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This review of the literature explored the experiences and effects of peer-assisted learning in basic medical education. Peer-assisted learning is most commonly utilized to teach clinical skills (including technical skills) and medical knowledge (76.4%). It has also been used, albeit less frequently, to facilitate small-group discussions including problem-based learning, to promote students’ personal and professional development, to provide mentoring for career development and adaptation to school, to give tutoring to at-risk students, and to implement work-based learning in clinical settings. Near-peer learning is a common type. The use of active learning techniques and digital technology has been increasingly reported. Students’ leadership had frequently been described. Student tutor training, programs for teaching skills, institutional support, and assessments have been conducted for effective peer-assisted learning. There is considerable positive evidence that peer-assisted learning is effective in teaching simple clinical skills and medical knowledge for tutees. However, its effects on complex skills and knowledge, small-group discussions, personal and professional development, peer mentoring, and work-based learning have rarely been studied. Additionally, little evidence exists regarding whether peer-assisted learning is effective for student tutors. Further research is needed to develop peer-assisted learning programs and to investigate their learning effects on student tutors, small-group discussion facilitation, personal and professional development, peer mentoring, and peer-led work-based learning in the clinical setting in South Korea. Formal programs and system advancement for a student-led learning culture is needed for effective peer-assisted learning.

Purpose: This study aimsed to gather opinions from medical educators on the possibility of introducing an interview to the Korean Medical Licensing Examination (KMLE) to assess professional attributes. Specifically following topics were dealt with: the appropriate timing and tool to assess unprofessional conduct; ; the possiblity of prevention of unprofessional conduct by introducing an interview to the KMLE; and the possibility of implementation of an interview to the KMLE.Methods: A cross-sectional study approach based on a survey questionnaire was adopted. We analyzed 104 pieces of news about doctors’ unprofessional conduct to determine the deficient professional attributes. We derived 24 items of unprofessional conduct and developed the questionnaire and surveyed 250 members of the Korean Society of Medical Education 2 times. Descriptive statistics, cross-tabulation analysis, and Fisher’s exact test were applied to the responses. The answers to the open-ended questions were analyzed using conventional content analysis.Results: In the survey, 49 members (19.6%) responded. Out of 49, 24 (49.5%) responded in the 2nd survey. To assess unprofessional conduct, there was no dominant timing among basic medical education (BME), KMLE, and continuing professional development (CPD). There was no overwhelming assessment tool among written examination, objective structured clinical examination, practice observation, and interview. Response rates of “impossible” (49.0%) and “possible” (42.9%) suggested an interview of the KMLE prevented unprofessional conduct. In terms of implementation, “impossible” (50.0%) was selected more often than “possible” (33.3%).Conclusion: Professional attributes should be assessed by various tools over the period from BME to CPD. Hence, it may be impossible to introduce an interview to assess professional attributes to the KMLE, and a system is needed such as self-regulation by the professional body rather than licensing examination.

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors’ roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

Background Medical education must adapt to different health care contexts, including digitalized health care systems and a digital generation of students in a hyper-connected world. The aims of this study are to identify and synthesize the values that medical educators need to implement in the curricula and to introduce representative educational programs. Methods An integrative review was conducted to combine data from various research designs. We searched for articles on PubMed, Scopus, Web of Science, and EBSCO ERIC between 2011 and 2017. Key search terms were “undergraduate medical education,” “future,” “twenty-first century,” “millennium,” “curriculum,” “teaching,” “learning,” and “assessment.” We screened and extracted them according to inclusion and exclusion criteria from titles and abstracts. All authors read the full texts and discussed them to reach a consensus about the themes and subthemes. Data appraisal was performed using a modified Hawker ‘s evaluation form. Results Among the 7616 abstracts initially identified, 28 full-text articles were selected to reflect medical education trends and suggest suitable educational programs. The integrative themes and subthemes of future medical education are as follows: 1) a humanistic approach to patient safety that involves encouraging humanistic doctors and facilitating collaboration; 2) early experience and longitudinal integration by early exposure to patient-oriented integration and longitudinal integrated clerkships; 3) going beyond hospitals toward society by responding to changing community needs and showing respect for diversity; and 4) student-driven learning with advanced technology through active learning with individualization, social interaction, and resource accessibility. Conclusions This review integrated the trends in undergraduate medical education in readiness for the anticipated changes in medical environments. The detailed programs introduced in this study could be useful for medical educators in the development of curricula. Further research is required to integrate the educational trends into graduate and continuing medical education, and to investigate the status or effects of innovative educational programs in each medical school or environment.

