텍스트네트워크 분석을 활용한 국내 의사 직무역량 연구동향 분석

김영전,이제욱,윤소정,Kim, Young Jon,Lee, Jea Woog,Yune, So Jung 연세대학교 의과대학 2022 의학교육논단 Vol.24 No.2

We use the concept of the "doctor's role" as a guideline for developing medical education programs for medical students, residents, and doctors. Therefore, we should regularly reflect on the times and social needs to develop a clear sense of that role. The objective of the present study was to understand the knowledge structure related to doctor's job competencies in Korea. We analyzed research trends related to doctor's job competencies in Korea Citation Index journals using text network analysis through an integrative approach focusing on identifying social issues. We finally selected 1,354 research papers related to doctor's job competencies from 2011 to 2020, and we analyzed 2,627 words through data pre-processing with the NetMiner ver. 4.2 program (Cyram Inc., Seongnam, Korea). We conducted keyword centrality analysis, topic modeling, frequency analysis, and linear regression analysis using NetMiner ver. 4.2 (Cyram Inc.) and IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA). As a result of the study, words such as "family," "revision," and "rejection" appeared frequently. In topic modeling, we extracted five potential topics: "topic 1: Life and death in medical situations," "topic 2: Medical practice under the Medical Act," "topic 3: Medical malpractice and litigation," "topic 4: Medical professionalism," and "topic 5: Competency development education for medical students." Although there were no statistically significant changes in the research trends for each topic over time, it is nonetheless known that social changes could affect the demand for doctor's job competencies.

의료면담 역할극 사례의 학습자 성찰일지 분석

김영전,이승현,유효현,Kim, Young Jon,Lee, Seung Hyun,Yoo, Hyo Hyun 연세대학교 의과대학 2017 의학교육논단 Vol.19 No.3

This study explores the phenomenon of learner reflection in writing. Sixty-nine reflection logs were submitted by students after medical interview role plays. Using thematic analysis methodology, the following three steps were carried out: (1) the entire contents of the logs were analyzed and coded, (2) the coded contents were reclassified and categorized into higher themes, and (3) all reflection logs were re-analyzed to derive the frequency according to their classifications. The learners' reflection contents were classified into 'preparation,' 'experience,' and 'future plan.' The levels of reflection were 'simple information and appreciation,' 'acquisition and application of knowledge,' and 'analysis and criticism.' The types of reflection were identified only at the level of 'analysis and criticism' and could be classified into 'relativization,' 'objectification,' and 'internalization.' Students' reflection levels were highest in the levels of 'acquisition and application of knowledge' (49.3%), and 'analysis and criticism' (37.7%). A total of 14.5% of the students showed 'internalization.' In order to enable internalized reflection at a critical level, instructional strategies to induce and promote reflection are needed.

침상 옆 교육의 교수설계모형의 특징과 한계

김영전,임철일,Kim, Young Jon,Lim, Cheol Il 연세대학교 의과대학 2014 의학교육논단 Vol.16 No.1

As a preliminary approach to developing a bedside teaching program, this study analyzed the instructional models that have been suggested for bedside teaching. The objects of analysis were four models: the 'Cox model,' which is composed of an experience cycle and an explanation cycle; the 'best teaching practice model' by Janicik and Fletcher; the 'twelve tips to improve bedside teaching' by Ramani; and the SNNAPS model for outpatient education by Wolpaw, Wolpaw, and Papp. This study was conducted in three steps. First, we identified the major components of each model and analyzed their characteristics and limitations. Second, we compared each model in terms of four aspects: the learner, learning interaction, learning context, and organization management. Third, on the basis of prior analysis, the possibilities and potential problems of the models were explored. Based on this review of the existing instructional design models, we proposed an additional four key elements for designing a bedside teaching program: multi-layered learners, various learning environments and contexts, time management by using media, and self-directed design.

