This paper details the development and implementation of Yonsei Medical E-Learning System 3.0 (YES 3.0), a new learning management system (LMS) for Yonsei University College of Medicine. Driven by the need to adapt to a rapidly changing medical education landscape, YES 3.0 addresses the previous system’s limitations and incorporates advanced features designed to improve learning experiences and educational outcomes. The development process involved extensive collaboration among faculty, students, staff, and the system developer, ensuring the system's alignment with the unique needs of the medical education environment. YES 3.0 features real-time monitoring of learning progress, comprehensive evaluation and grade management, personalized learning path recommendations, effective learner history management, and interview/guidance management functionalities. The system also supports the newly revised CDP2023 (Curriculum Development Project 2023) curriculum, with integrated learning across all courses and a strengthened scholarly advanced course. By automating and streamlining various educational processes, YES 3.0 enables maximized learning efficiency, promotes learner-centered education, and supports the cultivation of future medical professionals equipped to navigate the evolving healthcare environment. Implementing the system is expected to have positive impacts on both educational and economic aspects, contributing to the advancement of medical education at Yonsei University College of Medicine. This study also aims to offer insights and expected outcomes that can serve as a reference for other medical schools in adopting and operating LMS, ultimately providing useful information to educators considering establishing a digital learning environment.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

This paper details the development and implementation of Yonsei Medical E-Learning System 3.0 (YES 3.0), a new learning management system (LMS) for Yonsei University College of Medicine. Driven by the need to adapt to a rapidly changing medical education landscape, YES 3.0 addresses the previous system’s limitations and incorporates advanced features designed to improve learning experiences and educational outcomes. The development process involved extensive collaboration among faculty, students, staff, and the system developer, ensuring the system's alignment with the unique needs of the medical education environment. YES 3.0 features real-time monitoring of learning progress, comprehensive evaluation and grade management, personalized learning path recommendations, effective learner history management, and interview/guidance management functionalities. The system also supports the newly revised CDP2023 (Curriculum Development Project 2023) curriculum, with integrated learning across all courses and a strengthened scholarly advanced course. By automating and streamlining various educational processes, YES 3.0 enables maximized learning efficiency, promotes learner-centered education, and supports the cultivation of future medical professionals equipped to navigate the evolving healthcare environment. Implementing the system is expected to have positive impacts on both educational and economic aspects, contributing to the advancement of medical education at Yonsei University College of Medicine. This study also aims to offer insights and expected outcomes that can serve as a reference for other medical schools in adopting and operating LMS, ultimately providing useful information to educators considering establishing a digital learning environment.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

This paper details the development and implementation of Yonsei Medical E-Learning System 3.0 (YES 3.0), a new learning management system (LMS) for Yonsei University College of Medicine. Driven by the need to adapt to a rapidly changing medical education landscape, YES 3.0 addresses the previous system’s limitations and incorporates advanced features designed to improve learning experiences and educational outcomes. The development process involved extensive collaboration among faculty, students, staff, and the system developer, ensuring the system's alignment with the unique needs of the medical education environment. YES 3.0 features real-time monitoring of learning progress, comprehensive evaluation and grade management, personalized learning path recommendations, effective learner history management, and interview/guidance management functionalities. The system also supports the newly revised CDP2023 (Curriculum Development Project 2023) curriculum, with integrated learning across all courses and a strengthened scholarly advanced course. By automating and streamlining various educational processes, YES 3.0 enables maximized learning efficiency, promotes learner-centered education, and supports the cultivation of future medical professionals equipped to navigate the evolving healthcare environment. Implementing the system is expected to have positive impacts on both educational and economic aspects, contributing to the advancement of medical education at Yonsei University College of Medicine. This study also aims to offer insights and expected outcomes that can serve as a reference for other medical schools in adopting and operating LMS, ultimately providing useful information to educators considering establishing a digital learning environment.

Yonsei University College of Medicine (YUCM) adopted a criterion-referenced assessment (CRA) system in 2014. Six cohorts have graduated over the past decade under CRA. Positive impacts on student wellness and academic achievement were observed during the system’s initial years, and this study therefore aimed to analyze the changing perceptions of graduating students who experienced CRA to reflect YUCM’s experience of CRA implementation and suggest future directions and insights. Utilizing self-reporting graduation survey data of 621 graduates from 2018 to 2023, eight items regarding perceptions of CRA were examined with analysis of variance to explore changes in perceptions among the graduates, and short answers were also reviewed to investigate keywords and main themes. The CRA grading system positively influenced students’ learning motivation, level of class participation, cooperative attitudes, and self-directed attitudes. In particular, students’ perceptions of cooperative attitudes significantly improved from 2018 (3.97) to 2023 (4.46). The system also had a positive impact on students’ interest in conducting research from 2018 (3.04) to 2023 (3.56). Students’ perceptions of validity significantly increased from 2018 (3.40) to 2023 (3.92), and the perceptions of reliability also increased from 2018 (3.38) to 2023 (3.65), although the inter-year changes were not statistically significant. This study on graduating students’ changing perceptions of the CRA at YUCM aligned with the intended goals and context of its introduction and implementation. Ongoing improvements in fairness and reliability are required to enhance students’ perceptions of the system’s credibility, necessitating ongoing education and improvement efforts. Further studies on the positive and negative factors influencing perceptions of CRA are required to derive insights for system improvement.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disorder characterized by the presence of eosinophilic nuclear inclusions in neurons and somatic cells. It clinically manifests as cognitive decline, seizures, and autonomic dysfunction. A 44-year-old man presented with a transient visual field defect and hemiparesis. Based on characteristic imaging findings and pathological findings, NIID was suspected and diagnosed through genetic testing. This case emphasizes the importance of comprehensive clinical phenotype analysis and accurate genetic diagnosis.

Echinococcosis, caused by the tapeworm Echinococcus, is rare in Korea and is primarily imported from endemic areas. We report a case of a 37-year-old Korean man with multiple large hepatic cysts, initially diagnosed as simple cysts at a local clinic in 2018. The patient had lived in Oman, an endemic area, for several months in 2016. Upon referral to a tertiary hospital in 2023, due to progressive cyst enlargement, liver magnetic resonance imaging revealed three large cysts with a water lily sign. Serum IgG against Echinococcus was positive by enzyme-linked immunosorbent assay. After diagnosis of echinococcosis, treatment with albendazole and puncture-aspiration-injection-reaspiration (PAIR) was performed.Microscopic and molecular analysis of cyst aspirates confirmed Echinococcus granulosus infection. Follow-up computed tomography demonstrated a reduction in cyst size, yet the emergence of a new right pleural effusion and consolidation in the left lower lobe of the lung necessitated the continuation of albendazole therapy. This case highlights the importance of thorough travel history, imaging findings, and the effectiveness of PAIR combined with albendazole in treating imported echinococcosis.