Korean Journal of Medical Education

"Young-Mee Lee"

Short Communication

Integrating artificial intelligence into medical curricula: perspectives of faculty and students in South Korea: Suyoun Kim, Su Hyun Kim, Hansea Kim, Young-Mee Lee; Korean J Med Educ 2025;37(1):65-70.
Published online February 26, 2025; DOI: https://doi.org/10.3946/kjme.2025.324

Abstract
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Purpose
With the accelerated adoption of artificial intelligence (AI) in medicine, the integration of AI education into medical school curricula is gaining significant attention. This study aimed to gather the perceptions of faculty members and students regarding the integration of AI education into medical curricula in the Korean context.
Methods
Faculty members and medical students’ perspectives on integrating AI into medical curricula were assessed through thematic analysis of free-written responses from 157 faculty members and 125 students in a national online survey on medical AI competencies in South Korea.
Results
Three key themes emerged: content, which prioritizes basic knowledge and its practical applications, with an emphasis on ethical and legal responsibilities; curricular design, which advocates for a spiral curriculum tailored to learners' needs; and concerns, which highlight balancing AI integration with the principal goals of medical education while critically evaluating ongoing advancements.
Conclusion
Our study adds valuable insights into the content and methods to prioritize AI education. Given the rapid evolution of medical learners and AI technologies, continuous and timely needs assessment for AI curriculum development is crucial to maintain relevance and effectiveness.

Citations

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Review Article

Teaching clinical reasoning: principles from the literature to help improve instruction from the classroom to the bedside: Steven J. Durning, Eulho Jung, Do-Hwan Kim, Young-Mee Lee; Korean J Med Educ 2024;36(2):145-155.
Published online May 30, 2024; DOI: https://doi.org/10.3946/kjme.2024.292

Abstract
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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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BMC Medical Education.2024;[Epub] CrossRef

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Special Issue: Short Communication

Exploring 40 years of Korean medical education conference themes: Do-Hwan Kim, Sangmi Teresa Lee, Young-Mee Lee, Sanghee Yeo; Korean J Med Educ 2024;36(2):131-136.
Published online May 30, 2024; DOI: https://doi.org/10.3946/kjme.2024.290

Abstract
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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.

3,325 View
87 Download

Review Article

Scoping review: exploring residents’ views of supervisor entrustment and its effect on learning and professional development: Sunhee Shim, Hansea Kim, Young-Mee Lee; Korean J Med Educ 2024;36(1):81-98.
Published online February 28, 2024; DOI: https://doi.org/10.3946/kjme.2024.286

This scoping review aimed to systematically explore the complex and nuanced perceptions of residents entrusted with significant responsibilities by their supervisors in the clinical context. We conducted a comprehensive search strategy targeting six major electronic databases. Data were extracted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist and a scoping review protocol. Resident perceptions regarding entrustment and its impact on learning and professional development were categorized. This review elucidated the role of supervisor entrustment in shaping residents’ clinical performance, notably influencing autonomy, self-confidence, responsibility for patients, learning needs and goals, uncertainty management, and professional identity formation. Residents identified factors that promote and hinder performance and entrustment development resulting from supervisor entrustment and distinguished between appropriate supervision and over- or under-supervision. Our review suggests that residents’ perceptions of supervisor entrustment, as bestowed by supervisors, serves as a catalyst for enhancing autonomy, thereby exerting a significant influence on clinical performance, and fostering the development of a professional identity. However, residents’ views on appropriate supervision differ in some ways from supervisors’ perspectives. Further research is needed to bridge the gap between residents’ expectations of autonomy and what they are given, and to explore the intricate relationship between autonomy and entrustment.

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BMC Medical Education.2025;[Epub] CrossRef

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3 Scopus

Original Research

Physician empathy in Korean clinical contexts: developing a conceptual framework and exploring influencing factors: Su Hyun Kim, Young-Mee Lee; Korean J Med Educ 2023;35(1):9-20.
Published online February 28, 2023; DOI: https://doi.org/10.3946/kjme.2023.245

Abstract
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Purpose
Despite its well-known clinical importance, physician empathy (PE) has been variably defined and its concepts among cultures are yet to be studied. This study aimed to develop a conceptual framework of PE and explore influencing factors on physicians’ empathetic behavior in the Korean clinical context.
Methods
Forty-two faculty members and 67 residents participated in the two-round Delphi survey to arrive at a consensus regarding the conceptual framework of PE in 2019. To explore individual and external factors affecting physicians’ empathetic behavior, a Likert scale questionnaire based on an initial free-text response was administered to the same participants.
Results
The conceptual framework of PE among Korean doctors consisted of basic communication skills and attitudes, cognitively understanding of patients’ thoughts and emotions, and communicating the doctors’ understandings to patients. Individual attributes and system- and patient-factors were revealed as influencing factors for PE in real practice. The former included communication ability, self-awareness and management, humanism, clinical competence, and good personality traits. Excessive workload, time constraints, aggressive attitudes, and negative preconceptions towards doctors were perceived as inhibiting or hindering empathy in patient care.
Conclusion
PE in the Korean clinical context comprised behavioral and cognitive components. Individual attributes, as well as external factors including system- and patient-factors were identified to affect PE in clinical settings. Further studies are needed to enhance the conceptual clarity of PE and identify how to promote doctors’ empathetic practice even in less favorable healthcare environments.

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1 Scopus

Commentaries and Opinion

Tight and loose culture in medical education: Christine Heisen, Chiara Wychera, Hyunmi Park, Young-Mee Lee; Korean J Med Educ 2022;34(3):239-241.
Published online August 26, 2022; DOI: https://doi.org/10.3946/kjme.2022.234

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Toward the Qualitative Advancement of Medical Ethics Education in Korea: Focusing on Integration and Practice
Hanna Jung
Korean Journal of Medical Ethics.2025; 28(3): 173. CrossRef

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Original Research

How the coronavirus disease 2019 pandemic changed medical education and deans’ perspectives in Korean medical schools: Hyunmi Park, Young-Mee Lee, Ming-Jung Ho, Hee-Chul Han; Korean J Med Educ 2021;33(2):65-74.
Published online June 1, 2021; DOI: https://doi.org/10.3946/kjme.2021.187

Abstract
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Purpose
This study explored how the Korean Medical Colleges responded to the coronavirus disease 2019 (COVID-19) pandemic and the medical deans’ perspectives on what and how these adaptions influence the present and the future of medical education.
Methods
An email survey combining short and open-ended questions was distributed to all 40 Korean school deans in May 2020. Thirty-seven deans out of 40 medical schools in Korea (92.5%) participated.
Results
Most lectures moved online but students’ assessments were delayed and later held onsite. Clinical rotations continued except for an average of 3-week suspension during the first COVID-19 wave. The deans’ remarks on the positive influences far outweighed the negative impact of COVID-19 on medical education. Although technological adaptations caused initial hardship, the experience gained through the use of various online learning systems led to attitudinal changes on the importance of adopting new technology and a tailored and student centric curriculum in medical education.
Conclusion
The deans’ perspective changes has shown the possibility of the deans’ generation aligning more closely with the current Generation Z medical students. They projected further innovations in teaching and learning methods, especially applying flipped learning and highlighted the need to invest in faculty development so medical educators can be equipped and competent in diverse ICT (information and communications technology) learning platforms. Also, the need for advance preparations in medical education for future similar public health crises were stressed. Unprecedented changes brought by COVID-19 positively impacted Korean medical education in parts and the Korean deans envisioned further innovations using the experiences gained during this crisis.