의학교육에서의 역량기반교육의 가능성과 한계 탐색

김영전,임철일,Kim, Young Jon,Lim, Cheol Il 연세대학교 의과대학 2011 의학교육논단 Vol.13 No.1

Competency and competency-based education are topics of great interest to educators and administrators at most stages of undergraduate and postgraduate medical training. A competency-based approach in medical setting has been valued as a more effective way to strengthen learners' performance compared to the traditional education program. This article aims to explore theoretical and practical possibilities and limitations of competency-based medical education. We approached the topic in 3 gradual steps: the comprehension of background of competency-based education, the conceptual understanding of competency in professional education, and the exploration of possibilities and limitations of competency-based medical education. The last step of analysis was performed in three dimensions: educational objectives, references to judge performance, and performance evaluation criteria. In conclusion, we suggest 4 factors which need to be considered to implement a competency-based medical education.

한국의 환자중심 의사 역량 연구

전우택,정한나,김영전,김찬웅,윤소정,이건호,임선주,이선우,Jeon, Woo-Taek,Jung, Hanna,Kim, Young-Jon,Kim, Chanwoong,Yune, Sojung,Lee, Geon Ho,Im, Sunju,Lee, Sun-Woo 연세대학교 의과대학 2022 의학교육논단 Vol.24 No.2

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.

학습자 중심 소그룹 활동의 평가방법 : 의과대학 소그룹 학습 자기평가와 동료평가의 적용 가능성 탐색

권소희(Kwon So Hee),김영전(Kim Young Jon) 학습자중심교과교육학회 2020 학습자중심교과교육연구 Vol.20 No.21

소그룹 활동에서 집단 내 학습자의 참여 정도와 내용은 그룹 학습의 성공요인이다. 그러나 교수자가 그룹 내 개별 학습자의 참여 과정을 일일이 평가하기에는 물리적 한계가 있다. 본 연구는 소그룹 활동의 참여를 평가하는 방법으로 학습자 자기평가와 그룹 내 학습자 동료평가의 활용 가능성을 탐색하고자 하였다. 일개 의과대학 3학년 83명이 본 연구에 참여하였고, 학습자들은 8-9명으로 구성된 10개의 학습 소그룹을 구성하여, 총 24시간(6시간/1일, 총 4일) 동안 다양한 소그룹 활동을 수행하였다. 참여자들은 모든 활동이 끝난 후 그룹 내 활동에 대한 준비, 기여, 협력에 관한 10개의 문항에 대해 자기평가와 동료평가를 시행하였다. 두 평가 결과의 차이와 관련성을 확인하기 위해 대응표본 T-test, 관대화와 중심화 경향 분석, Pearson 상관분석을 시행하였다. 두 평가의 일치도는 급내 상관계수(ICC, intraclass correlation coefficient)와 95% 신뢰도 구간을 분석하였다. 분석결과 자기평가와 동료평가의 평가 주체에 따른 결과의 차이는 확인되지 않았다(p>.05). 관대화 경향은 자기평가(-.93)가 동료평가(-.52) 보다 크게 나타났다. 중심화 경향은 자기평가(.460)에서 확인되었다. 자기평가와 동료평가는 유의한 상관관계가 확인되었고(r=.73, p<.05). 문항별 신뢰도 계수는 0.40-0.60에 분포한다. 소그룹 활동 참여의 평가방법으로 자기평가와 그룹 내 동료평가가 대안이 될 수 있다. 그러나 과도한 중심화와 관대화 경향을 방지하기 위해서 구체적인 사실관계를 파악할 수 있는 평가 루브릭 개발과 이를 적용한 평가 방법에 대한 사전 교육이 강화될 필요가 있다. In small group activities, the degree and content of learners participation in a group is a success factor of group learning. However, it is not easy for an instructor to closely assess the each activities of every learners in the group. The purpose of this study was to explore the possibility of using learner s self-assessment and peer-assessment in the group. The subjects are 83 third grade students in a medical school. Learners organized 10 learning subgroups of 8-9 students and performed a variety of small group activities for a total of 24 hours (6 hours/1 day). Participants conducted self-assessment and peer assessments on 10 items of preparation, contribution, and co-operation after all activities were completed.Paired T-test, lenience/central tendency, and Pearson correlation analysis were performed to analyze the difference and relevance of self-assessment and peer assessments. Concordance between the two assessments was analyzed by intraclass correlation coefficient (ICC) and 95% confidence interval. No difference was found between the evaluation subjects, self-assessment and peer assessment(p>.05). In the tendency of leniency, self-assessment (-.93) was higher than peer-assessment(-.52). Centralization tendency was identified in self-assessment(.460). Self-assessment and peer-assessment showed a significant correlation(r=.73, p<.05), the confidence coefficient for each item is 0.40-0.60. Learner self-assessment and student peer assessment can be an alternative to evaluation of small group activity participation. However, in order to prevent leniency or centralization tendency in assessment, it is necessary to develop more detailed rubric items and preliminary guideline for student evaluators.

