Purpose: The COVID-19 (coronavirus disease 2019) pandemic led to significant changes in clinical clerkships, including reduced ward rounds. We aimed to determine how the pandemic–induced changes in the clinical practice environment affect the clinical performance of medical students. Methods: We analyzed objective structured clinical examination scores of third- and fourth-year medical students from 2019–2020 and 2020–2021 across six stations by the Seoul–Gyeonggi Consortium. Clinical, communication, and ability scores were measured and analyzed using repeated-measures multivariate analysis of variance. Results: The interaction between clinical practice progress and pandemic-induced changes significantly affected physical examination and medical history scores, though the differences were not substantial. Patient-physician interaction significance varied by measurement period. Clinical communication ability also showed significant differences based on the measurement period and practical experience. Conclusion During the pandemic, alternative learning methods, including self–learning, simulation/practice, and peer role–play, helped improve medical competency in areas such as history–taking and physical examination. However, these were less effective in improving patient–physician interactions or clinical communication efficacy. Alternative learning methods have limitations, and they cannot replace direct patient encounters in clinical practice.

Purpose: The COVID-19 (coronavirus disease 2019) pandemic led to significant changes in clinical clerkships, including reduced ward rounds. We aimed to determine how the pandemic–induced changes in the clinical practice environment affect the clinical performance of medical students. Methods: We analyzed objective structured clinical examination scores of third- and fourth-year medical students from 2019–2020 and 2020–2021 across six stations by the Seoul–Gyeonggi Consortium. Clinical, communication, and ability scores were measured and analyzed using repeated-measures multivariate analysis of variance. Results: The interaction between clinical practice progress and pandemic-induced changes significantly affected physical examination and medical history scores, though the differences were not substantial. Patient-physician interaction significance varied by measurement period. Clinical communication ability also showed significant differences based on the measurement period and practical experience. Conclusion During the pandemic, alternative learning methods, including self–learning, simulation/practice, and peer role–play, helped improve medical competency in areas such as history–taking and physical examination. However, these were less effective in improving patient–physician interactions or clinical communication efficacy. Alternative learning methods have limitations, and they cannot replace direct patient encounters in clinical practice.

Purpose: The COVID-19 (coronavirus disease 2019) pandemic led to significant changes in clinical clerkships, including reduced ward rounds. We aimed to determine how the pandemic–induced changes in the clinical practice environment affect the clinical performance of medical students. Methods: We analyzed objective structured clinical examination scores of third- and fourth-year medical students from 2019–2020 and 2020–2021 across six stations by the Seoul–Gyeonggi Consortium. Clinical, communication, and ability scores were measured and analyzed using repeated-measures multivariate analysis of variance. Results: The interaction between clinical practice progress and pandemic-induced changes significantly affected physical examination and medical history scores, though the differences were not substantial. Patient-physician interaction significance varied by measurement period. Clinical communication ability also showed significant differences based on the measurement period and practical experience. Conclusion During the pandemic, alternative learning methods, including self–learning, simulation/practice, and peer role–play, helped improve medical competency in areas such as history–taking and physical examination. However, these were less effective in improving patient–physician interactions or clinical communication efficacy. Alternative learning methods have limitations, and they cannot replace direct patient encounters in clinical practice.

Purpose: The COVID-19 (coronavirus disease 2019) pandemic led to significant changes in clinical clerkships, including reduced ward rounds. We aimed to determine how the pandemic–induced changes in the clinical practice environment affect the clinical performance of medical students. Methods: We analyzed objective structured clinical examination scores of third- and fourth-year medical students from 2019–2020 and 2020–2021 across six stations by the Seoul–Gyeonggi Consortium. Clinical, communication, and ability scores were measured and analyzed using repeated-measures multivariate analysis of variance. Results: The interaction between clinical practice progress and pandemic-induced changes significantly affected physical examination and medical history scores, though the differences were not substantial. Patient-physician interaction significance varied by measurement period. Clinical communication ability also showed significant differences based on the measurement period and practical experience. Conclusion During the pandemic, alternative learning methods, including self–learning, simulation/practice, and peer role–play, helped improve medical competency in areas such as history–taking and physical examination. However, these were less effective in improving patient–physician interactions or clinical communication efficacy. Alternative learning methods have limitations, and they cannot replace direct patient encounters in clinical practice.