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Short Communication

Medical students’ perspectives on recommencing clinical rotations during coronavirus disease 2019 at one institution in South Korea: Jewel Park, Hyunmi Park, Ji-Eun Lim, Hye Chang Rhim, Young-Mee Lee; Korean J Med Educ 2020;32(3):223-229.
Published online August 24, 2020; DOI: https://doi.org/10.3946/kjme.2020.170

Abstract
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Purpose
Clinical rotations of medical students across the world have inevitably been affected due to the coronavirus disease 2019 (COVID-19) pandemic. The aims of this study were to explore medical students’ perception on the school’s response and management of clinical rotation during the COVID-19 pandemic and on how it had affected the quality of their education.
Methods
An online questionnaire was distributed to third year medical students at one institution whose clinical rotations re-started during the pandemic. The questions asked about the students’ satisfaction with the school’s policy and feelings of safety, and the impact of COVID-19 on clinical learning.
Results
The students’ perception on the school’s response to the pandemic was mixed. Re-commencement of the clinical rotations and procurement of personal protective equipment was positive but a third of students still felt unsafe. The decreased number of hospital patients did not seem to have impacted their overall clinical education with praise on the role of the supervising physicians. Seventy-six-point seven percent of students conferred the positive educational opportunities on medical professionalism presented to them only as the clinical rotation during the ongoing pandemic.
Conclusion
Our observations on the re-commencement of clerkship during this pandemic may help equip medical institutions on future public health crisis.

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16 Scopus

Original Research

Faculty development in medical education: an environmental scan in countries within the Asia pacific region: Dujeepa D. Samarasekera, Shuh Shing Lee, Ardi Findyartini, Rita Mustika, Hiroshi Nishigori, Shunsuke Kimura, Young-Mee Lee; Korean J Med Educ 2020;32(2):119-130.
Published online May 28, 2020; DOI: https://doi.org/10.3946/kjme.2020.160

Abstract
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Purpose
In recent years, faculty development (FD) research is more noticeable within an inter-professional context and in allied health education. However, there is a paucity of published literature on FD medical education programs in Asia. With the formation of the Asia Pacific Medical Education Network (APME-Net) in 2015, a scoping review of an environmental scan of FD medical education programs in main institutions in South East Asia and Australia in 2018 was conducted.
Methods
A survey was developed to collect data on FD in medical education after several rounds of discussion with APME-Net members. The representatives from nine countries in Asia and Australia were invited to partner in this research project. They sent the questionnaire to the Dean of all different medical schools after ethical clearance. The data collected was analyzed using descriptive statistics.
Results
Only institutions in four countries responded to the questionnaire. The medical/health professions education center/department/unit has been established in most educational institutions in these countries. These centers/departments/units mostly carry out FD programs to improve the teaching and learning skills of trained participants, particularly clinical teachers via workshops and seminars. Staffing issues and participant buy-in are the current key priorities of the center/department/unit in terms of FD. Lastly, research related FD program has not been well-supported in these countries, hence, the lack of publication in this area.
Conclusion
Collaboration between countries to address key areas of interest and develop more standardized and productive FD medical education is required especially in research.

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Medical Education in the Age of Uncertainty

Enforced format change to medical education webinar during the coronavirus disease 2019 pandemic: Young-Mee Lee, Hyunmi Park, Sung-Bom Pyun, Young Wook Yoon; Korean J Med Educ 2020;32(2):101-102.
Published online May 28, 2020; DOI: https://doi.org/10.3946/kjme.2020.158

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UNNIKRISHNAN MENON, RIJU RAMACHANDRAN, SUJA GOPALAKRISHNAN, POORNIMA B, ANU SASIDHARAN, SUMITHRA N, UNNI C, NATASHA RADHAKRISHNAN, SUCHITRA SIVADAS
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Editorial

Transformation of medical education in uncertainty: Young-Mee Lee; Korean J Med Educ 2020;32(2):89-90.
Published online April 21, 2020; DOI: https://doi.org/10.3946/kjme.2020.155

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Students and faculty perception of distance medical education outcomes in resource-constrained system during COVID-19 pandemic. A cross-sectional study
Faiz Tuma, Aussama K. Nassar, Mohamed K. Kamel, Lisa M. Knowlton, Naseer Kadhim Jawad
Annals of Medicine and Surgery.2021; 62: 377. CrossRef

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1 Scopus

Original Research

Korean medical students’ attitudes toward academic misconduct: a cross-sectional multicenter study: Eun Kyung Chung, Young-Mee Lee, Su Jin Chae, Tai Young Yoon, Seok Yong Kim, So Youn Park, Ji-Young Park, Chang-Shin Park; Korean J Med Educ 2019;31(4):309-317.
Published online November 29, 2019; DOI: https://doi.org/10.3946/kjme.2019.141

Abstract
PDF

Purpose
This study investigated medical students’ attitudes toward academic misconduct that occurs in the learning environment during the pre-clinical and clinical periods.
Methods
Third-year medical students from seven medical schools were invited to participate in this study. A total of 337 of the 557 (60.5%) students completed an inventory assessing their attitudes toward academic misconduct. The inventory covered seven factors: scientific misconduct (eight items), irresponsibility in class (six items), disrespectful behavior in patient care (five items), dishonesty in clerkship tasks (four items), free riding on group assignments (four items), irresponsibility during clerkship (two items), and cheating on examinations (one item).
Results
Medical students showed a strict attitude toward academic misconduct such as cheating on examinations and disrespectful behavior in patient care, but they showed a less rigorous attitude toward dishonesty in clerkship tasks and irresponsibility in class. There was no difference in students’ attitudes toward unprofessional behaviors by gender. The graduate medical school students showed a stricter attitude toward some factors of academic misconduct than the medical college students. This difference was significant for irresponsibility in class, disrespectful behavior in patient care, and free riding on group assignments.
Conclusion
This study indicates a critical vulnerability in medical students’ professionalism toward academic integrity and responsibility. Further study evidence is needed to confirm whether this professionalism lapse is confined only to this population or is pervasive in other medical schools as well.

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The flipped classroom model for an undergraduate epidemiology course: Sangho Sohn, Young-Mee Lee, Jaehun Jung, Eun Shil Cha, Byung Chul Chun; Korean J Med Educ 2019;31(2):103-113.
Published online May 30, 2019; DOI: https://doi.org/10.3946/kjme.2019.122

Purpose
The flipped classroom has been suggested as a method for efficient teaching in medical education. However, its feasibility and effectiveness in the educational environment are often overlooked. The authors redesigned an epidemiology course applying the flipped classroom method under a traditional curriculum consisting of heavily scheduled classroom hours and explored its feasibility and effectiveness.
Methods
In the fall semester of 2017, we flipped the ‘practice of epidemiology’ course for third-year medical students at Korea University College of Medicine. We provided online lectures and assigned readings as pre-class materials, and substituted group discussions and communicative activities for traditional lectures. We conducted pre- and post-course surveys to review students’ perceptions. We also analyzed the pre-test results and final exam scores for quantitative comparison.
Results
Ninety-seven students out of 120 completed the course. Most students made use of the online lectures, but not the reading materials. Lack of time was the most frequently cited reason for under-preparedness. We observed improvements in preparedness, participation, and effectiveness at the end of the course, while changes in satisfaction were unclear. Students’ perceptions of course relevance and difficulty were predictive of pre-test outcomes, but the effects of preparedness and length of materials were insignificant. The authors found no evidence of differing test scores before and after the course.
Conclusion
This study supports the feasibility of the flipped classroom model even under a traditional, heavily scheduled medical curriculum. To encourage self-directed learning and achieve better learning outcomes, restructuring pre-existing curricular components should also be considered in parallel with new instructional methods.

