To explore the methods of cultivating the clinical thinking ability of acupuncture and moxibustion in the standardized training of resident physicians, so as to improve the medical record writing ability of the regular training physicians. The clinical diagnosis and treatment of acupuncture and moxibustion has its own characteristics and can't copy the syndrome differentiation and treatment mode of TCM internal medicine. In the treatment section, Acupuncture and Moxibustion, a standardized training textbook for national TCM resident physicians, takes clinical cases as the breakthrough point and uses the problem as the guide, guides the training physicians to cultivate acupuncture and moxibustion clinical diagnosis and treatment from three aspects: disease diagnosis, syndrome diagnosis, and treatment ideas, forms a complete understanding of the disease, and improves the standardization, logicality and systematicness of medical record writing through repeated practical training.
Humans ; Moxibustion ; Acupuncture Therapy ; Medical Records ; Physicians ; Writing

Despite the great socioeconomic burden of stroke, there have been few reports of stroke statistics in Korea. In this scenario, the Epidemiologic Research Council of the Korean Stroke Society launched the “Stroke Statistics in Korea” project, aimed at writing a contemporary, comprehensive, and representative report on stroke epidemiology in Korea. This report contains general statistics of stroke, prevalence of behavioral and vascular risk factors, stroke characteristics, pre-hospital system of care, hospital management, quality of stroke care, and outcomes. In this report, we analyzed the most up-to-date and nationally representative databases, rather than performing a systematic review of existing evidence. In summary, one in 40 adults are patients with stroke and 232 subjects per 100,000 experience a stroke event every year. Among the 100 patients with stroke in 2014, 76 had ischemic stroke, 15 had intracerebral hemorrhage, and nine had subarachnoid hemorrhage. Stroke mortality is gradually declining, but it remains as high as 30 deaths per 100,000 individuals, with regional disparities. As for stroke risk factors, the prevalence of smoking is decreasing in men but not in women, and the prevalence of alcohol drinking is increasing in women but not in men. Population-attributable risk factors vary with age. Smoking plays a role in young-aged individuals, hypertension and diabetes in middle-aged individuals, and atrial fibrillation in the elderly. About four out of 10 hospitalized patients with stroke are visiting an emergency room within 3 hours of symptom onset, and only half use an ambulance. Regarding acute management, the proportion of patients with ischemic stroke receiving intravenous thrombolysis and endovascular treatment was 10.7% and 3.6%, respectively. Decompressive surgery was performed in 1.4% of patients with ischemic stroke and in 28.1% of those with intracerebral hemorrhage. The cumulative incidence of bleeding and fracture at 1 year after stroke was 8.9% and 4.7%, respectively. The direct costs of stroke were about ₩1.68 trillion (KRW), of which ₩1.11 trillion were for ischemic stroke and ₩540 billion for hemorrhagic stroke. The great burden of stroke in Korea can be reduced through more concentrated efforts to control major attributable risk factors for age and sex, reorganize emergency medical service systems to give patients with stroke more opportunities for reperfusion therapy, disseminate stroke unit care, and reduce regional disparities. We hope that this report can contribute to achieving these tasks.
Adult ; Aged ; Alcohol Drinking ; Ambulances ; Atrial Fibrillation ; Cerebral Hemorrhage ; Emergency Medical Services ; Emergency Service, Hospital ; Epidemiology ; Female ; Hemorrhage ; Hope ; Humans ; Hypertension ; Incidence ; Korea ; Male ; Mortality ; Prevalence ; Reperfusion ; Risk Factors ; Smoke ; Smoking ; Stroke ; Subarachnoid Hemorrhage ; Writing

PURPOSE: This study investigated student experiences of mobile technology in a medical English course using a free mobile classroom application, Socrative and its impact on student learning to help them achieve the competency expected in the course. METHODS: Questionnaires were administered of year 2 medical students enrolled in a medical English course between 2016 and 2017 to investigate their experience in using Socrative. Learning outcomes were assessed by comparing students' academic performance with that of the 2015 cohort, who had taken the same course without using mobile technology, and also by measuring changes in their self-efficacy in English over time during the course. RESULTS: This study found students' positive perceptions of and overall satisfaction with their experience in using mobile technology in the medical English course. There were no differences in the academic performance between the study cohort and the comparison group. The ratio of students who were in the remediation program after the mid-term examination was 11%, whereas the remediation ratio of the 2015 cohort was 21%. Students' self-efficacy in English improved significantly in the writing and reading domains (p < 0.05). CONCLUSION: This study found several benefits of using Socrative in the medical English course. Socrative fostered the classroom interaction by encouraging input from every student and sharing it instantly with the whole class. There was also learning improvement with the use of Socrative. Furthermore, it has the potential to enhance assessment by offering more various forms of assessment than that of conventional audience response systems.
Cohort Studies ; Educational Technology ; Humans ; Learning ; Mobile Applications ; Problem-Based Learning ; Students, Medical ; Teaching ; Writing