Purpose: This study aimed to identify challenges and potential improvements in Korea's medical education accreditation process according to the Accreditation Standards of the Korean Institute of Medical Education and Evaluation 2019 (ASK2019). Meta-evaluation was conducted to survey the experiences and perceptions of stakeholders, including self-assessment committee members, site visit committee members, administrative staff, and medical school professors. Methods: A cross-sectional study was conducted using surveys sent to 40 medical schools. The 332 participants included self-assessment committee members, site visit team members, administrative staff, and medical school professors. The t-test, one-way analysis of variance and the chi-square test were used to analyze and compare opinions on medical education accreditation between the categories of participants. Results: Site visit committee members placed greater importance on the necessity of accreditation than faculty members. A shared positive view on accreditation’s role in improving educational quality was seen among self-evaluation committee members and professors. Administrative staff highly regarded the Korean Institute of Medical Education and Evaluation’s reliability and objectivity, unlike the self-evaluation committee members. Site visit committee members positively perceived the clarity of accreditation standards, differing from self-assessment committee members. Administrative staff were most optimistic about implementing standards. However, the accreditation process encountered challenges, especially in duplicating content and preparing self-evaluation reports. Finally, perceptions regarding the accuracy of final site visit reports varied significantly between the self-evaluation committee members and the site visit committee members. Conclusion This study revealed diverse views on medical education accreditation, highlighting the need for improved communication, expectation alignment, and stakeholder collaboration to refine the accreditation process and quality.

Purpose: Perioperative transfusion is reported to be an independent risk factor not only for postoperative complications but also for early recurrence of periampullary carcinoma after pancreaticoduodenectomy (PD). The purpose of this study was to evaluate the safety and efficacy of ferric carboxymaltose (FCM) in reducing the need for perioperative transfusion in iron deficiency anemia patients scheduled for PD. Methods: Twenty-two male patients (hemoglobin [Hb] 7 to <13 g/dL) and 18 female patients (Hb 7 to <12 g/dL) were enrolled in the study group and administered FCM 1–3 weeks before PD. The perioperative transfusion rate was the primary endpoint; morbidity, length of postoperative hospital stay, change in hematological parameters after FCM injection, and adverse effects of FCM were also investigated. Results: The perioperative transfusion rate of the study group was 22.5% (9 of 40). Hb level was significantly higher on the day of the operation compared to baseline (P < 0.001). Levels of Hb, transferrin saturation, and ferritin were higher at the follow-up compared to baseline (P = 0.008, P = 0.033, and P < 0.001, respectively). Conclusions FCM administration was associated with a reduced need for perioperative transfusion and can safely stabilize hematological parameters.

Siewert–Kartagener’s syndrome, a type of primary ciliary dyskinesia, is a complex disease comprising situs inversus, rhinosinusitis, and bronchiectasis. Situs inversus totalis is a condition in which all organs in the thoracic and abdominal cavities are reversed.Furthermore, primary ciliary dyskinesia, an autosomal genetic disease, may coexist with situs inversus totalis. Reports on Siewert–Kartagener’s syndrome in veterinary medicine are limited. We report a rare case of primary ciliary dyskinesia with Siewert-Kartagener’s syndrome in a dog, concurrently infected with canine distemper virus and type-2 adenovirus.This case highlights that situs inversus totalis can cause primary ciliary dyskinesia, and concurrent infections are possible.