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Commentaries and Opinions

It is time to reconsider the unnecessary division of premedical and medical studies: Young-Mee Lee; Korean J Med Educ 2018;30(4):279-281.
Published online December 1, 2018; DOI: https://doi.org/10.3946/kjme.2018.102

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Pre-clerkship students’ perception and learning behavior of online classes during coronavirus disease 2019 pandemic
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Review Article

Understanding uncertainty in medicine: concepts and implications in medical education: Kangmoon Kim, Young-Mee Lee; Korean J Med Educ 2018;30(3):181-188.
Published online August 27, 2018; DOI: https://doi.org/10.3946/kjme.2018.92

Abstract
PDF

In an era of high technology and low trust, acknowledging and coping with uncertainty is more crucial than ever. Medical uncertainty has been considered an innate feature of medicine and medical practice. An intolerance to uncertainty increases physicians’ stress and the effects of burnout and may be a potential threat to patient safety. Understanding medical uncertainty and acquiring proper coping strategies has been regarded to be a core clinical competency for medical graduates and trainees. Integrating intuition and logic and creating a culture that acknowledges medical uncertainty could be suggested ways to teach medical uncertainty. In this article, the authors describe the concepts of medical uncertainty, its influences on physicians and on medical students toward medical decision making, the role of tolerance/intolerance to uncertainty, and proposed strategies to improve coping with medical uncertainty.

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Medical Education in an Asian Context

Developing the Korean Association of Medical Colleges graduate outcomes of basic medical education based on “the role of Korean doctor, 2014”: Min Jeong Kim, Young-Mee Lee, Jae Jin Han, Seok Jin Choi, Tae-Yoon Hwang, Min Jeong Kwon, Hyouk-Soo Kwon, Man-Sup Lim, Won Min Hwang, Min Cheol Joo, Jong-Tae Lee, Eunbae B. Yang; Korean J Med Educ 2018;30(2):79-89.
Published online May 30, 2018; DOI: https://doi.org/10.3946/kjme.2018.83

Abstract
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The Korean Association of Medical Colleges (KAMC) developed graduate outcomes based on “The role of Korean doctor, 2014” to serve as guidelines regarding outcome-based education in Korea. The working group in this study analyzed 65 competencies proposed in “The role of Korean doctor, 2014” according to the developmental principle that certain outcomes should be demonstrated at the point of entry into the graduate medical education. We established 34 competencies as “preliminary graduate outcomes” (PGOs). The advisory committee consisted of 11 professors, who reviewed the validity of PGOs. Ultimately, a total of 19 “revised graduate outcomes” (RGOs) were selected. We modified the RGOs based on opinions from medical schools and a public hearing. In November 2017, the KAMC announced the “graduate outcomes for basic medical education,” which serves as a guide for basic medical education for the 40 medical schools throughout Korea. Medical schools can expand the graduate outcomes according to their educational goals and modify them according to their own context. We believe that graduate outcomes can be a starting point for connecting basic medical education to graduate medical education.

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Teaching clinical reasoning: principles from the literature to help improve instruction from the classroom to the bedside
Steven J. Durning, Eulho Jung, Do-Hwan Kim, Young-Mee Lee
Korean Journal of Medical Education.2024; 36(2): 145. CrossRef
The relationship between medical students’ empathy and burnout levels by gender and study years
Hyoung Seok Shin, Hyunmi Park, Young-Mee Lee
Patient Education and Counseling.2022; 105(2): 432. CrossRef
An analysis of verbs used in the course outcomes of outcome-based integrated courses at a medical school based on the taxonomy of educational objectives
Sanghee Yeo
Korean Journal of Medical Education.2019; 31(3): 261. CrossRef

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3 Scopus

Original Article

Development an instrument assessing residents’ attitude towards professionalism lapses in training: Hyo-Jin Kwon, Young-Mee Lee, Young-Hee Lee, Hyung-Joo Chang; Korean J Med Educ 2017;29(2):81-91.
Published online May 29, 2017; DOI: https://doi.org/10.3946/kjme.2017.55

Abstract
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Purpose
Medical professionalism is a fundamental competency for all physicians and continuous development of professionalism during residency training is crucial. The purpose of this study was to develop an instrument assessing residents’ attitudes toward unprofessional behaviors. Methods: A questionnaire survey was conducted in cooperation with the Korea Resident Association from May to July 2013. A total of 317 residents from seven university-affiliated hospitals in South Korea participated in the survey. Results: In the exploratory factor analysis, seven factors were extracted from the data; factor loadings of the 44 items ranged between 0.40 and 0.89. Through iterative discussion, three items below 0.45 were deleted and one additional item was removed due to its irrelevance. Twelve items included in Factor 1 were divided into two different categories. A final version of the questionnaire containing 40 items in eight categories was assessed using confirmatory factor analysis. It was deemed to have a good fit; the root mean square error of approximation and comparative fit index were 0.07 and 0.9, respectively. The reliability (Cronbach’s α) of the inventory was 0.97. Conclusion: The items of this instrument encompass a broad range of residents’ behaviors in clinical practice, research, and publication. In addition, it includes some types of misconduct that can be considered unique features of the authors’ cultural backgrounds. We recommend this instrument as an assessment tool to diagnose residents’ perceptions and attitudes towards professionalism lapses and to provide insight regarding potential improvement in professionalism education.

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Mapping the path to physician leadership: lessons from a comprehensive content analysis of Korean medical school curricula
Yoolwon Jeong, Suwan Go, Young-Hee Lee, Yoomi Chae
Korean Journal of Medical Education.2026; 38(2): 158. CrossRef
Modelado predictivo de actitudes y comportamientos ético-profesionales en médicos latinoamericanos mediante redes neuronales
Alberto Guevara Tirado, Raul Emilio Real Delor
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Perception of professionalism among Latin American physicians in 2024: A multi-national survey
Raúl Emilio Real-Delor, Alberto Guevara Tirado, Eduardo Enrique Chibas Muñoz, Ruth Stephany Benítez Penayo, Bárbara Girhfietl Caje Román, Jonatas De Oliveira Borba, Lucio Fabián Duarte Irala, Mirtha Sofía Fleitas Armoa, Elena Cecilia Franco Cácer
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Aoba Nakamura, Hajime Kasai, Mayumi Asahina, Yu Kamata, Kiyoshi Shikino, Ikuo Shimizu, Misaki Onodera, Yasuhiko Kimura, Hiroshi Tajima, Kazuyo Yamauchi, Shoichi Ito
BMC Medical Education.2024;[Epub] CrossRef
Medical professionalism among emergency physicians in South Korea: a survey of perceptions and experiences of unprofessional behavior
Sangun Nah, Sangsoo Han, Kyunghye Park, Chanwoong Kim, Hyun Noh, Eunkyung Eo
Clinical and Experimental Emergency Medicine.2022; 9(1): 54. CrossRef
Current Status of ‘Professional Identity Formation’ Education in the Medical Professionalism Curriculum in Korea
Young-Hee Lee
Korean Medical Education Review.2021; 23(2): 90. CrossRef
Iranian medical residents’ professionalism: A peer assessment study
Hassan Amini, Ramin Rezapour, Zahra Delir Akbari, Faezeh Bakhshi, Rahim Khodayari, Behnam Amini, Mohammad Saadati
Clinical Ethics.2020; 15(1): 17. CrossRef
Assessment of medical professionalism using the Professionalism Mini Evaluation Exercise (P-MEX) in a multi-ethnic society: a Delphi study
Warren Fong, Yu Heng Kwan, Sungwon Yoon, Jie Kie Phang, Julian Thumboo, Ying Ying Leung, Swee Cheng Ng
BMC Medical Education.2020;[Epub] CrossRef
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Brian Hodges, Robert Paul, Shiphra Ginsburg, the Ottawa Consensus Group Members
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Fei-fei Yu, Chun-yan Du, Zi-feng Liu, Li-jin Chen, Yi-xiang Huang, Ling-ling Zhang
Current Medical Science.2019; 39(4): 670. CrossRef

