1.The Patient-Centered Doctor’s Competency Framework in Korea
Woo Taek JEON ; Hanna JUNG ; Youngjon KIM ; Chanwoong KIM ; So Jung YUNE ; Geon Ho LEE ; Sunju IM ; Sun-Woo LEE
Korean Medical Education Review 2024;26(Suppl1):S48-S63
With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor’s awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor’s competency framework from the patient’s perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011–2020), domestic newspaper articles (2016–2020), and domestic social networking service data (2016–2020) related to doctor’s competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor’s competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists. Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor’s competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.
2.A Delphi Study to Validate the Patient-Centered Doctor’S Competency Framework in Korea
Sunju IM ; Youngjon KIM ; Chanwoong KIM ; Geon Ho LEE ; Sun-Woo LEE ; Woo Taek JEON ; Hanna JUNG ; So Jung YUNE
Korean Medical Education Review 2024;26(Suppl1):S64-S83
Defining a competent doctor is important for educating and training doctors. However, competency frameworks have rarely been validated during the process of their development in Korea. The purpose of this study was to validate the patient-centered doctor’s competency framework, which had been developed by our expert working group (EWG). Two rounds of Delphi questionnaire surveys were conducted among a panel of experts on medicine and medical education. The panel members were provided with six core competencies, 17 sub-competencies, and 53 enabling competencies, and were asked to rate the importance of these competencies on a 5-point Likert scale. Between April and July 2021, a total of 28 experts completed both rounds. The data of the Delphi study were analyzed for the mean, standard deviation, median, inter-rater agreement (IRA), and content validity ratio (CVR). A CVR >0.36 and IRA ≥0.75 were deemed to indicate validity and agreement. This study found that five enabling competencies were not valid, and agreement was not reached for three sub-competencies and two enabling competencies. In consideration of CVR and the individual opinions of panel members at each session, the final competencies were extracted through consensus meetings of the EWG. The competencies were modified into six core competencies, 16 sub-competencies, and 47 enabling competencies. This study is meaningful in that it proposes patient-centered doctor’s competencies enabling the development of residents’ milestone competencies, an assessment system, and educational programs.
3.Cohort Establishment and Operation at Pusan National University School of Medicine
So-Jung YUNE ; Sang-Yeoup LEE ; Sunju IM
Korean Medical Education Review 2023;25(2):119-125
Pusan National University School of Medicine (PNUSOM) began analyzing the cohort of pre-medical students admitted in 2015 and has been conducting purposeful analyses for the past 3 years. The aim of this paper is to introduce the process of cohort establishment, cohort composition, and the utilization of cohort analysis results. PNUSOM did not initially form a cohort with a purpose or through a systematic process, but was able to collect longitudinal data on students through the establishment of a Medical Education Information System and an organization that supports medical education. Cohort construction at our university is different in terms of a clear orientation toward research questions, flexibility in cohort composition, and subsequent guideline supplementation. We investigated the relevance of admission factors, performance improvements, satisfaction with the educational environment, and promotion and failure rate in undergraduate students, as well as performance levels and career paths in graduates. The results were presented to the Admissions Committee, Curriculum Committee, Learning Outcomes Committee, and Student Guidance Committee to be used as a basis for innovations and improvements in education. Since cohort studies require long-term efforts, it is necessary to ensure the efficiency of data collection for graduate cohorts, as well as the validity and ethics of the study.
4.A Delphi Study to Validate the Patient-Centered Doctor’s Competency Framework in Korea
Sunju IM ; Young-Jon KIM ; Chanwoong KIM ; Geon-Ho LEE ; Sun-Woo LEE ; Woo-Taek JEON ; Hanna JUNG ; Sojung YUNE
Korean Medical Education Review 2023;25(2):139-158
Defining a competent doctor is important for educating and training doctors. However, competency frameworks have rarely been validated during the process of their development in Korea. The purpose of this study was to validate the patient-centered doctor’s competency framework, which had been developed by our expert working group (EWG). Two rounds of Delphi questionnaire surveys were conducted among a panel of experts on medicine and medical education. The panel members were provided with six core competencies, 17 sub-competencies, and 53 enabling competencies, and were asked to rate the importance of these competencies on a 5-point Likert scale. Between April and July 2021, a total of 28 experts completed both rounds. The data of the Delphi study were analyzed for the mean, standard deviation, median, inter-rater agreement (IRA), and content validity ratio (CVR). A CVR >0.36 and IRA ≥0.75 were deemed to indicate validity and agreement. This study found that five enabling competencies were not valid, and agreement was not reached for three sub-competencies and two enabling competencies. In consideration of CVR and the individual opinions of panel members at each session, the final competencies were extracted through consensus meetings of the EWG. The competencies were modified into six core competencies, 16 sub-competencies, and 47 enabling competencies. This study is meaningful in that it proposes patient-centered doctor’s competencies enabling the development of residents’ milestone competencies, an assessment system, and educational programs.
5.Patient-Centered Doctor’s Competency Framework in Korea
Woo-Taek JEON ; Hanna JUNG ; Young-Jon KIM ; Chanwoong KIM ; Sojung YUNE ; Geon Ho LEE ; Sunju IM ; Sun-Woo LEE
Korean Medical Education Review 2022;24(2):79-92
With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor’s awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor’s competency framework from the patient’s perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011–2020), domestic newspaper articles (2016–2020), and domestic social networking service data (2016–2020) related to doctor’s competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor’s competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists.Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor’s competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.