Purpose The aim of this study was to inquire about the clinical performance and determine the performance pattern of medical students in standardized patient (SP) based examinations of domestic violence (DV). Methods The clinical performance sores in DV station with SP of third-year (n=111, in 2014) and 4th-year (n=143, in 2016) medical students of five universities in the Busan-Gyeongnam Clinical Skills Examination Consortium were subjected in this study. The scenarios and checklists of DV cases were developed by the case development committee of the consortium. The students’ performance was compared with other stations encountered in SP. The items of the checklists were categorized to determine the performance pattern of students investigating DV into six domains: disclosure strategy (D), DV related history taking (H), checking the perpetrator’s psychosocial state (P), checking the victim’s condition (V), negotiating and persuading the interviewee (N), and providing information about DV (I). Results Medical students showed poorer performance in DV stations than in the other stations with SP in the same examination. Most students did confirm the perpetrator and commented on confidentiality but ignored the perpetrator’s state and patient’s physical and psychological condition. The students performed well in the domains of D, H, and I but performed poorly in domains P, V, and N. Conclusion Medical students showed poor clinical performance in the DV station. They performed an ‘event oriented interview’ rather than ‘patient centered’ communication. An integrated educational program of DV should be set to improve students’ clinical performance.

Purpose Standardized patients (SPs) tend to rate medical students' communication skills subjectively and comprehensively, in contrast to such objective skill set defined in the clinical performance examination (CPX). Meanwhile, medical school instructors have a different approach in their evaluation of students' communication skills. We aim to analyze medical students' verbal communication skills using objective methods, and to determine the contributing factors of a patient-physician interaction (PPI) score. Methods Students with high- and low-ranking scores for PPI in CPX were selected. The Roter interaction analysis system was used to compare verbal communication behaviors of the students and SPs. Patient-centeredness scores (PCSs), physician's verbal dominance, and number of utterances were compared between the two groups. Results PCSs and physician's verbal dominance had no difference between the groups. The number of utterances during the limited time of 5 minutes of CPX was higher for the high-ranking students. They tended to employ more paraphrase/check for understanding, and closed questions for psychosocial state and open questions for medical condition. The SPs interviewed by high-ranking students gave more medical information and requested for more services. Conclusion In the case of the routine checkup, smooth conversations with more frequent utterances were detected in the high-ranking students. More medical information exchange and requests for services by SPs were higher for the high-ranking students. Medical communication instructors should keep in mind that our results could be indicators of a high PPI score.

Background Reports about longitudinal integrated clerkship (LIC) mostly deal with rural-based LICs. Clinical clerkships usually take place in urban academic medical center (AMC). We need to explore how to implement LIC in urban AMC. Authors reviewed the existing literature focused on urban-based LIC (uLIC) to explore the features and challenges uLIC. 'Method Authors adopted the scoping review framework. Research questions were: (1) What are the characteristics of uLIC studies? (2) How did medical schools implement uLICs? (3) What were the challenges when implementing uLICs? and (4) What gaps exist in uLIC research? Authors reviewed 495 studies from an initial electric database search and selected 27 articles for inclusion, and extracted relevant data and organized the demographic information and details of the uLICs for each of medical school. Authors conducted a thematic analysis on the challenges of uLIC. Results Twenty-five papers were published in the United States. Urban-based LICs were evaluated by participants’ responses (n=13) and students’ learning outcome (n=10). One paper discussed obstacles of uLIC implementation. Fourteen papers were reported by two medical schools (Harvard Medical School, University of California San Francisco College of Medicine). The two medical schools reported student selection methods and six medical schools reported student assessment methods. Challenges related to LICs included preceptors' burden about LIC education, students’ concern about academic achievement, students’ inability to adapt to LICs, shortage of educational resources of AMC, and lack of understanding about LICs. Conclusion Research is needed to understand the long-term outcomes of uLICs and strategies to overcome challenges. Medical schools should prepare student support systems and faculty development programs to facilitate successful implementation of uLICs. Medical schools’ and hospitals’ resources and funding should be taken into careful consideration prior to implementing uLICs.