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11 Scopus

Editorial

Connect medical education practices and research in Asia with the rest of world: Young-Mee Lee; Korean J Med Educ 2017;29(1):3-5.
Published online February 28, 2017; DOI: https://doi.org/10.3946/kjme.2017.47

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105 Download
1 Scopus

Original Article

Learners’ perspective: where and when pre-residency trainees learn more to achieve their core clinical competencies: Eusang Ahn, Ducksun Ahn, Young-Mee Lee; Korean J Med Educ 2016;28(4):355-371.
Published online December 1, 2016; DOI: https://doi.org/10.3946/kjme.2016.41

Abstract
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Purpose
While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills.
Methods
A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews. The questionnaire was based on the Accreditation Council for Graduate Medical Education core competencies.
Results
The majority of core clinical skills were acquired during their rotations in emergency medicine, general surgery, and cardiothoracic surgery. The semistructured interviews revealed that these departments required their trainees to be highly involved and analytical, and participate in clinical discourse.
Conclusion
The common factor among the three departments is an environment in which trainees are highly involved in clinical duties, and are expected to make first-contact patient encounters, participate in clinical discourse, interpret investigative results and arrive at their own conclusions. Work-based learning appear to be key to the trends observed, and further study is warranted to determine whether these findings are indicative of true acquisition of clinical competence.

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1 Scopus

Needs assessment of a core curriculum for residency training: Hyo-Jin Kwon, Young-Mee Lee, Hyung-Joo Chang, Ae-Ri Kim; Korean J Med Educ 2015;27(3):201-212.
Published online August 26, 2015; DOI: https://doi.org/10.3946/kjme.2015.27.3.201

Abstract
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Purpose
The core curriculum in graduate medical education (GME) is an educational program that covers the minimum body of knowledge and skills that is required of all residents, regardless of their specialty. This study examined the opinions of stakeholders in GME regarding the core curriculum. Methods: A questionnaire was administered at three tertiary hospitals that were affiliated with one university; 192 residents and 61 faculty members and attending physicians participated in the survey. The questionnaire comprised six items on physician competency and the needs for a core curriculum. Questions on subjects or topics and adequate training years for each topics were asked only to residents. Results: Most residents (78.6%) and faculty members (86.9%) chose “medical expertise” as the “doctor’s role in the 21st century.” In contrast, communicator, manager, and collaborator were recognized by less than 30% of all participants. Most residents (74.1%) responded that a core curriculum is “necessary but not feasible,” whereas 68.3% of faculty members answered that it is “absolutely needed.” Regarding subjects that should be included in the core curriculum, residents and faculty members had disparate preferences— residents preferred more “management of a private clinic” and “financial management,” whereas faculty members desired “medical ethics” and “communication skills.” Conclusion: Residents and faculty members agree that residents should develop a wide range of competencies in their training. However, the perception of the feasibility and opinions on the contents of the core curriculum differed between groups. Further studies with larger samples should be conducted to define the roles and professional competencies of physicians and the needs for a core curriculum in GME.

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The CanMEDS Competency Framework in laboratory medicine: a phenomenographic study exploring how professional roles are applied outside the clinical environment
Chloe Bogaty, Janneke Frambach
Canadian Medical Education Journal.2023;[Epub] CrossRef
Competency and Curriculum of the Resident as Teacher: A Review and Suggestions
Janghee Park
Korean Medical Education Review.2021; 23(1): 23. CrossRef
Current Status of the Resident Education Program and the Necessity of a General Competency Curriculum
Hyeon Ju Kim, Jung-Sik Huh
Korean Medical Education Review.2017; 19(2): 70. CrossRef
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Korean Journal of Medical Education.2015; 27(3): 159. CrossRef

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1 Scopus

Development of a code of professional conduct for medical students and residents: Young Hee Lee, Young-Mee Lee, Hyo Jin Kwon; Korean J Med Educ 2014;26(4):321-333.
Published online December 1, 2014; DOI: https://doi.org/10.3946/kjme.2014.26.4.321

Abstract
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Purpose
The purpose of this study was to describe the development of a code of professional conduct that should be practiced by medical students and residents. Methods: The content of a draft version of a code of professional conduct was generated through extensive literature reviews and the results of surveys that were administered to students and residents. The content validity for the draft version was reviewed by an expert panel: five experts in medical ethics and eight specialists in medical education. The survey was distributed as an email questionnaire and included closed-ended items and open comments. SPSS for Windows version 12.0 (SPSS Inc.) was used for the analysis. Results: After analyzing the experts’ reviews and holding a reiterative discussion, we developed the final version of a code of conduct for professional behavior. It consists of nine categories and 44 items for students and 44 items for residents. The nine categories were academic integrity, responsibility during clerkship or hospital work, endeavor to improve clinical competency, respect for patients and keeping confidentiality, honesty in patient care, boundary issues and conflicts of interests, impaired physician behaviors, respect for others, and research ethics. Conclusion: Because our code of conduct for professional behaviors cannot extensively include all aspects of medical pro -fessionalism, we focused on behaviors that can be used to monitor and prevent misconduct by medical learners. Further studies and discourse among stakeholders should be performed to develop a national consensus statement or code of conduct to reinforce professionalism for learners in medicine.

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A Study of Core Humanistic Competency for Developing Humanism Education for Medical Students
Hee-Yeon Jung, Jae-Won Kim, Seunghee Lee, Seong Ho Yoo, Ju-Hong Jeon, Tae-woo Kim, Joong Shin Park, Seung-Yong Jeong, Seo Jin Oh, Eun Jung Kim, Min-Sup Shin
Journal of Korean Medical Science.2016; 31(6): 829. CrossRef
Learning objectives achievement in ethics education for medical school students
Sujin Chae, Kiyoung Lim
Korean Journal of Medical Education.2015; 27(2): 131. CrossRef
Review of diverse research contents in this issue
Sun Kim
Korean Journal of Medical Education.2014; 26(4): 249. CrossRef

14,522 View
178 Download
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Evaluating the short-term effects of a communication skills program for preclinical medical students: Young-Mee Lee, Young Hee Lee; Korean J Med Educ 2014;26(3):179-187.
Published online September 1, 2014; DOI: https://doi.org/10.3946/kjme.2014.26.3.179

Abstract
PDF

Purpose
Regardless of the growing importance of communication skills as a core clinical competence, few studies have determined the effects of communication skills courses in undergraduate medical curricula in Asian medical schools. The purpose of this study was to examine the effectiveness of a communication skills program for preclinical medical students.
Methods
A communication skills course was provided to 111 second-year medical students in a medical college in Korea. Students’ self-assessed competency of communication skills was evaluated by a questionnaire survey. To examine the improvement in observed communication skills, the students’ encounters with standardized patients (SPs) were assessed at the first session and at the final course assessment. A structured checklist, consisting of 25 communication skills items, was used for the assessment.
Results
Students’ self-assessed competency of communication skills increased significantly after completion of the course (p<0.001). The observed communication skills scores also improved significantly at the end of the course; the mean scores of the first SPs encounters was 49.6 (standard deviation [SD], 11.1), and those of cases A and B at the final assessment were 61.5 (SD, 8.4) and 69.6 (SD, 7.8), respectively (F₆₁=269.54, p<0.001).
Conclusion
Even a short period of medical communication skills course was beneficial in developing and improving communication skills competency in preclinical medical students. Further studies should be followed to examine whether the acquisition of communication skills during preclinical studies can be sustained into clerkship and actual practice.

