Analyzing the characteristics of mission statements in Korean medical schools based on the Korean Doctor’s Role framework

Article information

Korean J Med Educ. 2024;36(1):99-104

Publication date (electronic) : 2024 February 28

doi : https://doi.org/10.3946/kjme.2024.287

Ye Ji Kang¹, Soomin Lee², Hyo Jeong Lee¹, Do-Hwan Kim^,1

¹Department of Medical Education, Hanyang University College of Medicine, Seoul, Korea

²Hanyang University College of Medicine, Seoul, Korea

Corresponding Author: Do-Hwan Kim (https://orcid.org/0000-0003-4137-7130) Department of Medical Education, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea Tel: +82.2.2220.0693 Fax: +82.2.2220.0694 email: mededkimdh@hanyang.ac.kr

Received 2023 October 11; Revised 2023 December 8; Accepted 2024 January 3.

Abstract

Introduction

An institution’s mission is to declare its purpose, identity, priorities, and direction of its existence [1]. Universities employ mission statements (MSs) to chart their courses, establish benchmarks for student admission and guide curriculum development. Similarly, medical schools utilize MSs to define their educational philosophy, goals, and learning outcomes, thereby shaping student education [2]. Furthermore, these statements may also reflect the complex web of relationships that medical schools maintain with stakeholders, such as clinical enterprises, faculty, students, healthcare professionals, patients, and families [2].

In Korea, the creation of MSs in medical schools is a relatively recent phenomenon. The catalyst for this transformation has been the accreditation system, specifically the Korean Institute of Medical Education and Evaluation (KIMEE), which certifies and evaluates medical schools [3]. The 2019 Accreditation Standards of KIMEE (ASK2019), aligned with the World Federation for Medical Education’s Basic Medical Education (BME) Standards 2015, underline the need for institutions to establish a mission rooted in their founding principles, incorporating feedback from a diverse range of stakeholders [3].

Accreditation is a valuable opportunity and resource for enhancing medical education, as it encourages the creation of a mission and helps define the identity and educational direction of the university [4]. According to ASK2019, the MS should serve as the foundation for setting outcomes for graduates, and it is recommended to align it with the national physician competency framework. The MS should indicate the kinds of experts the medical school wants to cultivate through education, and it is expected to align with graduate outcomes [2]. In Korea, the Korean Doctor’s Role (KDR) framework, developed by the Korean Medical Association, stands as the representative competency framework, emphasizing doctors’ societal roles in modern healthcare. The framework consists of five domains and eleven competencies. Each domain includes “patient care,” “communication and collaboration,” “social accountability,” “professionalism,” and “education and research.” KDR was first published in 2014 and was revised once to the 2022 version to reflect advances in medicine and changes in the health care environment [5].

Previous studies have investigated MSs in medical schools by coding, categorizing, and identifying their relationships [4,6]. According to a specific study, the features of MSs in U.S. medical schools were categorized into “traditional” and “emerging” themes, with the research outcome highlighting the dominance of “traditional” themes, particularly focusing on “education” and “research” [6]. While there is active research on MSs abroad, investigating or documenting such characteristics in the context of mission establishment is lacking in Korea due to its relatively short history in mission setting. Given this situation, we evaluated the collective attributes of MSs in all Korean medical schools using the KDR framework, aiming to examine the alignment between MSs and the KDR domains.

Methods

Results

1. Characteristics of medical schools and their MSs

Table 1 presents the status of the analyzed Korean medical schools. There were 30 private medical schools (75.0%), and 27 medical schools located in non-metropolitan areas (67.5%). The current MSs were written between 2015 and 2021, with approximately 83.9% of medical schools reorganizing or revising their MSs after 2018. On average, the missions had a length of 79 characters and included 21.2 concept words.

Table 1.

Descriptive Statistics

2. KDR domain and competency frequencies with representative concepts in the MSs

Table 2 shows concept words frequencies in the MSs categorized into KDR domains with representative concepts. At the KDR domain level, “social accountability” (n=39) was the most frequent domain of medical school MSs, and “professionalism” had the lowest frequency (n=8). Similarly, for the KDR competency level, “involvement in public and global health initiatives” (3.1, n=36) was the most frequent, while there was no competency for “self-regulation based on professional leadership” (4.2) or “professionalism and self-management” (4.3). On average, the medical school’s mission included 2.88 domains (standard deviation [SD]=1.24; range, 0–5) and 3.3 competencies (SD=1.64; range, 0–7).