PURPOSE: Assessment in different languages should measure the same construct. However, item characteristics, such as item flaws and content, may favor one test-taker group over another. This is known as item bias. Although some studies have focused on item bias, little is known about item bias and its association with items characteristics. Therefore, this study investigated the association between item characteristics and bias. METHODS: The University of Groningen offers both an international and a national bachelor’s program in medicine. Students in both programs take the same progress test, but the international progress test is literally translated into English from the Dutch version. Differential item functioning was calculated to analyze item bias in four subsequent progress tests. Items were also classified by their categories, number of alternatives, item flaw, item length, and whether it was a case-based question. RESULTS: The proportion of items with bias ranged from 34% to 36% for the various tests. The number of items and the size of their bias was very similar in both programmes. We have identified that the more complex items with more alternatives favored the national students, whereas shorter items and fewer alternatives favored the international students. CONCLUSION: Although nearly 35% of all items contain bias, the distribution and the size of the bias were similar for both groups. The findings of this paper may be used to improve the writing process of the items, by avoiding some characteristics that may benefit one group whilst being a disadvantage for others.
Bias (Epidemiology) ; Education, Medical ; Educational Measurement ; Humans ; Writing

Scholarly article writing and publishing in international peer-reviewed journals can become an overwhelming task for many medical, nursing, and healthcare professionals in a university setting, especially in countries whose native language is not English. To help improve their scientific writing skills and publishing capacity, a university-based editing system and writing programs can be developed as educational platforms. These are delivered by a team of specialist editors composed of tenured faculty members who have a strong medical background and extensive experience in teaching courses on medical research, editing, writing, and publishing. For the editing system, the specialist editors provide comprehensive editing, personalized consultation, full editorial support after peer review, guidance with online submissions/resubmissions, and detailed editorial review at different stages of the manuscript writing. In addition, the specialist editors can develop writing programs such as medical writing and editing internships, academic courses in medical writing or research study designs and reporting standards, special interactive lectures and sessions on predatory publishing, seminars on updated editorial guidance of global editorial associations, academic visits on medical writing and editing, medical writing mentoring program, networking programs in scholarly communication, and publication resources in medical writing and scholarly publishing. These editing system and writing programs can serve as integrated platforms for improving scientific writing skills and publishing capacity by providing continuing education in medical writing, editing, publishing, and publication ethics.
Delivery of Health Care ; Education, Continuing ; Ethics ; Humans ; Internship and Residency ; Lectures ; Medical Writing ; Mentors ; Nursing ; Peer Review ; Publications ; Specialization ; Writing*

There are currently very limited reports on the strengths and weaknesses of Japanese medical students in processing (i.e., searching, reading, synthesizing, writing, editing, refining) and presenting medical content based on scholarly journal articles. We developed and offered a 3-week group independent research course in English as a summer elective named “Improving Medical English Skills and Creating English Medical Content (PPT and video) Based on Medical Journal Articles” to our fourth-year Japanese medical students who follow a 6-year medical curriculum as the target audience. Herein, we describe the specific strengths and weaknesses of 6 students who chose and completed the course. Thereafter, we assessed the possible reasons underlying these weaknesses, pondered on the potential implications of such weaknesses on the critical thinking, logical reasoning, and communication skills of Japanese medical students, and suggested approaches to further enhance these skills. The assessments, implications, and suggestions given may provide medical educators new insights on how to newly organize educational and clinical programs to address such weaknesses, improve searching, reading, writing, editing, and presentation skills, enhance critical thinking and logical reasoning abilities, and gain in-depth knowledge essential for effectively appraising and communicating medical content.
Asian Continental Ancestry Group ; Curriculum ; Humans ; Logic ; Students, Medical* ; Thinking* ; Writing*

Appropriate prescription writing is one of the critical medical processes affecting the quality of public health care. However, this is a complex task for newly qualified intern doctors because of its complex characteristics requiring sufficient knowledge of medications and principles of clinical pharmacology, skills of diagnosis and communication, and critical judgment. This study aims to gather data on the current status of undergraduate prescribing education in South Korea. Two surveys were administered in this study: survey A to 26 medical schools in South Korea to gather information on the status of undergraduate education in clinical pharmacology; and survey B to 244 intern doctors in large hospitals to gather their opinions regarding prescribing education and ability. In survey A, half of the responding institutions provided prescribing education via various formats of classes over two curriculums including lecture, applied practice, group discussions, computer-utilized training, and workshops. In survey B, we found that intern doctors have the least confidence when prescribing drugs for special patient populations, especially pregnant women. These intern doctors believed that a case-based practical training or group discussion class would be an effective approach to supplement their prescribing education concurrently or after the clerkship in medical schools or right before starting intern training with a core drug list. The results of the present study may help instructors in charge of prescribing education when communicating and cooperating with each other to improve undergraduate prescribing education and the quality of national medical care.
Curriculum ; Diagnosis ; Education ; Education, Medical ; Female ; Group Practice ; Humans ; Judgment ; Korea ; Pharmacology, Clinical ; Pregnant Women ; Prescriptions ; Public Health ; Schools, Medical ; Writing