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BMC Medical Education.2024;[Epub] CrossRef
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Chandramani Thuraisingham, Siti Suriani Abd Razak, Vishna Devi Nadarajah, Norul Hidayah Mamat
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Abeer S. Al Shahrani, Samah F. Ibrahim, Norah M. AlZamil, Eman S. Soliman, Lamya A. Almusharraf, Amel A. Fayed, Noreen Mirza
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Sukkyung You, Sun Ah Lim
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Sukkyung You, Ji Eun Yoo, Yunsung Koh
Personality and Individual Differences.2019; 142: 7. CrossRef
Clinical communication skills and professionalism education are required from the beginning of medical training - a point of view of family physicians
Camila Ament Giuliani dos Santos Franco, Renato Soleiman Franco, José Mauro Ceratti Lopes, Milton Severo, Maria Amélia Ferreira
BMC Medical Education.2018;[Epub] CrossRef
How do medical students differ in their interpersonal needs?
Yera Hur, A Ra Cho, Sun Huh, Sun Kim
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Crossref

Development of an inventory assessing medical students' attitudes towards academic misconduct: Hyo Jin Kwon, Young-Mee Lee, Young Hee Lee; Korean J Med Educ 2013;25(3):211-220.
Published online September 30, 2013; DOI: https://doi.org/10.3946/kjme.2013.25.3.211

Abstract
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PURPOSE
Identifying medical students' perceptions of and experiences with unprofessional behavior in school can help them develop and maintain higher standards of professional ethics. The aim of this study was to develop an instrument that assesses medical students' attitudes toward academic misconduct.
METHODS
A draft version of the questionnaire form was developed, based on an extensive literature review and iterative discussions. The validity of the content of this draft form was evaluated by medical students, physicians, and education specialists. A total of 803 medical students answered the questionnaire. Exploratory factor analysis was performed using principal axis factoring and Varimax rotation. A confirmatory factor analysis was also conducted by root mean square error of approximation (RMSEA) and comparative fit index (CFI). The internal consistency of the scales was calculated using the Cronbach alpha statistic.
RESULTS
The exploratory factor analysis generated 6 factors with 29 items: scientific misconduct (8 items); irresponsibility in the class (6 items); disrespectful behavior in patient care (5 items); dishonesty in clerkship tasks (4 items); free-riding on group assignments (4 items); and irresponsibility during clerkship (2 items). After adding a single item that addressed cheating on examinations, a 30-item inventory was developed. A confirmatory factor analysis demonstrated a favorable RMSEA (0.082) and reasonable fit (CFI, 0.844). The coefficient alpha for each factor varied between 0.80 and 0.90.
CONCLUSION
Our instrument is useful in identifying students' ethical standards with regard to academics and examining the prevalence of unprofessional behavior in medical students.

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Review

Trends Analysis on Research Articles in the Korean Journal of Medical Education: Young Hee Lee, Young-Mee Lee, Hyojin Kwon; Korean J Med Educ 2012;24(4):287-299.
Published online December 31, 2012; DOI: https://doi.org/10.3946/kjme.2012.24.4.287

Abstract
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The purpose of this study was to examine the chronological changes and progress in medical education research in Korea and to identify the less investigated topics that need further study and improvement with regard to methodological quality. Of the 590 articles that were published from 1989 to 2010 in the Korean Journal of Medical Education, 386 original research papers were extracted for the analysis. The extracted papers were systematically reviewed using 2 analysis schemes that we developed: one scheme was designed to classify research topics, and the other determined the methodology that was used. The main results were as follows: The most popular research areas were curriculum, educational method, and evaluation in basic medical education; in contrast, studies that addressed postgraduate education, continuous professional development, and educational administration were less frequent; The most frequently studied topics were clinical performance/skills evaluation, clerkship, curriculum development, and problem-based learning, Quantitative studies predominated over qualitative studies and mixed methods (265 vs. 95 vs. 26). Two hundred forty papers were descriptive, cross-sectional studies, and 17 were experimental studies. Most qualitative studies were non-participation observational studies. In conclusion, there has been dramatic growth in the extent of medical education research in Korea in the past two decades. However, more studies that investigate the graduate medical education and the continuous professional development should be performed. Moreover, robust experimental designs and methods should be applied to provide stronger evidence that can practice best-evidence medical education.

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Editorial

Survival Games at Medical Schools: Young-Mee Lee; Korean J Med Educ 2012;24(3):185-187.
Published online September 30, 2012; DOI: https://doi.org/10.3946/kjme.2012.24.3.185

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Jeongmin Lee, Hyunkyung Park, Yeonhwa Jung, Jiyae Noh
Journal of The Korean Association For Science Education.2015; 35(4): 565. CrossRef

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Review

A Review of the Patterns of Unprofessional Behavior and Evaluation Programs to Prevent Misconduct by Medical Students: Young Hee Lee, Young-Mee Lee; Korean J Med Educ 2012;24(2):93-101.
Published online June 30, 2012; DOI: https://doi.org/10.3946/kjme.2012.24.2.93

Abstract
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In recent years, several high-profile cases related with misconduct by doctors and medical students have led to increased media interest and public concern regarding doctors who fail to maintain the expected professional standards. In response to these concerns and the increasing awareness of the social responsibility of medicine, the importance of professionalism in medical school is receiving renewed attention in our medical society. Many studies in other countries have stressed the early detection and intervention of unprofessional behaviors in medical students using an adequate evaluation system. The authors intended to explore strategies that reinforce professionalism education and prevent misconduct in medical students. We conducted an extensive literature review to identify patterns and categorize issues of misconduct and unprofessional behavior by medical students; existing evidence to determine why early detection and intervention of are crucial to prevent future misbehavior and disciplinary action by doctors; and education and evaluation systems to enhance professionalism for medical students.

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Development of a code of professional conduct for medical students and residents
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Korean Journal of Medical Education.2014; 26(4): 321. CrossRef
Development of an inventory assessing medical students' attitudes towards academic misconduct
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Korean Journal of Medical Education.2013; 25(3): 211. CrossRef

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Teaching Tips

Challenges in Communication Skills Education in Medicine: Based on Personal Experience and Reflection: Young-Mee Lee; Korean J Med Educ 2012;24(1):65-68.
Published online March 31, 2012; DOI: https://doi.org/10.3946/kjme.2012.24.1.65

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Original Article

Reactions of First-Year Medical Students to Cadaver Dissection and Their Perception on Learning Methods in Anatomy: Young Hee Lee, Young-Mee Lee, Soonwook Kwon, Sun-Hwa Park; Korean J Med Educ 2011;23(4):275-283.
Published online December 31, 2011; DOI: https://doi.org/10.3946/kjme.2011.23.4.275

Abstract
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PURPOSE
The purpose of this study was to investigate the reactions of medical students to cadaver dissection and their preferred learning methods in studying anatomy.
METHODS
Participants were 110 first-year medical students 57 from a pre-medical course and 53 from the graduate entry level. A self-reported questionnaire survey was used to assess students' emotional and physical reactions to their encounters with cadavers in the dissecting room and their preferred teaching and learning methods and materials. Frequency, paired t-test, and cross-sectional analyses were conducted.
RESULTS
Most students experienced negative physical symptoms, such as eye soreness (72%), mile headache or dizziness (40%), headache (18%), decrease in appetite (17%), nausea (15%), and disgust (10%), in the first encounter with a cadaver in the dissection room. They also experienced adverse emotional responses, such as surprise (38%), depression (37%), sadness (23%), fear (23%) and feelings of guilt (19%), anxiety (17%), and crying (2.7%). However, most of these reactions decreased significantly 8 weeks later, except for nausea. Regarding teaching and learning methods, students reported that lectures and cadaver dissections were the most helpful methods in studying anatomy.
CONCLUSION
The results shows that initial encounters with a cadaver in the dissecting room caused emotional and physical distress to first-year medical students, but most students adapted gradually to the stressful learning environment. In addition, students regarded cadaver dissection as one of the most helpful learning experiences in studying anatomy.