공과대학 학생들의 창의성교육에 관한 인식

임철일(Cheol-il Lim),김영전(Young-jon Kim),김동호(Dong-ho Kim) 한국공학교육학회 2012 공학교육연구 Vol.15 No.2

There have been various educational approaches to foster students creativity in engineering colleges, but little has been conducted based on empirical study results of students perception on creativity education. This study aims to explore the students perception on creativity in engineering such as characteristics of creative engineers, the level of individual or group creativity and creative education in engineering colleges. According to the survey results of 538 respondents, engineering students considered three factors such as ‘innovative driven’, ‘eager for high intellectuality’, ‘activity expression’ as characteristics of creative engineer. They evaluated both of individual or group creativity levels as subnormal. They perceived the importance of creativity education, but were not satisfied with current creativity educational experiences. They pointed out ‘limited supports of nation or organization’, ‘credit system decided by the paper-based exam’, ‘non-systematized creativity classes’ as impending factors for creativity in engineering education. Students suggested ‘securing the budget for practice and field participation’, ‘changing of perception on creativity education itself’, ‘developing the creativity classes combined with engineering subjects’ as fostering factors in creativity education. This studdy suggests several implications of educational approaches to creativity education in engineering colleges.

의과대학의 학습경험 중심 전문직업성 프로그램 운영 및 평가

유효현(Hyo Hyun Yoo),김영전(Young Jon Kim) 한국콘텐츠학회 2018 한국콘텐츠학회논문지 Vol.18 No.1

본 연구는 의과대학에서 학습자 주도의 학습경험중심의 전문직업성 프로그램을 개발하여 운영한 후 효과성과 사용성 평가를 통해 대학수준에서 학습경험 중심의 교육과정의 실제적 함의를 밝히고자 한다. 의과대학 1학년 74명의 학생들이 학생경험개발 모형에 기반하여 설계된 PDS1(Patient-Doctor-Society1): 전문직업성, 1주일 블록수업(총 30시간), 1학점 과목에 참여하였다. 학생들은 모두 6가지의 학습주제와 학습자원 및 지원도구를 제공받아 경험의 준비, 조직, 공유, 성찰, 평가로 구성된 학습활동 단계를 수행하였다. 교육의 효과성 평가는 24개 설문항목을 사전-사후 비교하였고, 사용성 평가는 학생대상의 만족도 설문 및 교수자 학생대상의 면담이 시행되었다. 전문직업성에 대한 학습자 자기평가 결과, 리더십과 자기 주도적 학습, 전문성에 대한 태도, 사회적 책무성 모두 학습 이전과 이후의 결과에 유의미한 차이가 확인되었다. 학생을 대상으로 하는 프로그램의 만족도는 항목별 3.58~3.78에 분포하였다. 교수자와 학습자 면담에서는 교육과정설계, 운영, 평가의 전 과정에서 실질적인 사용성을 확인하였다. 연구결과는 학습경험중심의 교육과정설계와 평가의 현장 적용 가능성에 대하여 실증적 타당성을 제시해주었다. 본 연구는 의과대학에서 학습자 주도의 학습경험 방식으로 전문직업성 교육프로그램을 개발하여 운영한 실증적 사례로써 함의가 있다. This study explores how to implement a learning experience-based professionalism program for a medical students and evaluates its program through effectiveness and usability test. This study aims to provide practical implications for experience-based learning in an undergraduate level. Seventy four first-year medical students enrolled in PDS1(Patient-Doctor-Society 1): professionalism, one-week block (30 hours), one-credit program based on a experience-based learning model. All of the students were given six learning themes and learning resources and supporting tools, and conducted stepwise learning activities; preparation, organization, sharing, reflection and evaluation of experiences. The effectiveness of learning was evaluated by comparing the pre and post results of student’s self-assessment on 24 questionnaire items about professionalism. After the course, the students and instructors conducted a usability evaluation of the program through questionnaires or group interviews. Learners’ self-assessment results of professionalism such as leadership, self-directed learning, professional attitude, and social accountability all showed significant differences between the pre- and post-test. Satisfaction of the program was distributed to 3.58~3.78 according to items. Instructors and learner interviews confirmed practical usability throughout the course design, implementation and students evaluation. The results of the study showed the feasibility of implementing learning experience-based professionalism program in medical school. This study provides practical implications to develope and evaluate the learning experience-based professionalism program in medical education.