Purpose High self-awareness can promote communication and empathy. The Enneagram is a well-known personality tool to enhance self-awareness. We evaluated differences in empathy among medical students using the Enneagram typology. Methods This cross-sectional study included first and second grade students at the Inje University College of Medicine. The Jefferson Scale of Empathy was used to measure empathy and the Korean Enneagram Personality Type Indicator was used for examining personality characteristics. Empathy scores were analyzed according to the Triads, Hornevian group, Harmonic group, and each Enneagram type. Results The Instinctive triad, the Withdrawns, and the Positive outlook group were the most common, and the Feeling triad, the Assertives, and the Emotional realness group were the least common. Students in the Feeling triad and the Dutifuls had higher compassionate care (CC) scores as compared to their counterparts. Type 2 and 6 students showed the two highest empathy and CC scores. The empathy score of type 3 students was the lowest. Type 7 had the lowest CC score but the highest perspective taking score. Conclusion These differences in empathy according to Enneagram personality types can be applied to medical education to maintain and improve medical students' empathy.

The aim of this study is to provide the background of developing guides to clinical performance and basic clinical skills and to introduce how to teach and learn using the guide. The students’ performance problems presented in an objective clinical skills examination were disease-centered tertiary hospital clinical care, incomplete performance, doing by rote, and an exam-oriented learning attitude. The problems were caused by a tertiary hospital-based educational environment as well as schools and faculty who are unfamiliar with the concept of patient-centered care. The purpose of the guide to clinical performance and basic clinical skills is to overcome these problems and address the causes. The guides show a clinical presentation approach to primary care; clinical care integrated with knowledge, skills, and attitude; a schematic approach; and a patient-centered attitude. To achieve these goals, a strategy to change the educational culture is important. Curricular reform, faculty development, and improving educational facilities and environments are suggested.

Purpose The quality of problem representation is critical for developing students' problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students' experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. Methods A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. Results The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. Conclusion SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.

The purpose of this report was to describe our experience in planning and developing a portfolio for a clinical clerkship curriculum. We have developed a portfolio for assessing student competency since 2007. During an annual workshop on clinical clerkship curricula, clerkship directors from five Paik hospitals of Inje University met to improve the assessment of the portfolio. We generated templates for students to record their activities and reflection and receive feedback. We uploaded these templates to our school's website for students to download freely. Annually, we have held a faculty development seminar and a workshop for portfolio assessment and feedback. Also, we established an orientation program on how to construct a learning portfolio for students. Future actions include creating a ubiquitous portfolio system, extending the portfolio to the entire curriculum, setting up an advisor system, and managing the quality of the portfolio. This study could be helpful for medical schools that plan to improve their portfolio assessment with an outcome-based approach.

Objectives To examine the relationship between stress, social support, and empathy among medical students. Methods We evaluated the relationships between stress and empathy, and social support and empathy among medical students. The respondents completed a question-naire including demographic information, the Jefferson Scale of Empathy, the Perceived Stress Scale, and the Multidimensional Scale of Perceived Social Support. Corre-lation and linear regression analyses were conducted, along with sub-analyses according to gender, admission system, and study year. Results In total, 2,692 questionnaires were analysed. Empathy and social support positively correlated, and empathy and stress negatively correlated. Similar correla-tion patterns were detected in the sub-analyses; the correla-tion between empathy and stress among female students was negligible. In the regression model, stress and social support predicted empathy among all the samples. In the sub-analysis, stress was not a significant predictor among female and first-year students. Conclusions Stress and social support were significant predictors of empathy among all the students. Medical educators should provide means to foster resilience against stress or stress alleviation, and to ameliorate social support, so as to increase or maintain empathy in the long term. Furthermore, stress management should be emphasised, particularly among female and first-year students.

The purpose of this study is to investigate domestic and international research trends in studies of medical students’ characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.

Objective Despite the growing emphasis on patient safety and the need for patient safety education, few schools have included this subject in their curriculum. Medical students need to understand and demonstrate appropriate patient safety skills early and continuously in their professional education. Therefore, we introduced a week of patient safety curriculum as a pilot program and attempted to describe and evaluate the effectiveness of a patient safety curriculum for second-year medical students. Design, Setting, Participants A 1-week patient safety course was developed and taught to all second-year medical students as part of an existing patient–doctor society course. The curriculum was composed of interactive lecture, discussion, and small-group debriefing facilitated by a tutor dealing with topics about patient safety. Students were asked to complete questionnaires on awareness about patient safety before and after the curriculum. Results The comparison of questionnaire data obtained before and after the curriculum revealed that the students' awareness about patient safety was significantly increased. Among them, awareness of the frequency of medical errors made by physicians and the awareness of the adverse outcomes due to medical errors were remarkably changed. Conclusions These findings suggest that a patient safety course could increase the medical students' awareness of patient safety and the reality of medical errors. Continued development and implementation of patient safety curriculum will make medical students, as future doctors and health-care leaders, prepared to better practice and offer safer health care services than ever.