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Content Analysis of Standardized-Patients' Descriptive Feedback on Student Performance on the CPX: Young Hee Lee, Young-Mee Lee, Byung Soo Kim; Korean J Med Educ 2010;22(4):291-301.
Published online December 31, 2010; DOI: https://doi.org/10.3946/kjme.2010.22.4.291

Abstract
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PURPOSE
The goal of this study was to explore what kind of additional information is provided by the descriptive comments other than the rating scales, on the physician-patient interaction (PPI) in the clinical performance examination (CPX) and its feedback role in identifying students' strengths and weaknesses in communication skills.
METHODS
The data were collected from 18 medical schools in Seoul and Gyeonggi region, which participated in the CPX for fourth-year medical students in 2006 and 2007. In total 12,650 examination cases in 2006 and 12,814 cases in 2007 were analyzed. Descriptive comments from the standardized patients (SPs) were analyzed by content analysis, which includes a 4-step process: coding, conceptualizing, categorizing and explanation.
RESULTS
Ten categories (41 concepts) for 'strength' and 11 for 'weakness' (40 concepts) in the PPI were extracted. Among them, 10 categories were the same in both strength and weakness: providing adequate interview atmosphere, attentive listening, providing emotional support, non-verbal behaviors, professional attitude, questioning, explanation, reaching agreement, counseling & education and conducting adequate physical examination. For the 'structured and organized interview', only weakness was described. In 'providing emotional support' and 'adequate interview atmosphere', comments on strengths were more frequently mentioned than weaknesses. However, communication skills that were related to non-verbal behaviors were more frequently considered weaknesses rather than strengths. The numbers and content of the SP's comments on students' strengths and weaknesses in the PPI varied depending on the case specificities.
CONCLUSION
The results suggest that the SPs' descriptive comments on student' performance on the CPX can provide additional information versus structured quantitative assessment tools such as performance checklists and rating scales. In particular, this information can be used as valuable feedback to identify the advantages and dicadvantages of the PPI and to enhance students' communication skills.

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Editorial

How to Make a 'Good Doctor': Young-Mee Lee; Korean J Med Educ 2010;22(4):247-248.
Published online December 31, 2010; DOI: https://doi.org/10.3946/kjme.2010.22.4.247

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Original Article

Development of a Patient-Doctor Communication Skills Model for Medical Students: Young Hee Lee, Young-Mee Lee; Korean J Med Educ 2010;22(3):185-195.
Published online September 30, 2010; DOI: https://doi.org/10.3946/kjme.2010.22.3.185

Abstract
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PURPOSE
Communication is a core clinical skill that can be taught and learned. The authors intended to develop a patient-doctor communication model for teaching and assessing undergraduate medical students in Korea.
METHODS
To develop a model, literature reviews and an iterative process of discussion between faculty members of a communication skills course for second year medical students were conducted. The authors extracted common communication skill competencies by comparing the Kalamazoo Consensus Statement, SEGUE framework communication skills, the Calgary Cambridge Observation Guides, and previous communication skills lists that have been used by the authors. The content validity, with regard to clinical importance and feasibility, was surveyed by both faculty physicians and students.
RESULTS
The first version of the model consisted of 36 items under 7 categories: initiating the session (8 items), building a relationship (6), gathering information (8), understanding a patient's perspectives (4), sharing information (4), reaching an agreement (3), and closing the session (3). It was used as a guide for both students and teachers in an actual communication skills course. At the end of the course, student performance was assessed using two 7-minute standardized patient interviews with a 34-item checklist. This assessment tool was modified from the first version of the model to reflect the case specificity of the scenarios. A patient-doctor communication model, which can be taught to those with limited patient care experience, was finally developed.
CONCLUSION
We recommended a patient-doctor communication skills model that can be used for teaching and evaluating preclinical and clinical students. Further studies are needed to verify its validity and reliability.

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Review

Patient Safety Curriculum in Medical Education: Young-Mee Lee; Korean J Med Educ 2009;21(3):217-228.
Published online September 30, 2009; DOI: https://doi.org/10.3946/kjme.2009.21.3.217

Abstract
PDF

Since release of the Institute of Medicine (IOM) report, To Err Is Human: Building a Safer System, patient safety has emerged as a global concern in the provision of quality health care. In response to growing recognition of the importance of patient safety, some medical schools in other countries have created and/or implemented patient safety curricula. In Korea, however, patient safety medical curriculum has not been actively discussed by medical educators. The purpose of this article is to introduce patient safety concepts and the global efforts on patient safety medical education. Specifically, this article describes; 1) current concepts in patient safety, 2) global trends of patient safety movement and education, 3) contents, instructional and assessment methods of patient safety education for both undergraduate medical education and graduate medical education, suggested in the previous studies, 4) WHO Patient Safety Guide for Medical Curriculum developed by the Medical Education Team within the World Alliance for Patient Safety and 5) known barriers against patient safety education. Patient safety is a major priority for all healthcare providers. In reality, however, teaching and learning about patient safety in medical curriculum offers a challenge to all medical schools, especially, the health care environment is not favorable to physicians such as Korea. More attention and recognition about patient safety by all health personnel and medical educators is needed. In addition, the national conversation about medical errors and patient safety and how best to incorporate it to the existing curriculum should be discussed.

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Original Article

What Do the Patients Want to be Called during Medical Encounters?: Su Hyun Kim, Young-Mee Lee; Korean J Med Educ 2009;21(2):163-173.
Published online June 30, 2009; DOI: https://doi.org/10.3946/kjme.2009.21.2.163

Abstract
PDF

PURPOSE
The aims of this study were to explore the terms that patients preferred to be called during medical encounters and to provide a guideline about the proper use of appellations about patients in teaching medical students.
METHODS
Patients were asked to select items from given examples to indicate how they wanted to be addressed by their doctors and how their doctors tended to address them. These terms were categorized into 3 groups; 1) terms that includes name, 2) "patient+honorific suffix, boon (hwanja- boon)", and 3) other general terms. The survey also included questions on patient's perception of the importance of terms of address in building a good doctor-patient relationship. The questionnaire was distributed to 440 out-patients of the three university affiliated hospitals in Seoul and Gyeonggi province from August to September 2007.
RESULTS
Three hundred ninety-two respondents were analyzed after excluding 58 respondents who did not meet the study criteria. The ages of the respondents ranged from 18 to 80 years, and 56% of them were male. Most patients preferred to be called by the terms that includes their name (284, 72.4%) and the most preferred term was "family name (FN)+given name (GN)+honorific suffix, nim" (156, 39.8%), while doctors used the terms "patient+honorific suffix, boon" (188, 48.0%) most frequently. About 59% of respondents were addressed as they preferred. Patients in their 30s and 40s showed significantly higher perceptions of the importance of terms of address than other age groups (p= 0.0007).
CONCLUSION
Patients preferred to be called by their full name with an honorific suffix; however, patients' preferences and doctors' usage were not in agreement in many cases. The results of this study suggest that doctors should pay more attention to the proper use of appellation during medical encounters. Furthermore, these results can be used to teach undergraduate medical students and guide physicians on how to address patients in practice.

