Clinical reasoning has been characterized as being an essential aspect of being a physician. Despite this, clinical reasoning has a variety of definitions and medical error, which is often attributed to clinical reasoning, has been reported to be a leading cause of death in the United States and abroad. Further, instructors struggle with teaching this essential ability which often does not play a significant role in the curriculum. In this article, we begin with defining clinical reasoning and then discuss four principles from the literature as well as a variety of techniques for teaching these principles to help ground an instructors’ understanding in clinical reasoning. We also tackle contemporary challenges in teaching clinical reasoning such as the integration of artificial intelligence and strategies to help with transitions in instruction (e.g., from the classroom to the clinic or from medical school to residency/registrar training) and suggest next steps for research and innovation in clinical reasoning.
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Purpose The Korean Society of Medical Education (KSME) was founded in 1983 and celebrated its 40th anniversary in 2023. This study examines the evolution of topics discussed at KSME conferences from 1971 through 2023, highlighting shifts in the focus of medical education.
Methods We analyzed 90 KSME conferences over 5 decades (1970s, 1980s, 1990s, 2000s, and 2010s), categorizing the topics into three eras based on emerging themes and continuity.
Results Consequently, 37 topics covered at the conference were categorized. Ten topics continuously appeared from the 1970s to the 2010s, including future directions of medical education, teaching methods, faculty development, and curriculum. The topics from the 1970s to the 1990s included 14 areas, such as medical education evaluation, non-undergraduate curriculum, community-related, and research. Thirteen new topics emerged after the 2000s, such as social accountability, student support, professionalism, and quality improvements. The most common topics under innovations in medical education, a case of curriculum innovation at universities that began after 2000, were clinical clerkship, curriculum development, and medical humanities.
Conclusion KSME’s selection of conference topics has been strategically aligned with societal needs and the evolving landscape of medical education. Future topics should continue to address relevant societal and educational challenges.
Purpose This study assessed the alignment between Korean medical schools’ mission statements (MSs) and Korean Doctor’s Role (KDR) domains, considering school characteristics.
Methods We analyzed the South Korean medical school’s MS characteristics using a mixed-methods approach. Quantitative analysis preprocessed MS text data to identify concept words, while qualitative content analysis categorized information into predefined KDR domains and extracted themes from other parts.
Results At the KDR domain level, “social accountability” was the most frequent, followed by “education and research” and “patient care,” while “professionalism” had the least frequency. At the competency level, the most frequent domains were “involvement in public and global health initiatives,” while “self-regulation based on professional leadership” and “professionalism and self-management” were not present.
Conclusion The study found that the majority of MSs had a homogeneous pattern and included traditional themes. Medical schools should evaluate and incorporate missing elements in their MSs to reflect the institution’s own purpose and current societal needs.
Purpose Team-based learning in medical education facilitates the formation of interpersonal relationships, enhances academic achievement, and establishes future clinical connections. Despite medical schools’ distinct educational environments and curricula, research investigating students’ learning and behavioral characteristics within this context remains limited. This study aimed to investigate the specific characteristics of interpersonal relationship formation among freshmen medical students in team-based learning activities.
Methods Focus group interviews were conducted with 11 students who participated in a team-based class held during the first semester of the premedical year.
Results Medical students passively expressed their thoughts and feelings, such as active sympathy for the team’s opinions and self-censorship of SNS (social networking service) conversations. When performing team activities, students were excessively conscious of others and focused on evenly dividing their work, minimizing their opinions, and fulfilling their share to prevent potential interpersonal conflicts. Interpersonal activities were only superficial, as students intentionally maintained a certain distance from team members or used team activities as an opportunity to accumulate relational capital.
Conclusion The results of this study are expected to provide a useful basis for designing and conducting team activity classes to enhance interpersonal relationship formation.
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Purpose First-year students can form a preconception based on life experiences before entering college and identifying learners’ existing characteristics can be useful foundation data for curriculum development. This study examines what preconceptions freshman students had about medicine before entering medical school.
Methods A total of 110 first-year students were asked about what preconceptions they had about “medicine”. A total of 1,124 data were used in the content analysis method.
Results The results were extracted into 5, and 12 twelve categories. On the theme of “scientific discipline”, the knowledge students had about general health was based on scant expertise and little evidence. Students perceived medicine as Western and scientific, considering Korean traditional medicine as unscientific. Students believed that “medical practice” should be a “disease treatment” and “patient-centered” approach rather than a “social responsibility”. In “the role of the doctor”, students were concerned about the doctor's being financially stable on the positive side, and about the high-intensity workload on the negative side. In “medical education”, students believed that studying medicine would be “hard and difficult” because of the “importance of memorizing” and “extensive study load”. In “specialty stereotype”, students had biases that were mostly concentrated on “psychiatry” and “surgery”
Conclusion Perception of “medicine” has been revealed to a varied range of themes, but some have been inaccurate or unrealistic. These prejudices and groundless beliefs have a gap with the learning outcomes that students should achieve in the curriculum, and these preconceptions seem to have been influenced by South Korea’s unique cultural context.
