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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.

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.

BACKGROUND For medical education, studies about competency often explore the acquisition, performance, and evaluation of particular skills, knowledge, or behaviors that constitute physicians’ competency according to specific in role. Therefore, a more macroscopic analysis method is required to analyze the core competencies of doctors in society in this era. OBJECTIVE The purpose of this study is to analyze the research trends related to physician competency to reflect the social needs according to changes in the medical environment. METHODS The authors used topic modeling to identify potential research topics by analyzing data from research related to physician competency published between 2011 and 2020. The authors pre-processed 1,354 articles and extracted 272 keywords. RESULTS The terms that appeared most frequently in research related to physician competency since 2010 were, in order, “knowledge,” “hospital,” “family,” “job,” “guideline,” “management,” and “communication.” The terms that appeared in most studies were “education,” “model,” “knowledge,” and “hospital.” Topic modeling revealed that the main topics about physician competency included “Evidence-based clinical practice,” “Community-based healthcare,” “Patient care,” “Career and self-management,” “Continuous professional development,” and “Communication and cooperation.” We divided the studies into four periods (2011–2013; 2014–2016; 2017–2019; and 2020–2021) and performed a linear regression analysis. The result showed the change in topics by period. The “hot topics,” which show increased interest among scholars over time, included “Community-based healthcare,” “Career and self-management,” and “Continuous professional development.” CONCLUSIONS Based on the analysis of research trends, it is forecasted that physicians’ professionalism and community-based medicine will continue to be studied in future research on physician competency.

The purpose of this study is to discuss the main principles and concepts of social constructivism, examine the literature on the application of social constructivism in medical education, and explore the meaning and limitations of the utilization of social constructivism with learning theory. A literature search was carried out in two stages, utilizing PubMed, CINAHL and Education Source databases. The first search included both fields (social constructivism AND medical education), while the second search was performed by subject (Vygotsky or ZPD or zone of proximal development or scaffolding AND medical education). A total of 96 papers were found through the first and second searches, and after reviewing the abstracts of all 96 papers, 41 papers were deemed suitable for research purposes. In medical education, social constructivism is applied in areas such as (1) social and cultural behaviors (hidden curriculum), (2) social construct of “meaning” (dialogue and discourse), (3) learner’s identity transformation (expert), and (4) instructional intervention (ZPD and scaffolding). Social constructivism has provided many ideas to explore in terms of the composition of knowledge in the sociocultural context of health care, but it has not demonstrated an explicit instructional method or educational effects.

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.

ObjectiveHeterogeneous nuclear ribonucleoprotein A1 (HNRNPA1), serine/arginine-rich splicing factor 1 (SRSF1), and SRSF3 are splicing regulators associated with oncogenesis. However, the alterations of SF proteins and their diagnostic values in cervical cancer are unclear. To apply SFs clinically, effective marker selection and characterization of the target organ properties are essential.Materials and MethodsWe concurrently analyzed HNRNPA1, SRSF1, SRSF3, and the conventional tumor markers squamous cell carcinoma antigen (SCCA) and carcinoembryonic antigen (CEA) in cervical tissue samples (n = 127) using semiquantitative immunoblotting. In addition, we compared them with p16 (cyclin-dependent kinase inhibitor 2A [CDKN2A]), which has shown high diagnostic efficacy in immunohistochemical staining studies and has been proposed as a candidate protein for point-of-care screening biochemical tests of cervical neoplasia.ResultsHNRNPA1, higher molecular weight forms of SRSF1 (SRSF1-HMws), SRSF3, CEA, and p16 levels were higher (P < 0.05) in cervical carcinoma tissue samples than in nontumoral cervical tissue samples. However, the levels of SRSF1-Total (sum of SRSF1-HMws and a lower molecular weight form of SRSF1) and SCCA, a commonly used cervical tumor marker, were not different between carcinoma and nontumoral tissue samples. In paired sample comparisons, HNRNPA1 (94%) showed the highest incidence of up-regulation (carcinoma/nontumor, >1.5) in cervical carcinoma, followed by p16 (84%), SRSF1-HMws (69%), SRSF3 (66%), CEA (66 %), SCCA (32%), and SRSF1-Total (31%). HNRNPA1 (92%) and p16 (91%) presented the two highest diagnostic accuracies for cervical carcinoma, which were superior to those of SRSF3 (75%), SRSF1-HMws (72%), CEA (72%), SCCA (59%), and SRSF1-Total (55%).ConclusionsOur results identified that HNRNPA1 is the best diagnostic marker among the SFs and conventional markers given its excellent diagnostic efficacy for cervical carcinoma, and it has a p16-comparable diagnostic value. We suggest that HNRNPA1 is an additional effective target protein for developing cervical cancer detection tools.

PURPOSE This study analyzed the learning characteristics of primary care physicians that are necessary to develop proper educational support systems in continuing medical education. METHODS The research participants were 15 physicians with an average of 8 years of experience in primary care clinics. The data were collected through in-person interviews with each participant and analyzed by keyword coding, expert review, and content elaboration. RESULTS The learning styles of primary care physicians were classified as "reactive," "organized," and "exploratory," according to their problem-solving approaches in clinics. The types of learning interaction were "unilateral acquisition," "mutual exchange," and "organization participation." The primary motives of learning in clinics were the primary care physicians' recognition of accountability and the intrinsic enjoyment of learning itself. CONCLUSION For continuous professional development--i.e., the self-directed learning of primary care physicians with problem-solving approaches--learning interactions in professional communities should be considered in continuing educational support systems.