PURPOSE The aims of this study were to define the necessity and effectiveness of patient safety education during surgical clerkship to develop competency for managing and preventing medical errors. METHODS Fifty 3rd-year students participated in the patient safety education program during a 4-week surgical clerkship. The students were divided into 4 groups: control group, pretest-only group, education-only group, and pretest and education group. Students were assessed using short essays and an oral exam for reasoning skills, clinical performance exams for patient education and communication skills, and multisource feedback and direct observation of error reporting for real-world problem-solving skills. The results were analyzed with SPSS 14.0K. The reliability (Cronbach alpha) of the entire assessment was 0.893. RESULTS There was no difference in scores between early and late clerkship groups. Reasoning skills were improved by the pretest. Reasoning, patient education, and error reporting skills were much more developed by patient safety education. Real-world error identification, reporting, and communication did not change after the 4-week course. CONCLUSIONS Patient safety education during surgical clerkship is necessary and effective. Error prevention and competency management in the real world should developed.

T his study is aimed to reflect non-cognitive traits that should be assessed in admissions interviews for medical school applicants, with the goal being to increase the reliability of the admissions interview. The admissions interview is valued for its ability to assess noncognitive and nonteachable attributes of good doctors, especially which cannot be evaluated with other admission assessment tools. Various characteristics of applicants including age, gender, exam scores, and nonverbal communication were found to have influenced the interview results. Bias from interviewers was a significant factor in the results of the interview. A Structured interview in multiple stations such as the Multiple Mini-Interview showed the highest reliability and validity. To make the interview fair, no information about the applicants was provided to the interviewers and interviewers were recruited from different backgrounds. There have been few research papers on admission interviews in Korea. Active research on the qualities of good doctors and effective and reliable admission interview methods should be encouraged. A strategy should be developed to overcome the philosophical obstacles that medical school professors want to admit academically excellent applicants.

Purpose: The purpose of this study is to evaluate the changing pattern of communication skills of medical students according to length and methods of training. Methods: We evaluated a 1-week communications training course in 2003, a 1-year course in 2004, and a 1-semester course in 2005 during development of our curriculum. We have conducted the 10-minute CPX on abdominal pain annually since 2002 to assess the clinical performance of medical students who have completed the 3rd year clerkship. We selected CPX videos that were appropriate for assessment. One hundred sixty-four videos were available (1-week didactics: 42 cases, 1-week training: 28 cases, 1-semester training: 50 cases, 1-year training: 44 cases). We developed a 10-item global rating checklist to assess communication skills. A 5-point Likert scale was used to evaluate each item (4-very likely, 0-least likely). Two expert standardized patient (SP) raters evaluated the communication skills of students independently. We analyzed the outcomes based on the training length and methods. The reliability (G coefficient) was 0.825 with 2 SPs and 1 station. Results: The communication skills of students improved with practice and longer training, especially with regard to opening the interview, expressing empathy, understanding the patient's perspective, and preparing for the physical examination. Rapport-building, organization of the interview, understandable explanation, nonverbal communication, active listening and consideration during the physical examination was unchanged between durations of training. The scores for empathetic expression, active listening and understanding the patient's perspective were low across all groups. Conclusion: We should concentrate our efforts to improve students' skills in empathetic expression, active listening and understanding the patient's perspective.

The aim of this report was to discuss the development and content of a guide on clinical performance and basic clinical skills for medical students. We published the first edition of this guide in 2010 and will publish the second edition in 2016. Initially, we took a survey on important clinical presentations and fundamental clinical and technical skills in 41 medical schools in Korea. Ultimately, we chose 80 core clinical presentations and 56 clinical skills. In the guide to basic clinical skills, we described the physical examination and technical skills according to the preprocedural preparation, procedure, and postprocedural process. In the guide on clinical performance, we reviewed patient encounters-from history taking and the physical examination to patient education. We included communication skills, principles of patient safety, and clinical reasoning schemes into the guides. In total, 43 academic faculty members helped develop the basic clinical skills guide, 75 participated in establishing the clinical performance guide, and 16 advisors from 14 medical specialty societies contributed to the guide. These guides can help medical students approach patients holistically and safely.

