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. 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.
Purpose: The purpose of this study was to identify the correlation between communication skills for emotional empathy and academic achievement on the Clinical Performance Examination (CPX). Methods: One hundred twelve medical school students were observed to determine the extent to which they applied communication skills for emotional empathy (preparation stage: interview attitude, respect; rapport stage: encouragement, active listening, will for support; empathy stage: verbal expression empathy, nonverbal expression empathy, acceptance) to the CPX, as well as their level of understanding of these skills to calculate the Pearson r, which can be used to determine the correlation between communication skills and academic achievement (hematochezia, fatigue, abnormal menstruation, chest pain, alcohol problems). Results: Male students had higher scores than females for all communicational skills except verbal expression empathy. Fourth-year students had statistically more significant correlations than third-year students with regard to the rapport stage 'active listening' and empathy stage 'nonverbal expression' and abnormal menstruation and chest pain. Correlations were also more significant for hematochezia in the preparation stage 'interview attitude,' rapport stage 'encouragement,' and empathy stages 'verbal and nonverbal expression' and 'acceptance.' The empathy stage 'nonverbal expressions' was more significant for fourth-year students with alcohol problems. Third-year students largely had negative correlations between emotional empathy communication skills and CPX academic achievement, especially between the preparation stage 'respect' and abnormal menstruation, and between the rapport stage 'encouragement' and hematochezia. Conclusion: There was a significant correlation between hematochezia, wherein MS students deliver bad news to patients, and communication skills for emotional empathy.
Purpose:The optimal type of patient simulation for different levels of learners has not been extensively studied. The purpose of the study was to compare preclerkship medical student responses and course achievement according to different types of patient simulations in an introductory advanced life support (IALS) course. Methods: A full-day, simulation-based IALS course was developed for preclerkship medical students who attended a four-week introduction to a clinical medicine program. One hundred eighteen students were trained in three days. Onsite interactive simulation with verbal debriefing (interactive type) was applied on the first day, and full-mission, realistic simulation with video-assisted debriefing (realistic type) was applied on the second and third days. At the end of course, students evaluated the course and their simulation experiences and completed a written post-test. Results: Student responses to the course and patient simulations were very positive. Students who experienced the realistic type of patient simulations more highly rated in realistic experiences, such as patient care, than the interactive type group (3.83±0.88 vs. 3.41±0.84, p=0.018). Values for team communication training were more highly rated by students in the interactive type group than the realistic type (4.69±0.52 vs. 4.39±0.86, p=0.022). There was no significant difference in post-test scores between the two groups (realistic, 67.63±10.80; interactive, 66.73±9.93, p=0.654). Conclusion: Both types of patient simulation provide valuable learning experiences to preclerkship medical students, with their own advantages in an IALS course. Onsite interactive simulation with verbal debriefing may be more cost-effective tool for preclerkship medical students.
The purpose of this article is to systematically review the literature that describes training and assessment that use an integrated patient simulator (IPS). We also tried to determine how to train learners with simulators, plan, and perform research on simulator-based education. Literature searches were conducted to identify articles from PubMed, EMBASE, and KMbase that were related to training and assessment that use an IPS, published from January 1999 to September 2008. Forty articles met the criteria and were analyzed. The results were as follows: Studies on IPS are the most common in graduate medical education (GME). The impact of IPS-based education is relatively greater in GME versus undergraduate medical education (UME) or continuing medical education (CME). IPS research in GME is characterized by addressing the effectiveness of clinical application, the training of procedures, and algorithms, rather than knowledge or simple skills. And research design is more elaborate in GME than UME or CME. IPS training in CME focuses mostly on specific clinical skills. Most training sessions in UME are offered to groups, but assessment is performed for a single student. Also, inter-rater reliability is checked unsatisfactorily in UME. IPS research in UME is characterized by limitations in design due to connections to the regular curriculum. According to findings above, we propose that: more detailed research design should be performed to overcome the limitations of UME research. For GME, increasing simulator-based training opportunities is desired, because its effectiveness and adaptability are relatively high.
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