진료수행 시험에서 채점자 및 시험 일자에 따른 결과 차이

권소희(So-Hee Kwon),김영전(Young-Jon Kim) 한국콘텐츠학회 2018 한국콘텐츠학회논문지 Vol.18 No.8

본 연구는 진료수행 시험 상황을 재연하여 실제 의사가 채점한 결과와 표준화 환자가 채점한 결과의 차이가 있는지, 첫째 날 응시한 학생과 정보가 노출된 둘째 날 응시한 학생의 점수 차이를 비교하고자 하였다. 의과대학 4학년 101명이 4가지 세트(본태성고혈압, 수면장애, 기분저하, 무월경)로 구성된 진료수행 시험에 응시하였다. 학생들은 첫째 날과 둘째 날 중 표준화환자 채점 세트와 의사 채점 세트로 구성된 평가 일정 하나에 무작위로 배정되었다. 각 진료수행의 평가지침은 병력청취, 신체진찰, 환자교육, 환자의사관계, 진찰태도로 영역을 구분하여 구성하였다. 각 상황별, 영역별 성취점수를 표준점수로 변환하여 집단 간 차이를 비교하였다. 모든 영역에서 여학생의 성취점수가 남학생의 성취보다 유의하게 높았다(P=.001). 표준화 환자가 채점한 집단과 의사가 채점한 집단의 평균의 유의한 차이는 없었다(p=.425). 연속되는 시험일자 중 둘째 날 응시한 군이 병력청취와 신체진찰영역에서 유의한 차이를 보였다. 본 연구에서는 채점자의 신분에 따른 평가 결과에 차이가 없음을 다시 한 번 밝히면서 표준화 환자를 활용한 평가의 가능성을 확인하였다. The purpose of this study is to clarify the difference between the scoring results by scorer(doctors and standardization patients) and examination dates. A total of 101 students in the fourth grade of medical school participated in four clinical practice test. Students were randomly assigned to either day-1 or day-2, which was consisted of a standardized patient scoring set or a physician scoring set. Station checklists consisted of history taking, physical examination, patient education, physician-patient relationship and clinical courtesy. The achievement scores of each case and each domain were converted to the standard score, and the differences between groups were compared. Female students achievement scores were significantly higher than male students achievement scores in all domains. There was no significant difference between means by the standardized patients group and doctors group. Day-2 group was significantly higher than day-1 group in both of history taking and physical examination domains. If the principles of checklist are clearly defined, the scorer status (either physician or standardized patients) does not determine the difference of students’ practice test scores.