Table 2.

Frequency and Representative Concepts of Korea Doctors’ Role Domain and Competency in the Mission Statements

The number of concept words in each domain matched the frequency order. In domain 3, “social accountability” (n=92) was the highest, “society” (n=33) and “humanity” (n=28) appeared the most. On the other hand, the number of concept words included in “professionalism” was the smallest at 15.

Table 3 presents results from an inductive analysis of semantic units not assigned to the KDR domains or competencies during the deductive analysis. Many medical schools specified the founding or religion (Buddhist spirit or Catholic spirit) as a mission and provided the reason for the existence of the institution as “an institution that nurtures doctors.” The specific characteristics of the doctors to be trained were “doctors who volunteer and sacrifice” and “doctors with good attitudes.”

Table 3.

Analysis of Phrases Not Assigned to Korea Doctors’ Role Domains or Competencies

Discussion

This study aimed to analyze the characteristics of medical school MSs by matching them with the KDR framework. The conclusions of this study are summarized as follows.

First, the MSs exhibited a generally homogeneous pattern across all schools. The deductive analysis of the KDR divided the competencies into two groups: those commonly present (e.g., 3.1), and those infrequently found (e.g., 4.2 and 4.3) in medical schools. Also, the top 25 concept words (10%) accounted for approximately 50% (406 times) of the total frequency, confirming the homogeneity of MSs. This phenomenon may result from medical schools using similar vocabulary in a domain, possibly influenced by accreditation criteria such as ASK2019 standards, motivating nearly 84% of Korean medical schools to establish or revise their MSs between 2018 and 2021. This suggests that external factors, such as Korean medical education accreditation, may have motivated the establishment or revision of MSs in these schools.

Second, Korean medical schools’ MSs relatively undervalued the “communication and collaboration” and “professionalism” domains. Ironically, professionalism has been identified as an underdeveloped competency in the country’s medical profession [8]. A recent study found both the public and healthcare workers recognize the importance of communication with patients and families and ethical medical practice, yet dissatisfaction remains in these areas [9]. Notably, interpersonal skills, communication, teamwork, and professionalism tend to have the most significant self-other assessment discrepancies. In conclusion, the underemphasis of these domains may result in an insufficient recognition of deficiencies within the Korean medical field concerning societal demands.

Third, the MSs predominantly highlight the “traditional” roles of academic medicine, represented by “education,” “research,” and “service.” These roles are also explicitly outlined in the KDR (Domain 5. Education and research) or indirectly implied through domains closely associated with “service” (Domain 1. Patient care, Domain 3. Social accountability) [10]. Nevertheless, Valsangkar et al. [6] analyzed the MSs of 170 US medical schools and discovered emerging themes that go beyond the traditional focus, addressing the emerging healthcare agenda. These include “primary care,” “diversity,” “prevention,” “distribution ,” and “cost control.” Among these, however, only “diversity” was found to be included in the MS of three Korean medical schools.

The study has several important implications. First, MSs should review and emphasize missing elements. Omissions may imply a lack of awareness or commitment, even though inclusion does not guarantee visible performance [6]. MSs in Korean medical schools should precisely articulate themes like “service and sacrifice,” “good character,” and “excellent capability” to prevent confusion or misinterpretation. These themes might imply KDR framework domains; however, it is crucial to use clearer terms for effective communication. Second, medical schools must establish an MS reflecting emerging social needs alongside traditional triple mission roles (education, research, and service). While some Korean medical schools address issues like physician distribution and diversity, not all have proactively responded. Accreditation can drive changes in medical schools [4].

A MS signifies a concise organization’s core purpose, not an elaborate document; making an in-depth analysis was not feasible. Additionally, considering the macroscopic, long-term, and abstract nature of the MSs, it might be constrained in fully addressing all the roles and competencies outlines in the KDR. Finally, it is essential to acknowledge that an MS’s contents do not guarantee implementation and to continuously monitor medical schools’ MSs in response to societal changes.

Article information Continued