6.Burnout of Faculty Members of Medical Schools in Korea
Ji-Hyun SEO ; Hwa-ok BAE ; Bong Jo KIM ; Sun HUH ; Young Joon AHN ; Sung Soo JUNG ; Chanwoong KIM ; Sunju IM ; Jae-Bum KIM ; Seong-Joon CHO ; Hee Chul HAN ; Young-Mee LEE
Journal of Korean Medical Science 2022;37(9):e74-
Background:
There is no national survey on medical school faculty members’ burnout in Korea. This study aimed to investigate burnout levels and explore possible factors related to burnout among faculty members of Korean medical schools.
Methods:
An anonymous online questionnaire was distributed to 40 Korean medical schools from October 2020 to December 2020. Burnout was measured by a modified and revalidated version of the Maslach Burnout Inventory-Human Service Survey.
Results:
A total of 996 faculty members participated in the survey. Of them, 855 answered the burnout questions, and 829 completed all the questions in the questionnaire. A significant number of faculty members showed a high level of burnout in each sub-dimension: 34% in emotional exhaustion, 66.3% in depersonalization, and 92.4% in reduced personal accomplishment. A total of 31.5% of faculty members revealed a high level of burnout in two sub-dimensions, while 30.5% revealed a high level of burnout in all three sub-dimensions.Woman faculty members or those younger than 40 reported significantly higher emotional exhaustion and depersonalization. Long working hours (≥ 80 hours/week) showed the highest reduced personal accomplishment scores (F = 4.023, P = 0.018). The most significant stressor or burnout source was “excessive regulation by the government or university.” The research was the most exasperating task, but the education was the least stressful.
Conclusion
This first nationwide study alerts that a significant number of faculty members in Korean medical schools seem to suffer from a high level of burnout. Further studies are necessary for identifying the burnout rate, related factors, and strategies to overcome physician burnout.
8.Assessing the Validity of the Preclinical Objective Structured Clinical Examination Using Messick’s Validity Framework
Hye-Yoon LEE ; So-Jung YUNE ; Sang-Yeoup LEE ; Sunju IM
Korean Medical Education Review 2021;23(3):185-193
Students must be familiar with clinical skills before starting clinical practice to ensure patients’ safety and enable efficient learning. However, performance is mainly tested in the third or fourth years of medical school, and studies using the validity framework have not been reported in Korea. We analyzed the validity of a performance test conducted among second-year students classified into content, response process, internal structure, relationships with other variables, and consequences according to Messick’s framework.As results of the analysis, content validity was secured by developing cases according to a pre-determined blueprint. The quality of the response process was controlled by training and calibrating raters. The internal structure showed that (1) reliability by generalizability theory was acceptable (coefficients of 0.724 and 0.786, respectively, for day 1 and day 2), and (2) the relevant domains had proper correlations, while the clinical performance examination (CPX) and objective structured clinical examination (OSCE) showed weaker relationships. OSCE/CPX scores were correlated with other variables, especially grade point average and oral structured exam scores. The consequences of this assessment were (1) making students learn clinical skills and study themselves, while causing too much stress for students due to lack of motivation; (2) reminding educators of the need to apply practical teaching methods and to give feedback on the test results; and (3) providing an opportunity for faculty to consider developing support programs. It is necessary to develop the blueprint more precisely according to students’ level and to verify the validity of the response process with statistical methods.
9.Challenges and Strategies in Medical Education in the COVID‐19 Pandemic
Korean Medical Education Review 2021;23(3):154-159
The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted all aspects of undergraduate, postgraduate, and continuing medical education. Only the focus of medical education—care for patients and communities—has remained an integral part of all of the above sectors. Several challenges have been experienced by learners and educators as the education and training of future doctors has continued in the midst of this crisis, including the cancellation of face-to-face classes and training, reduced patient encounter opportunities, fairness issues in online assessments, disruption of patient interview-based exams, reflections on the role of doctors in society, and mental health-related problems linked to isolation and concerns about infection. In response to these disruptions, educators and institutions have rapidly deployed educational innovations. Schools have adopted educational strategies to overcome these challenges by implementing novel education delivery methods in an online format, providing clinical experiences through simulation or telehealth methods, introducing online assessment tools with formative purposes, encouraging learners’ involvement in nonclinical activities such as community service, and making available resources and programs to sustain learners’ mental health and wellness. During the COVID-19 pandemic, educators and institutions have faced drastic changes in medical education worldwide. At the same time, the quantitative expansion of online education has caused other problems, such as the lack of human collaboration. The long-term effects of the COVID-19 pandemic on medical education need to be studied further.
10.Educational Program Evaluation System in a Medical School
So-Jung YUNE ; Sang-Yeoup LEE ; Sunju IM
Korean Medical Education Review 2020;22(2):131-142
A systematic educational program evaluation system for continuous quality improvement in undergraduate medical education is essential. Monitoring and evaluation (M&E) are two distinct but complementary processes referred to in an evaluation system that emphasizes formative purpose. Monitoring involves regular data collection for tracking process and results, while evaluation requires periodic judgment for improvement. We have recently completed implementing an educational evaluation using the M&E concept in a medical school. The evaluation system consists of two loops, one at the lesson/course level and the other at the phase/graduation level. We conducted evaluation activities in four stages: planning, monitoring, evaluation, and improvement. In the planning phase, we clarified the purpose of evaluation, formulated a plan to engage stakeholders, determined evaluation criteria and indicators, and developed an evaluation plan. Next, during the monitoring phase, we developed evaluation instruments and methods and then collected data. In the evaluation phase, we analyzed results and evaluated the criteria of the two loops. Finally, we reviewed the evaluation results with stakeholders to make improvements. We have recognized several problems including excessive burden, lack of expertise, insufficient consideration of stakeholders’ evaluation questions, and inefficient data collection. We need to share the value of evaluation and build a system gradually.

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