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.

본 연구의 목적은 건강한 한국 성인을 대상으로 손쉽게 측정 가능한 지표인 TG/HDL콜레스테롤 비에 영향을 주는 영양소 섭취 및 일반적 요소를 파악하고, 이 비와 대사증후군과의 연관성을 통해 대사증후군을 미리 예측하기 위함이다. 본 연구는 2016년도 국민건강영양조사에 참여한 건강한 성인 2,828명을 대상으로 건강 설문조사, 식이섭취 현황과 검진조사를 활용하여 TG/HDL콜레스테롤 비와 대사증후군 유무, 영양소 섭취와의 상관성을 알아보았다. 연구결과 TG/HDL콜레스테롤 비와 연관성이 있는 일반적 지표는 나이, 성별, 흡연, 음주 횟수, 혈압, 공복 시 혈당, 당화혈색소, 총콜레스테롤, 고밀도지단백콜레스테롤, 중성지방, 저밀도지단백콜레스테롤, 허리둘레, BMI, 고민감도 CRP, 요산, 크레아티닌, 요산/크레아티닌 비였다. 관련 요인을 보정한 후 분석한 결과 대사증후군 유무와 TG/HDL 콜레스테롤 비는 양의 상관관계를 보였고, 대사증후군 구성요소 중 공복 시 혈당, 중성지방, 고밀도지단백콜레스테롤이 이 비와 양의 상관성을 보였다. 영양소 섭취에서는 에너지와 당질 섭취량이 TG/HDL콜레스테롤 비와 연관성을 보였다. 특히 에너지 섭취량을 줄이는 것이 TG/HDL콜레스테롤 비를 낮추고 대사증후군의 위험성을 낮출 수 있음을 알 수 있다. 연구결과를 볼 때 TG/HDL콜레스테롤비가 높은 일반인을 대상으로 하는 대사관련 영양 교육 및 보건 교육 관련 구체적인 프로그램의 실행이 필요함을 알 수 있다.

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 competencybased 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.

Purpose: This study aimed to explore the relationship between students` seating preferences and academic achievement in medical school. Methods: The subjects of this study were 109 second-year students in C medical school. The pattern of seat selection of 109 students was surveyed by participant observation for 48 days, and a questionnaire was administered to determine the factors that were considered by students. Using SPSS version 12.0, we analyzed the factors that students considered with regard to seat selection and seat preference and the frequency of seat movements between areas. We performed one-way ANOVA to analyze the differences in academic achievement between students who moved seats versus those who did not. Results: The most common reasons for seat selection were to focus better on the lecture (60 students), to focus better on lecture, and to feel familiar with the same seat (60 students). Students` preferred seats were in rows A4, A7, A5, and A3 (in descending order), which are primarily the central sections, and columns B15, B1, B14, B19 (in descending order), which are primarily both ends of the division. The difference in academic achievement between students who moved seats and those who did not was not significant (p>0.05). Among students who did not move seats, the difference in academic achievement between 9 seating areas was not significant in 6 subjects (p>0.05). Conclusion: The results of this study suggest that we should reconsider a professor`s general perception regarding academic achievement according to seat location.

PURPOSE Simple instructional systems design (ISD) model is based on a fast development, usability test, and continuos feedback, which are necessary for educational program development in medical school. This study aims to figure out the usability of Simple ISD model for a medical ethics education program by describing a developmental details of each phase and its evaluation results. METHODS Research has been conducted in two steps. First, while researchers participated in the program development by using Simple ISD model, we collected empirical data of each development activities. Second, the developed program was evaluated by students' web-based usability test, a 8-students' focus group interview and 5 faculty members' individual interviews in 4 domains; learning contents, instructional methods and strategies, achievement evaluation, and self-evaluation. RESULTS Following the circular process of analysis, design, development, and usability test of Simple ISD model, a 10-week medical ethics program covering 9 instructional topics was developed. The average points of response on the developed medical ethics program in 2008 and 2009 are increased from 3.96 to 4.59 and 4.41, respectively. The prospects and limitations of the program are discussed. CONCLUSION From a development study of the medical ethics program by using Simple ISD model, we could implement a more usable medical ethics program, and found 4 different usability of the Simple ISD model; the rapid development of educational program, program improvement by continuous feedback, faculty members' engagement in instructional design, and professional development of the faculty members.

PURPOSE To examine how pediatricians in private practices are affected by the process of training medical students in their clinics as part of a community-based clerkship program. MATERIALS AND METHODS In 2007, a questionnaire was sent to 35 pediatricians who had provided private clinical settings for clerkship training for the previous 3 years. The questionnaire covered a number of points, including the pediatricians' motivation to join and/or reasons to quit the program; if there were changes seen in their stress levels while supervising students; changes in their treatment procedures or attitudes because of the students' presence; responses of patients and/or their guardians in regard to have medical students treating them, and whether the doctors were inspired to grow professionally by participating in the program. RESULTS Of the 35 pediatricians, 31 (88.5%) responded. Eighteen respondents (58%) selected 'responsibility to cooperate with medical school' as a reason to participate. Fifteen physicians (48.3%) answered that the clerkship program had a positive impact on their treatment procedures and their attitude towards patients. CONCLUSION Based on the pediatricians' responses, the community-based clerkship program may instill intellectual inspiration and promote professional growth among the pediatricians in private practices, resulting in potentially better treatment for patients.