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Differences in Patients' Awareness of Doctors' Communication Styles, Patients' Satisfaction, and Patients' Compliance among Patient Social Styles: Sung Soo Kim, Duk Young Cho, Byung Kyu Park, In Kyung Hwang, Chulhun L. Chang, Young-Mee Lee, So Jung Yune; Korean J Med Educ 2008;20(4):321-331.
Published online December 31, 2008; DOI: https://doi.org/10.3946/kjme.2008.20.4.321

Abstract
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PURPOSE
It has been well known that doctor-patient communication is a key to the better doctor-patient relationship. However, in Korea, there has not been much researches on the causal factors influencing the doctor-patient communication as well as on patient satisfaction and compliance. This study attempts to investigate the relationships between patient social styles and doctors' communication styles as well as patient outcomes. METHODS: Patient subjects were recruited from two mid-size local hospitals. The questionnaires consist of social styles, patient-perceived doctors' communication, and patient satisfaction/compliance measures. One hundred ninety useable data were analyzed. RESULTS: For those highly satisfied patients, patients with analytic style showed the highest percentage of viewing their doctors as highly empathic. On the other hand, for those patients with high compliance, expressive style patients showed the highest rates of regarding their doctors as highly affective. And amiable style patients are most likely to view their doctors as highly cognitive. For analytic style patients, cognitive empathy had positive effects on patient satisfaction. For amiable style patients, doctors' cognitive empathy had positive influence on patient compliance. For expressive style patients, doctors' affective empathic communication had positive effects on both patient satisfaction/compliance while cognitive had positive effects only on patient compliance. CONCLUSION: The results show that the different social styles of patients might influence on the fact how the patients perceive their doctors' communication as well as how much they are satisfied and compliant. Thus, when we as an medical educators need to realize the importance of this mechanism and bring this learning into classrooms.

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Association Between Student Performance in a Medical Communication Skills Course and Patient-Physician Interaction Scores on a Clinical Performance Examination: Young-Mee Lee, Byung Soo Kim; Korean J Med Educ 2008;20(4):313-320.
Published online December 31, 2008; DOI: https://doi.org/10.3946/kjme.2008.20.4.313

Abstract
PDF

PURPOSE
Since 2006, Korea University Medical College has offered a medical communication skills program for third-year medical students. This study examined the relationship between medical student interview performance in a medical communications skills course and students' patient-physician interaction (PPI) scores on the Clinical Performance Examination (CPX). METHODS: Participants were 130 fourth-year students who took both the medical communication skills course in 2006 and the CPX in 2007. Students' scores in performance evaluation, assessed by SP interview, and their PPI scores were used for data analysis.
RESULTS
This study hypothesized that students who performed well in the medical communication skills course would have high PPI scores on the CPX. Students' PPI total and individual item scores showed statistically significant differences by the performance level of the medical communication skills course. Some of these differences were statistically significant, even after controlling for the influence of GPA. CONCLUSION: This study has practical implications for medical communications education, demonstrating that the knowledge and skills that are acquired in a communications skills course can be maintained.

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Jae Jin Han, Myoung Jin Lee, Hyun-jung Im
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Jong Won Jung, Young-Mee Lee, Byung Soo Kim, Ducksun Ahn
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Dae-hyun Kim, Hui-jung Yoon, Min-ji Lee, Ji-yon Ahn, Seun-jun Lee, Young-sung Suh
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The Effects of Medical Students' Achievement Goal Orientations on Affective Attitudes towards Anatomy Learning: Soohyun Jeon, Young-Mee Lee, Sun-Hwa Park; Korean J Med Educ 2008;20(3):189-198.
Published online September 30, 2008; DOI: https://doi.org/10.3946/kjme.2008.20.3.189

Abstract
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PURPOSE
This study was designed to investigate how medical students' achievement goal orientations towards anatomy class influence perceived affect towards anatomy learning.
METHODS
Participants were 124 medical students. Students' self-report measures were used for the assessment of their achievement goal orientations, perceived value, interests, effort, tension, test anxiety, and negative dissection experiences. Correlation and multiple regression analyses were used for the data analyses. RESULTS: Students with high levels of mastery-approach goals displayed high interests, values, and efforts while they showed low levels of tension, test anxiety, and negative dissection experiences. In contrast, students with high mastery- and performance-avoidance goals showed high levels of tension and/or test anxiety. Students' performance-approach goals are positively associated with both high effort and high negative dissection experiences. CONCLUSION: These findings offer theoretical and practical implications for anatomy teaching and learning by suggesting that students' learning experiences vary in terms of students' achievement goal orientations which may make differences in students' psychological experiences in a class.

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The Relationship Between Personality Types, Communication Skills and Learning Attitudes in Premedical Students: Young Hee Lee, Young-Mee Lee, Byung Soo Kim; Korean J Med Educ 2008;20(3):177-187.
Published online September 30, 2008; DOI: https://doi.org/10.3946/kjme.2008.20.3.177

Abstract
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PURPOSE
The purpose of this study was to explore the relationship between the personality types of premedical students and their self-assessed communication skills and attitudes toward a communication skills course.
METHODS
The participants were 59 second-year premedical students from Korea University College of Medicine. The Myers-Briggs type indicator (MBTI), which was validated in Korea, was used for evaluating personality types. Self-reported competency in communication and attitudes toward a communication skills course were measured by questionnaire.
RESULTS
Sensing (S) and thinking (T) personality types were predominant in this study group (76%). The relationship between the personality indicator 'Extraversion (E)-Introversion (I)' and the selfreported communication skills was statistically significant for four items of communication skills. Also, the personality indicator 'Thinking (T)-Feeling (F)' significantly correlated with one item: ask if the person has any further suggestions. Personality 'I' students showed more concern with regard to their communication skills than 'E' types. 'Sensing (S)'-type students had a more positive attitude toward the communication skills course than "iNtuition (N)" types.
CONCLUSION
Students' self-assessed competence in communication and attitudes toward the communication skills course varied between personality types. These results suggest that the personality types of students should be considered in developing a communication skills course.

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A Preliminary Study for Exploring the Attributes of being a "Good Doctor": Young-Mee Lee, Duck-Sun Ahn; Korean J Med Educ 2007;19(4):313-323.
Published online December 31, 2007; DOI: https://doi.org/10.3946/kjme.2007.19.4.313

Abstract
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PURPOSE
Our understanding of the characteristics that make a 'good doctor' is continually changing. The aim of this study is to identify the attributes deemed important for being a 'good doctor' and to examine to what extent doctors actually possess them.
METHODS
A list of characteristics of a good doctor was generated from literature review and from opinions from medical education experts, a focus group of medical students and a pilot survey of patients. An inventory comprising 33 statements was administered to 598 medical students, 145 faculty, 164 primary care physicians and 85 patients.
RESULTS
All participants regarded 'accurate diagnosis and treatment' as the most important attribute for being a 'good doctor' and 'keeping up-to-date' as the second important attribute. Empathy towards patients, continuing professional development (CPD), kind manners towards patients were also regarded as important. There was a discrepancy between perceived importance and competency in the areas of communication skills, health advocacy and social contribution according to the participating groups.
CONCLUSION
Excellence in clinical ability was identified as the most important attribute of a 'good doctor'. Compassion and CPD were also identified as important characteristics. More sophisticated studies are needed to further explore the attributes of a 'good doctor' for our society.