PURPOSE Identifying patients' agendas is important; however, the extent of Korean medical students' agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students' agenda solicitation. METHODS A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients' reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient's initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined. RESULTS The medical students did not explore the patients' concerns and did not negotiate an agenda. Interruption of the patient's opening statement occurred in 4.62±2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions. CONCLUSION Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students' ability to set an agenda.

Background Understanding the basic qualities of communication between emergency physicians and patients could improve communication in the emergency department. Objective The objectives of this scoping review are to map the literature about the gaps in communication between emergency physicians and patients in the emergency department and make recommendations for further research. Methods A scoping review of literature published since 1980 and written in English was undertaken using the following databases: Pubmed, Scopus, and SocINDEX. The articles were searched for using two-keyword combinations of the following keywords joined by “AND”: “communication,” “patient,” “emergency physician,” “emergency department/emergency room/accident,” and “emergency room.” Seventeen articles were included in the final review. Results Five research issues were covered by the 17 papers: patient-centered communication, information sharing, bad news delivery, shared decision making, and physicians' perspectives on communication. Emergency physicians have several communication characteristics: doctor-driven decision making, focusing on efficient information gathering, immature communication techniques, and obstacles to overcoming miscommunication. Patients also have several communication characteristics: active participation in medical encounters, expectation of physician as a reliable guide, understanding physicians' difficulties, and factors that contribute to understanding. Conclusions Several conclusions about emergency department communication between patients and emergency physicians were drawn. Additional research is required to consider diverse patient needs in the emergency department. Furthermore, training programs for emergency physicians to improve the quality of communication should be developed and implemented in line with our research findings.

Aims: This study examined changes in the perceptions and attitudes as well as the sense of individual and collective responsibility in medical students after they received patient safety education. Method: A three-day patient safety curriculum was implemented for third-year medical students shortly before entering their clerkship. Before and after training, we administered a questionnaire, which was analysed quantitatively. Additionally, we asked students to answer questions about their expected behaviours in response to two case vignettes. Their answers were analysed qualitatively. Results: There was improvement in students’ concepts of patient safety after training. Before training, they showed good comprehension of the inevitability of error, but most students blamed individuals for errors and expressed a strong sense of individual responsibility. After training, students increasingly attributed errors to system dysfunction and reported more selfconfidence in speaking up about colleagues’ errors. However, due to the hierarchical culture, students still described difficulties communicating with senior doctors. Conclusions: Patient safety education effectively shifted students’ attitudes towards systems-based thinking and increased their sense of collective responsibility. Strategies for improving superior-subordinate communication within a hierarchical culture should be added to the patient safety curriculum.

Previous studies on empathy in Korean medical students were conducted on small populations or with different scales of measurement, resulting in low representativeness and generalisability of the findings.To evaluate empathy in Korean medical students throughout the country and to make suggestions to improve empathy.The Jefferson Scale of Empathy (JSE) (Korean) was used, and the impact of sex, age, the medical school admission system, and grade of the respondents was investigated.We analyzed 5343 questionnaires and found a mean empathy score of 105.9 ± 12.8. Females and post-baccalaureate students had higher scores as compared with their counterparts. There was a significant difference between the admission systems after controlling for gender. Students from higher grade levels had lower scores than those from the lower grade levels.The JSE score of Korean medical students was lower than that of students in Western countries. The difference of gender and medical school admission system should be considered, and capability to apply empathy to clinical practice should be focused upon in medical training.

