Objectives: Stress can affect learning and memories in students. Prior stress-related studies on students were conducted mainly through surveys. So, we investigated how heart rate variability (HRV)-measured stress related to academic achievement in medical students during clerkship. Subjects and Methods: A cross-sectional study was conducted. HRV measurements were performed in 97 third-year medical students during their family medicine clerkship course. Data on written and skilled exam scores of the end of the school year were also collected. We assessed association between HRV-measured stress and written/skilled exam scores. Results: Written exam scores showed a positive correlation with standard deviation of the N-N intervals (SDNN) (r=0.245, p=0.016), sympathetic nervous system/parasympathetic nervous system (SNS/PNS) balance (r=0.218, p=0.033), and stress index (r=0.381, p=0.004). Students with an unhealthy SDNN, with a dominant SNS, and a high stress index had a higher scorer in written exams than students with a healthy SDNN, a balanced SNS/PNS, and a normal stress index, respectively (p=0.004, 0.018, and 0.012, respectively). Moreover, skilled exam scores were negatively correlated with body mass index (r=-0.249, p=0.014), and were higher in female students (r=0.240, p=0.018). Students with an abnormal autonomic balance diagram (ABD) had a higher score than students with a normal ABD (p=0.03). Conclusion: This study shows that medical students with higher stress measured by HRV have higher academic achievement, especially in written exam. Further studies are needed to reconfirm the results of this study and to assess the long-term effects of HRV measured stress on medical education.

BackgroundTask-specific checklists, holistic rubrics, and analytic rubrics are often used for performance assessments. We examined what factors evaluators consider important in holistic scoring of clinical performance assessment, and compared the usefulness of applying holistic and analytic rubrics respectively, and analytic rubrics in addition to task-specific checklists based on traditional standards.MethodsWe compared the usefulness of a holistic rubric versus an analytic rubric in effectively measuring the clinical skill performances of 126 third-year medical students who participated in a clinical performance assessment conducted by Pusan National University School of Medicine. We conducted a questionnaire survey of 37 evaluators who used all three evaluation methods—holistic rubric, analytic rubric, and task-specific checklist—for each student. The relationship between the scores on the three evaluation methods was analyzed using Pearson’s correlation. Inter-rater agreement was analyzed by Kappa index. The effect of holistic and analytic rubric scores on the task-specific checklist score was analyzed using multiple regression analysis.ResultsEvaluators perceived accuracy and proficiency to be major factors in objective structured clinical examinations evaluation, and history taking and physical examination to be major factors in clinical performance examinations evaluation. Holistic rubric scores were highly related to the scores of the task-specific checklist and analytic rubric. Relatively low agreement was found in clinical performance examinations compared to objective structured clinical examinations. Meanwhile, the holistic and analytic rubric scores explained 59.1% of the task-specific checklist score in objective structured clinical examinations and 51.6% in clinical performance examinations.ConclusionThe results show the usefulness of holistic and analytic rubrics in clinical performance assessment, which can be used in conjunction with task-specific checklists for more efficient evaluation.

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Purpose:The purpose of this study was evaluation of the current status of medical students' documentation of patient medical records.Methods:We checked the completeness, appropriateness, and accuracy of 95 Subjective-Objective-Assessment-Plan (SOAP) notes documented by third-year medical students who participated in clinical skill tests on December 1, 2014. Students were required to complete the SOAP note within 15 minutes of an standard patient (SP)-encounter with a SP complaining rhinorrhea and warring about meningitis.Results:Of the 95 SOAP notes reviewed, 36.8% were not signed. Only 27.4% documented the patient’s symptoms under the Objective component, although all students completed the Subjective notes appropriately. A possible diagnosis was assessed by 94.7% students. Plans were described in 94.7% of the SOAP notes. Over half the students planned workups (56.7%) for diagnosis and treatment (52.6%). Accurate documentation of the symptoms, physical findings, diagnoses, and plans were provided in 78.9%, 9.5%, 62.1%, and 38.0% notes, respectively.Conclusion:Our results showed that third-year medical students’ SOAP notes were not complete, appropriate, or accurate. The most significant problems with completeness were the omission of students’ signatures, and inappropriate documentation of the physical examinations conducted. An education and assessment program for complete and accurate medical recording has to be developed.

Background There is no national survey on medical school faculty members’ burnout in Korea. This study aimed to investigate burnout levels and explore possible factors related to burnout among faculty members of Korean medical schools. Methods An anonymous online questionnaire was distributed to 40 Korean medical schools from October 2020 to December 2020. Burnout was measured by a modified and revalidated version of the Maslach Burnout Inventory-Human Service Survey. Results A total of 996 faculty members participated in the survey. Of them, 855 answered the burnout questions, and 829 completed all the questions in the questionnaire. A significant number of faculty members showed a high level of burnout in each sub-dimension: 34% in emotional exhaustion, 66.3% in depersonalization, and 92.4% in reduced personal accomplishment. A total of 31.5% of faculty members revealed a high level of burnout in two sub-dimensions, while 30.5% revealed a high level of burnout in all three sub-dimensions. Woman faculty members or those younger than 40 reported significantly higher emotional exhaustion and depersonalization. Long working hours (≥ 80 hours/week) showed the highest reduced personal accomplishment scores (F = 4.023, P = 0.018). The most significant stressor or burnout source was “excessive regulation by the government or university.” The research was the most exasperating task, but the education was the least stressful. Conclusion This first nationwide study alerts that a significant number of faculty members in Korean medical schools seem to suffer from a high level of burnout. Further studies are necessary for identifying the burnout rate, related factors, and strategies to overcome physician burnout.