Good assessment is crucial for feedback on curriculum and to motivate students to learn. This study was conducted to perform item analysis on the Medical Education Assessment Consortium clinical knowledge mock examination (MEAC CKME) (2011–2016) and to evaluate several effects to improve item quality using both classical test theory and item response theory. The estimated difficulty index (P) and discrimination index (D) were calculated according to each course, item type, A (single best answer)/R (extended matching) type, and grading of item quality. The cut-off values used to evaluate P were: >0.8 (easy); 0.6–0.8 (moderate); and <0.6 (difficult). The cut-off value for D was 0.3. The proportion of appropriate items was defined as those with P between 0.25–0.75 and D ≥0.25. Cronbach α was used to assess the reliability and was compared with those of the Korean Medical Licensing Examination (KMLE). The results showed the recent mean difficulty and decimation index was 0.62 and 0.20 for the first MEAC CKME and 0.71 and 0.19 for the second MEAC CKME, respectively. Higher grade items evaluated by a self-checklist system had better D values than lower grade items and higher grade items gradually increased. The preview and editing process by experts revealed maintained P, decreased recall items, increased appropriate items with better D values, and higher reliability. In conclusion, the MEAC CKME (2011–2016) is deemed appropriate as an assessment to evaluate students' competence and prepare year four medical students for the KMLE. In addition, the self-checklist system for writing good items was useful in improving item quality.
Curriculum ; Discrimination (Psychology) ; Education, Medical ; Humans ; Licensure ; Mental Competency ; Students, Medical ; Writing

PURPOSE: This intervention was aimed to analyse the effect of academic writing and journal critiquing as educational approaches in improving critical thinking and collaborative learning among undergraduate medical students. METHODS: A research proposal writing format was created for the 4th year medical students of Melaka Manipal Medical College, Malaysia during their ophthalmology clinical postings. The students worked in small groups and developed research protocols through an evidence based approach. This was followed by writing reflective summaries in academic portfolios about the activity undertaken. A mixed methods study was designed to explore the possible role of collaborative research proposal writing in enhancing critical thinking and collaborative learning. RESULTS: Analysis of reflections submitted by 188 medical students after the intervention indicate that majority of them found an improvement in their skills of critical thinking and collaborative learning as a result of research protocol writing. All participants agreed that the model helped in applying concepts to new situations in the form of designing their own study, which reflected in enhanced higher order cognitive skills. CONCLUSION: This study shows that the introduction of a structured module in the core medical curriculum that focuses on research writing skills embedded with collaborative and reflective practices can enhance collaborative learning, critical thinking, and reasoning among medical students.
Curriculum* ; Foster Home Care* ; Humans ; Learning* ; Malaysia ; Ophthalmology ; Research Design ; Students, Medical* ; Thinking* ; Writing*

Over the past few years, updated editorial policy statements of several associations have provided a platform for improving the quality of scientific research and publishing. The updates have particularly pointed to the need for following research reporting standards, authorship and contributorship regulations, implementing digital tools for the identification and crediting academic contributors, and moving towards optimal ethical open-access models. This article overviews some of the recent editorial policy statements of global editorial associations and reflects on the role of the regional counterparts in advancing scholarly publishing. One of the globally promoted documents is the Recommendations of the International Committee of Medical Journal Editors (ICMJE). Its latest versions contain statements on proper research reporting, reviewing, editing, and publishing. Points on ethical target journals and ‘predatory’ sources are also available. This year, in a move to update its editorial policy, the Committee on Publication Ethics (COPE) released the Core Practices, comprehensively reflecting on the major issues in publication ethics. Updated joint statements of medical writers associations are also available to implement transparent policy on contributorship in sponsor-supported research projects and related reports. Several suggestions are put forward to improve global editorial statements on online profiling, crediting, and referencing. It is also highlighted that knowledge and implementation of updated editorial guidance is essential for editors' good standing.
Authorship ; Editorial Policies ; Ethics ; Information Storage and Retrieval ; Joints ; Medical Writing ; Periodicals as Topic ; Publications ; Quality Control ; Research Report ; Social Control, Formal