PURPOSE The purpose of this study was to explore the relationships among medical students' assessments on peers' group presentations, instructors' assessments of those presentations, and students' educational achievements in other assignments and tests. METHODS A total of 101 first-year students from a medical school participated in the study. The students' educational achievements in a 4-week long integrated curriculum were analyzed. Student's final grades were comprised of the following education criteria: two written tests (60%), 15 group reports (25%), one individual report (7%), and four group presentations (15%). We compared scores of the group presentation assessed by the peers and the two instructors. Furthermore, we compared peers' assessment scores with each component of the evaluation criteria. RESULTS Pearson correlation analysis showed significant correlaton for the assessments between peers and instructors (r=0.775, p

Purpose The aim of the study was to introduce our experience of establish task-based learning outcomes for core clinical clerkships. Methods We first define our educational goal and objectives of the clinical clerkship curriculum according to knowledge, cognitive function and skill, and attitude. We selected clinical presentations and related diseases with expert panels and allocated them to core clinical departments. We classified doctor's tasks into 6 categories: history taking, physical examination, diagnostic plan, therapeutic plan, acute and emergent management, and prevention and patient education. We described learning outcomes by task using behavioral terms. Results We established goals and objectives for students to achieve clinical competency on a primary care level. We selected 75 clinical presentations and described 377 learning outcomes. Conclusion Our process can benefit medical schools that offer outcome-based medical education, especially for clinical clerkships. To drive effective clerkships, a supportive system including assessment and faculty development should be implemented.

Purpose: Selecting medical students through interviews seems difficult and the reliability of the results is one of the major concerns. The purpose of this study was to investigate the reliability and acceptability of the Multiple Mini-Interview (MMI) in selecting medical students of Kangwon National University. Methods: Eighty-four applicants participated in the MMI which consists of 3 8-minute stations that have 9 checklist items and 3 global items. The 3 domains that we chose were motivation to become a doctor, communication and interpersonal skills, and ethical decision-making. We placed 2 interviewers in each room. The interviewers were chosen from our faculty. We analyzed the reliability of the MMI with urGENOVA for PC. We conducted a survey of these applicants and interviewers. Results: The reliability was 0.791. Students answered that the interview was impressive and enjoyable. Students were also satisfied with the level and quality of the MMI cases. They described that they were evaluated objectively. Interviewers also responded positively. They stated that more stations and more efforts to develop the cases were needed to improve the reliability and validity. Conclusion: The MMI was acceptable to our applicants and faculty. It is reliable for assessing medical school applicants in Korea. We should develop more stations and better cases to increase the reliability and validity of the MMI.

Purpose: Despite recommendations for introducing student internships (SI) in undergraduate medical education in Korea, the feasibility of surgical SIs has not been demonstrated in the Korean context. We thus identified tasks that could be performed by surgical student interns in a Korean education hospital. Methods: The opinions of surgery clerkship directors of medical schools nationwide, regarding the tasks, symptoms and signs, disease entities, and procedures that student interns could perform in their hospitals, were subjected to descriptive analysis. Results: Out of the 41 medical schools in Korea, 32 responded. Five implemented an optimal-quality SI program. Two schools considered third-year clerkship as SI. The respondents replied that student interns could be involved in basic nonspecific tasks such as history taking, physical examination, medial recording, reporting patients’ status, and assisting during surgery. However, more surgery-specific tasks such as perioperative management or caring for a patient with acute abdominal pain were considered difficult for student interns to encounter in the Korean context. Conclusion: Surgical educators should determine a specific role for student interns and encourage them to perform surgery-specific tasks. We recommend societal and system support, and curriculum renovation to establish an SI program in Korea.

Purpose: This study was performed to evaluate the usefulness of abdominal computed tomography (CT) for patients with right lower quadrant (RLQ) pain. Methods: Between January 2006 and July 2008, 191 consecutive patients with RLQ pain underwent abdominal CT (CT group). Forty-two patients who had undergone abdominal ultrasound (US group) and 52 patients without abdominal CT or abdominal ultrasound for RLQ pain (clinical Dx group) underwent emergent operations. Using the Alvarado scoring system, we scored all patients. The abdominal CT was performed in the abdominal and pelvic area with contrast. Results: One hundred twenty-one (63.4%) of the 191 patients in the CT group were preoperatively diagnosed as having acute appendicitis and underwent surgery. There were three cases of negative appendectomy (1.6%). In the US group and the clinical Dx group, the negative appendectomy rates were 4.8% and 3.8%, respectively. The sensitivity of the abdominal CT was 96.7%. In the CT group, in addition to acute appendicitis, colitis, nonspecific enteritis, diverticulitis, urinary stone, ovary, uterine, and diseases were indentified. Conclusions: In this study, abdominal CT scans in patients with RLQ pain were useful for the diagnosis acute appendicitis and for the differential diagnosis of other diseases presenting with RLQ pain. The false positive rate was significantly lower in the CT group than in the other groups.