 7 domains and 18 subdomains were evaluated. Each item was evaluated for its level of importance, and the responses were rated on a 4-point Likert scale. Consensus levels were defined as “high” (interquartile range [IQR] ≤ 1, agreement ≥ 80%, content validity ratio [CVR] ≥ 0.7), "Moderate" (IQR ≥ 1, agreement 50–79%, CVR 0.5–0.7), and "Low" (IQR > 1, agreement < 50%, CVR < 0.5).
Results:
Strong consensus was reached for key priorities for developing guidelines in areas such as health literacy, digital health literacy, medical terminology, user interface, and user experience design for mobile apps. Chatbot use and video (e.g., YouTube) also achieved high consensus, whereas AI-powered platforms such as ChatGPT showed moderate-to-high agreement. Telemedicine was excluded because of insufficient consensus.
Conclusion
The key priorities identified in this study provide a foundation for the development of ICT-based patient education guidelines for RDs in the Republic of Korea.Future efforts should focus on integrating digital tools into clinical practice to enhance patient engagement and improve clinical outcomes.
7.Core domains for pre-registered nurses based on program outcomes and licensing competencies
Soyoung YU ; Hye Young KIM ; Jeung-Im KIM ; JuHee LEE ; Ju-Eun SONG ; Hyang Yuol LEE
Journal of Korean Academy of Nursing 2025;55(2):249-268
Purpose:
This study aimed to identify core domains for pre-registered nurses by comparing licensing competencies with program outcomes (POs) in undergraduate nursing education. This was accomplished in preparation for the transition of the Korean Nurse Licensing Examination (KNLE) from a tradition seven-subject format to a newly integrated, competency-based single-subject format that reflects current trends in nursing assessment.
Methods:
A literature review and survey were conducted. From 828 studies retrieved via PubMed, CINAHL, and Google Scholar using keywords such as “newly graduated registered nurses” and “competency OR competence,” 18 were selected according to pre-established inclusion and exclusion criteria. Documents from national and international nursing organizations were included to extract relevant licensing competencies. We also reviewed POs from all undergraduate nursing schools in South Korea to align educational outcomes with the identified core domains.
Results:
The core domains identified were clinical performance and decision-making, professional attitudes and ethics, communication and interpersonal skills, leadership and teamwork, quality improvement and safety, health promotion and prevention, and information technology and digital health. These domains showed strong alignment with POs under the fourth-cycle accreditation standards.
Conclusion
It concludes the seven core domains will be appropriate for evaluating pre-registered nurses in the integrated KNLE. Based on the seven identified core domains, expert consensus should be sought in the next phase to support the development of integrated, competency-based test items grounded in these domains.
8.Expert Consensus on Developing Information and Communication Technology-Based Patient Education Guidelines for Rheumatic Diseases in the Korea
Junghee YOON ; Soo-Kyung CHO ; Se Rim CHOI ; Soo-Bin LEE ; Juhee CHO ; Chan Hong JEON ; Geun-Tae KIM ; Jisoo LEE ; Yoon-Kyoung SUNG
Journal of Korean Medical Science 2025;40(1):e67-
Background:
This study aimed to identify key priorities for the development of guidelines for information and communication technology (ICT)-based patient education tailored to the needs of patients with rheumatic diseases (RDs) in the Republic of Korea, based on expert consensus.
Methods:
A two-round modified Delphi study was conducted with 20 rheumatology, patient education, and digital health literacy experts. A total of 35 items covering 7 domains and 18 subdomains were evaluated. Each item was evaluated for its level of importance, and the responses were rated on a 4-point Likert scale. Consensus levels were defined as “high” (interquartile range [IQR] ≤ 1, agreement ≥ 80%, content validity ratio [CVR] ≥ 0.7), "Moderate" (IQR ≥ 1, agreement 50–79%, CVR 0.5–0.7), and "Low" (IQR > 1, agreement < 50%, CVR < 0.5).
Results:
Strong consensus was reached for key priorities for developing guidelines in areas such as health literacy, digital health literacy, medical terminology, user interface, and user experience design for mobile apps. Chatbot use and video (e.g., YouTube) also achieved high consensus, whereas AI-powered platforms such as ChatGPT showed moderate-to-high agreement. Telemedicine was excluded because of insufficient consensus.
Conclusion
The key priorities identified in this study provide a foundation for the development of ICT-based patient education guidelines for RDs in the Republic of Korea.Future efforts should focus on integrating digital tools into clinical practice to enhance patient engagement and improve clinical outcomes.
10.Brain Injury and Short-Term Neurodevelopmental Outcomes in Neonates Treated with Respiratory Extracorporeal Membrane Oxygenation: A Single-Center Experience
Keon Hee SEOL ; Byong Sop LEE ; Kyusang YOO ; Joo Hyung ROH ; Jeong Min LEE ; Jung Il KWAK ; Tae-Gyeong KIM ; Juhee PARK ; Ha Na LEE ; Chae Young KIM ; Soo Hyun KIM ; Ji Yoon JEONG ; Euiseok JUNG
Neonatal Medicine 2025;32(1):39-48
Purpose:
This study aimed to characterize the clinical patterns and severity of brain injury in neonates who survived extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory failure during the neonatal period, to evaluate their short-term neurodevelopmental outcomes, and to identify the factors associated with these outcomes.
Methods:
We retrospectively reviewed the medical records of neonates who survived ECMO between 2018 and 2024. Based on brain magnetic resonance imaging (MRI) findings, the patients were classified into two groups: no/mild and moderate/severe brain injury. Neurodevelopmental outcomes were assessed at 12–40 months of age using the Bayley Scale of Infant Development II/III and/or the Korean Developmental Screening Test.
Results:
Among the 19 neonates included in the study, 18 (94.7%) showed varying degrees of brain injury on MRI (mild: 12, moderate: 1, severe: 5). Neonates with moderate/severe brain injury had significantly longer durations of ECMO support and extended durations of mechanical ventilation and were more likely to receive continuous renal replacement therapy than those with no or mild injury. Developmental delay was identified in 36.8% of survivors and was significantly associated with prolonged mechanical ventilation, longer neonatal intensive care unit stays, and a higher incidence of seizures.
Conclusion
Brain injury is frequently observed on MRI in neonates treated with ECMO. However, its direct association with adverse neurodevelopmental outcomes is not definitive. Since MRI findings alone cannot predict developmental outcomes, clinical and environmental factors should be integrated into prognostic assessments.

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