Background/Aims: Many patients with Crohn’s disease (CD) undergo intestinal resection during the disease course. Despite surgery, postoperative recurrence (POR) commonly occurs. Although postoperative use of tumor necrosis factor α (TNF-α) inhibitors is known to be effective in preventing POR, few studies have evaluated the effectiveness of continuing the same TNF-α inhibitors postoperatively in patients who received TNF-ɑ inhibitors before surgery. Methods: This retrospective observational study was performed in a single tertiary medical center. We retrospectively reviewed patients who had undergone the first intestinal resection due to CD and divided them into two groups: TNF-α inhibitor users in both the preoperative and postoperative periods, and TNF-α inhibitor users in only the preoperative period. We compared the clinical outcomes between these two groups. Results: In total, 45 patients who used TNF-α inhibitors preoperatively were recruited. Among them, TNF-α inhibitors were used postoperatively in 20 patients (44.4%). The baseline characteristics except age at diagnosis were similar in both groups. The rates of surgical and endoscopic recurrence were not different between the two groups, but the cumulative clinical recurrence rate was significantly lower in the postoperative TNF-α inhibitors group (log-rank p=0.003). In multivariate Cox regression analysis, postoperative TNF-α inhibitors use was significantly associated with a decreased risk of clinical recurrence (adjusted hazard ratio, 0.204; 95% confidence interval, 0.060 to 0.691; p=0.011). Conclusions Continuing TNF-α inhibitors postoperatively in patients who were receiving TNF-α inhibitors before surgery significantly reduced the rate of clinical recurrence. For patients with CD who received TNF-α inhibitors preoperatively, continuing their use after surgery could be recommended.

Background/Aims: The optimal tools for monitoring Crohn’s disease (CD) are controversial. We compared radiology plus ileocolonoscopy and radiology alone in terms of prognosis prediction and evaluated the agreement between radiologic and ileocolonoscopic findings in patients with CD. Methods: Patients with CD who were followed up with computed tomography enterography (CTE) or magnetic resonance enterography (MRE) alone or CTE or MRE plus ileocolonoscopy were retrospectively recruited. Time to relapse was investigated to evaluate the difference in prognosis using the log-rank and Cox regression tests, and the agreement between radiologic and ileocolonoscopic findings was determined using a kappa value. Results: A total of 501 patients with CD in clinical remission who underwent CTE or MRE and/or ileocolonoscopy were analyzed. Of these, 372 (74.3%) patients underwent CTE or MRE alone and 129 (25.7%) patients underwent CTE or MRE plus ileocolonoscopy. The cumulative maintenance rate of clinical remission between the two groups was not significantly different (p = 0.526, log-rank test). In multivariate analysis, age <40 years (hazard ratio [HR], 2.756; 95% confidence interval [CI], 1.263 to 6.013) and a history of steroid use (HR, 2.212; 95% CI, 1.258 to 3.577) were found to independently predict an increased risk for clinical relapse in patients with CD in clinical remission. Radiologic and ileocolonoscopic findings had a moderate degree of agreement (κ = 0.401, –0.094 to 0.142). The comparison of agreement between radiologic and ileocolonoscopic findings was the highest in the anastomotic site (κ = 0.749, –0.168 to 0.377). Conclusions Radiology plus ileocolonoscopy was not superior to radiology alone in predicting the prognosis of CD.

Background/Aims: Golimumab has been used for patients with ulcerative colitis (UC) since 2013. However, there is limited data on the effectiveness and safety of the real-world use of golimumab in Asian patients. Methods: This was a multicenter, prospective, observational study. We enrolled patients with moderate-to-severe UC who were administered subcutaneous golimumab at 46 medical centers between May 2014 and November 2019. The primary outcome was the effectiveness and safety of golimumab at week 22. Clinical outcomes and adverse events were assessed according to partial Mayo score at weeks 0, 2, 6, 14, and 22. Results: A total of 130 patients were included (mean age: 45.7±16.0 years). The clinical response/ remission rates at weeks 2, 6, 14, and 22 were 40.4%/22.9%, 56.0%/35.8%, 70.6%/49.5%, and 67.9%/48.6%, respectively. Based on full Mayo score at week 14, clinical response and remission rates were 84.2% and 39.5%, respectively. Mucosal healing rate was 65.8%. In multivariate analysis with logistic regression, longer disease duration was significantly associated with a higher clinical response rate (adjusted odds ratio [aOR], 1.136; 95% confidence interval [CI], 1.006 to 1.282; p=0.040 at week 6; aOR, 1.256; 95% CI, 1.049 to 1.503; p=0.013 at week 22). A higher baseline Mayo endoscopic subscore was significantly associated with a lower clinical response rate at week 6 (aOR, 0.248; 95% CI, 0.089 to 0.692; p=0.008). The incidence of adverse drug reactions was 4.6% (6/130, nine events). No serious unexpected adverse drug reactions or deaths were reported. Conclusions Golimumab was effective and safe as an induction and maintenance treatment for Korean patients with moderate-to-severe UC.