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Purpose This study aims to analyze pre-clerkship medical students’ learning strategies and perceptions in online classes during the coronavirus disease 2019 pandemic.
Methods To develop the survey items, 20 pre-clerkship students were interviewed about their learning experiences in the first semester of 2020. A total of 425 pre-clerkship students have participated in the survey, which comprised four parts (general experience, learning strategies, important features, and overall satisfaction).
Results Before classes began, students generally had “neutral expectations” about online classes (2.90 out of 5). At the end of the semester, overall satisfaction with the curriculum was moderate (3.04 out of 5). Premedical students reported lower scores in “daily study hours” and “regular lifestyle” and higher scores in “experience of playing recorded lectures solely for an attendance check” (p<0.001). In addition, first-year premedical students not only showed significantly lower utilization of learning strategies compared to other grades (p<0.001).
Conclusion Although pre-clerkship students mostly shared similar perceptions and behaviors in their learning regardless of grade level, some characteristics were either more prominent in premedical students on the whole or limited to first-year premedical students.
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Purpose A pharmacology course in undergraduate medical education aims to enable students to cultivate the ability of applying drugs in the clinical context using basic scientific knowledge. Although team-based learning could be a useful approach, the literature on pharmacology education using team-based learning is limited. This study aims to evaluate the effectiveness of a pharmacology course using team-based learning.
Methods We developed an “integrated clinical pharmacology” course for first-year medical students. All 49 students enrolled in the course. Individual and group scores were recorded for each session, and a post-course survey was conducted after the course. We compared the performance of the current class to that of a previous class based on scores in a nationwide test conducted at the end of every year.
Results The reactions of the students were generally positive, with the exception of their perception of the preparatory burdens for the individual test. Throughout the team-based learning sessions, the achievement at the group level was significantly higher than at the individual level. In the nationwide test, however, when we divided students into high and low achiever groups, only the low achievers demonstrated significant improvement compared to the cohort from the previous year.
Conclusion The study demonstrates that team-based learning could be an effective way of teaching pharmacology to medical students in the preclinical stage. Although most of the students were actively engaged regardless of their preparedness, low-achieving students in particular seemed to gain more benefits than high achievers regarding the acquisition of knowledge.
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Methods Fifty-one 2nd year premedical students enrolled in a ‘Critical Thinking for Premeds’ course. Students were required to read or watch a selected material, submit group discussion agendas, attend five group discussion sessions, and write critical essays. Five tutors facilitated the group discussions, observed and assessed the students’ performance and critical essay. Students’ critical thinking disposition and opinion on assigned reading materials were examined before and after the course. A program evaluation survey was conducted to investigate the students’ reaction after the course.
Results On average, students appreciated 78.6% of the total assigned materials. The students indicated that group discussions and the narrative comments of facilitators contributed the most to develop critical thinking. After the course, the students’ tendency preferring cheaper price books, as well as medicine-related books decreased significantly. Students who had critical essay scores greater than or equal to the median demonstrated a significant improvement in critical thinking disposition scores.
Conclusion The course was well-accepted by premedical students and had several positive outcomes. A more effective use of the course could be anticipated with a clearer explanation of the purpose, the consideration of previous reading experience, and use of complementary learning activities.
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Purpose The Mongolian National University of Medical Sciences is the only national university in Mongolia and has produced more than 90% of health professionals in the country. Experts from Mongolia and Korea embarked on a collaborative effort to develop educational programs for faculty development based on the personal and professional needs of faculty members. This study aimed to evaluate the outcomes of those educational programs to determine whether this transnational collaboration was successful.
Methods A needs assessment survey was conducted among 325 faculty members. Based on the results of this survey, the joint expert team developed educational programs on seven core topics: clinical teaching, curriculum development, e-learning, item writing, medical research, organizational culture, and resident selection. Surveys evaluating the satisfaction and the attitudes of the participants were conducted for each program.
Results Throughout the 17-day program, 16 experts from Korea and 14 faculty members from Mongolia participated as instructors, and a total of 309 participants attended the program. The average satisfaction score was 7.15 out of 8.0, and the attitudes of the participants towards relevant competencies significantly improved after each educational program.
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Purpose The purpose of this study was to develop criteria to evaluate a premedical curriculum to ultimately improve the quality of premedical education.
Methods The first draft of the evaluation criteria was developed through a literature review and expert consultation. The Delphi survey was conducted to ensure the validity of the draft.