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Item Analysis of Clinical Performance Examination Using Item Response Theory and Classical Test Theory: Hyun-Sun Lim, Young-Mee Lee, Duck-Sun Ahn, Joon-Young Lee, Hyung Im; Korean J Med Educ 2007;19(3):185-195.
Published online September 30, 2007; DOI: https://doi.org/10.3946/kjme.2007.19.3.185

Abstract
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PURPOSE
The objectives of this study were: 1) to analyze Clinical Performance Examination(CPX) items using item response theory(IRT) and classical test theory(CTT) and 2) to discuss how to apply and interpret these results in order to improve the quality of CPX items. In addition, we intended to explore statistical procedures in order to merge examination data from several different medical schools.
METHODS
The subject of the study was the 2005 CPX examination data from 10 medical schools located in Seoul and the Kyunggi province. For merging data from ten different medical schools, Levene's test for homogeneity of variances was used. Homogeneous group selection was conducted based on ANOVA or Kruskal-Wallis' test and Tukey's multiple comparisons appropriately. The generalized partial credit model was applied to analyze polytomous items and the 2-parameter logistic model was used to analyze dichotomous items.
RESULTS
Data from 8 medical schools were incorporated into the analysis. The result of the discrimination index by IRT was different from that of CTT in both polytomous and dichotomous items. Discrimination index from IRT tended to be lower than that of CTT. Difficulty index of dichotomous items of two models was correlated well with each other. However, for polytomous items, IRT model provided more information than CCT.
CONCLUSION
We discovered that the CPX items were mostly easy in terms of difficulty index, and the result from IRT and CCT model did not correlated well in the discrimination index. IRT may provide more detailed information for polytomous items, but the checklist and criteria of scoring system should be cautiously reviewed.

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Brief Communication

Implementing a Communication Skills Course for Undergraduate Medical Students: Young-Mee Lee, Youn-Jae Oh, Duck-Sun Ahn, Suk-Min Yoon; Korean J Med Educ 2007;19(2):171-175.
Published online June 30, 2007; DOI: https://doi.org/10.3946/kjme.2007.19.2.171

Abstract
PDF

PURPOSE
The purposes of this study were to describe a viable communication skills course for medical students and to discuss how to improve it for better teaching.
METHODS
The subjects were a communication skills course and one hundred thirty three third-year medical students who participated in the course in 2006. Program evaluation by students was conducted using questionnaire at the end of each session and the entire course.
RESULTS
The communication course was named as "Medical Communication Skills". Basic communication skills and interview skills for specific clinical situations were taught. We used experiential leaning methods such as standardized patient (SP) interviews with feedback. Students rated the course highly especially for SP-based practice sessions and student group projects. The course evaluation indicated that the students considered communication skills to be significantly more important as a clinical competency after the completion of the course.
CONCLUSION
We confirmed that the communication skills course was well perceived by medical students and they preferred experiential learning methods more than didactic methods.

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Original Article

A Study on How Young Doctors and Patients Perceive the Doctor-patient Relationship: Sowon Ahn, Young-Mee Lee, Duck-Sun Ahn; Korean J Med Educ 2006;18(3):279-287.
Published online December 31, 2006; DOI: https://doi.org/10.3946/kjme.2006.18.3.279

Abstract
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PURPOSE
We specifically investigated the young doctor (residents) patient doctor-patient relationship in Korea. A society built on Confucianism, age is expected to affect even the doctor-patient relationship.
METHODS
57 residents participated and answered 6 open-ended questions. 90 patients of various age participated and answered 3 open-ended and 6 close-ended questions.
RESULTS
It seems that the general problem of the doctor-patient relationships was related to attitudes and communication skills. Over 80% of the residents felt uncomfortable and received inappropriate verbal expressions and attitudes from their patients simply because they were young or younger than the patients. This negative experience resulted mostly from the residents' self-perceived lack of experience and clinical competence and the patients' distrust of young doctors. As for the patients, over 80% preferred middle-aged doctors to young doctors. Middleaged doctors were thought to be easier to understand, better mannered, more humane, and clinically competent. Most residents expected professional respect from their patients, while patients expected kindness and humility from the young doctors. This shows a gap in the reciprocal expectations between residents and patients.
CONCLUSION
Young doctors are perceived as inexperienced and incompetent and, consequently, not trusted by patients in Korea. To improve the resident-patient relationship, improvement in attitude and communication skills is needed.

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The Relation of Self-Efficacy with Environmental Factors, Personality and Academic Achievement in Medical Students: Young-Mee Lee, Byung-Joo Ham, Kyung-A Lee, Duck-Sun Ahn, Meyoung-Kon Kim; Korean J Med Educ 2006;18(3):249-257.
Published online December 31, 2006; DOI: https://doi.org/10.3946/kjme.2006.18.3.249

Abstract
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PURPOSE
The purpose of this study was to explore the relation of self-efficacy with environmental factors, personality, and academic achievement in medical students.
METHODS
Study subjects consisted of 141 first-year medical students at Korea University Medical School during one academic year (2003~2004). All participants completed a 24-item questionnaire on self-efficacy beliefs, a 16-item questionnaire asking demographic and socioeconomic data, and the Temperament and Character Inventory (TCI). Spearman'sorrelation of selfefficacy with other variables was generated. The differences of self-efficacy scores according to the level of satisfaction with school life, total family income per month and the reasons for entering medical college were analyzed by ANOVA.
RESULTS
Age and overall satisfaction with school correlated with self-confidence and total family income per month was related to self-regulation. Students who entered medical college due to the socioeconomic stability of medicine showed significantly lower preference for task difficulty than those who had other reasons for entering medical college. The GPAs of premedical studies correlated with self-regulation and the GPAs of Med 1 and the cumulative GPAs of premedical and Med I were related to the preference for task difficulty.
CONCLUSION
This result supports that self-efficacy beliefs were related with some environmental factors, personality and academic achievements in medical students.

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Patients' Attitudes Toward the Involvement of Medical Students in Their Care: Young-Mee Lee, Ji-Hoon Kim, Duck-Sun Ahn, Byung-Soo Kim, Se-Hwa Yoo; Korean J Med Educ 2004;16(1):41-50.
Published online April 30, 2004; DOI: https://doi.org/10.3946/kjme.2004.16.1.41

Abstract
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PURPOSE
There is a negative assumption that patients are reluctant to have medical students be involved in their care. In response, students refrain from revealing to the patients that they are students in order that they may participate in patient-care. The purpose of this study is to determine whether patients' attitudes towards medical students is negative or positive, and to explore the level acceptable by patients of students' involvement in their care. METHODS: The study subjects were 90 inpatients in two university hospitals. The questionnaire consisted of 12 items covering patient's attitude toward student involvement in their care, acceptable patient-care activities in which students could be involved, and preference for being told if caregiver is a medical student. RESULTS: Patients' attitudes towards students' participation in their care were relatively more favorable than expected. 46.8% of patients reported that they would permit students to be involved up to and including simple non-invasive techniques. 76.2% of patients stated that they would allow students to participate in their future in-hospital care. Most patients preferred knowing that the caregiver was a medical student.
CONCLUSION
The results of this study are reassuring. A higher than expected percentage of patients surveyed disclosed that they would accept medical students being involved in their care. Medical educators should provide a safe environment for medical students to be able to tell the patients, "I am a student doctor".

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