Results The final premedical curriculum criteria consisted of three evaluation areas (curriculum development, curriculum implementation, and curriculum outcome), five evaluation items (educational objective, organization of curriculum, instructional method, class management,
and educational outcome), and 18 evaluation indicators.
Conclusion There should be further discussion on the evaluation questionnaire and the content for each evaluation indicator with regard to its practical application. Also, a concrete evaluation system, including evaluation standards and rating scales, should be developed.
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Purpose The educational purpose of a medical school is important, because it guides educational decisions in an individual organization and projects the image of the doctors that we are generating. By analyzing the educational goals of entire medical schools, this study aimed to examine the current orientation and future direction of undergraduate medical education in Korea.
Methods Educational goals were collected from the website of each medical school and subjected to inductive content analysis. After identifying categories and themes, we examined the differences between medical school subgroups and compared the categories with competencies that have been suggested by the “Korean Doctor's Role.” Results Thirteen themes were identified: medical expertise, professionalism, contribution to various levels of society, self-management and development, basic educational ideology, research ability, cooperation, leadership, dealing with future change, respect for life, creativity, problem-solving ability, and ability to educate. There was a significant difference in educational goals between medical schools when grouped by geographic location and affiliation of research-driven hospitals. Of the 16 competencies that are suggested by the Korean Doctor's Role, 12 had one or more corresponding categories.
Conclusion Per their current educational purposes, Korean medical schools pursue a broad variety of competencies that need cultivating during the course of undergraduate medical education. Further research is needed to determine how best to apply these educational purposes in actual institutions and ultimately lead them to become part of the competency of a graduate.
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Purpose Seoul National University College of Medicine (SNUMC) introduced a multiple mini-interview (MMI) to assess the noncognitive ability of applicants in 2013. This study aims to examine whether students differ with regard to their personal career values and academic achievements by admission type.
Methods We administered a survey about career values and self-perception of competencies. We then compared the survey results and academic achievements by admission type. Finally, the correlation coefficient between MMI score and academic achievement was calculated in the MMI group. The data were analyzed by t-test and correlation analysis.
Results There was no statistically significant difference in career values between groups. For self-perception of competency, only the ‘interact in heterogeneous groups’ domain was higher for those who entered through the MMI. The MMI group had a higher and broader level of academic achievement. Within the MMI group, there was a significant correlation between grade point average and MMI station scores.
Conclusion The characteristics of students who entered through the MMI were more in accordance with the goals of SNUMC and the competency of future doctors. Considering the unique feature of premedical academic achievement, this result implies that such students have superior noncognitive abilities, such as self-development and internal motivation. How these differences change subsequently remains to be seen.
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PURPOSE The Lee Jong-Wook Seoul Project, which began in 2011, is a training program that aims to educate faculty members of Lao University of Health Sciences in medical knowledge and skills. The project has tremendous significance, attempting to apply the Korean health care developmental model to developing countries. Precise evaluation of the project outcome must be performed to enhance the effectiveness, improve the shortcomings, and adjust the future direction of the program.
METHODS Trainers and exchange professors were asked to fill out questionnaires in the middle and at the end of the program. Eight months after its completion, an evaluation team visited Lao and interviewed each exchange professor individually. Also, 360-degree feedback was obtained from their colleagues. We analyzed the answers to the questionnaires, based on Kirkpatrick's 4-level model.
RESULTS The trainers and exchange professors had positive reactions to the program. All participants felt that their knowledge and skills improved (in their respective fields), although the actual improvement was not extensive, according to their trainers' assessments. The 360-degree feedback demonstrated that the participants actively passed on their experience, knowledge, and skills to their colleagues on returning to work.
CONCLUSION Although a 4-level evaluation was not conducted and despite the limitations in examining academic achievement, interviewing Lao professors, and acquiring quantitative data at Lao University of Health Sciences, this project has demonstrated its value in the development of individual professors and their colleagues.
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PURPOSE The aim of this study was to examine the background and improvement of the reformed premedical curriculum in Seoul National University and to analyze in which it corresponds with its intentions. It gives implications to premedical curriculum through its development model.
METHODS The background and improvement of the reformed premedical curriculum was analyzed through several reports from those of associated committees. The development model of the reformed curriculum was made in order to examine correspondence with the intentions of its reformation.
RESULTS The graduate credit increased while compulsory credit was in decrease which leads to the elimination of standardized education based on the natural sciences. The requirements in compulsory liberal arts and elective major subjects were suggested in order to develop students' perspectives in humanities.
CONCLUSION As premed is a preliminary course before studying medicine, premedical curriculum should reflect the needs of those parties concerned-society, professors, students, etc.- and be based on core values and educational philosophy of the school in order to derive its competences.
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