Objective The number of high-risk pregnancies is increasing in tertiary medical centers. Therefore, we investigated perioperative outcomes based on risk factors to ascertain proper maternal and neonatal management. Methods We reviewed the medical records of patients receiving cesarean sections over an 8-year period. Clinical parameters for anesthesia and the neonatal outcome were compared among high-risk groups after subdivision by the number of clinical risk factors. The groups were as follows: group A (one risk factor), group B (two risk factors), and group C (three or more risk factors). Results Patient age, estimated blood loss (EBL), and volume of transfused red blood cell (RBC) were higher in group B than group A. Birth weight, 1- and 5-minute Apgar scores, and gestational age were lower while the frequency of neonatal intensive care unit (NICU) admission was higher in group B than group A. Group C patients were significantly older than group A or B patients. Birth weight, 1- and 5-minute Apgar scores and gestational age were significantly lower while frequency of NICU admission was higher in group C than group A and B. Conclusion The number of maternal risk factors was positively associated with adverse outcomes in the neonates.
[Purpose] This study aims to explore the nature of competency for the effective operation of competency-based curriculum in university education and conduct a case comparison study focusing on the design of the backword curriculum. The focus of the discussion is on competency-based education and compares competency-based education operated by universities in Australia, Finland, the United States, and Canada. In particular, at the university education level, the design and development of competency-based curriculum were compared with a focus on backward design. [Methods] To achieve this purpose, first, in terms of literature research, we explore the possibility of integrating competency-based education and backward curriculum design. In addition, competency-based education in university education operated in four countries is analyzed based on the established comparative criteria, focusing on case studies. [Results] Based on the commonalities and differences of comparison results, a plan to realize a competency-based curriculum was proposed, focusing on the possibility of integrating competency-based curriculum development and backward design. As a result of major research, a backword design that can be used in university education was proposed, focusing on the possibility of integration of competency-based backword curriculum design. Therefore, in terms of goals, the selection of competencies related to the professional world and goals that reflect the needs of learners are set. In addition, it presents performance tasks and feedback related to life in terms of evaluation that can confirm goals. Finally, it is the stage of teaching and learning development that can learn all cognitive, affective, and psychological areas. We design this series of competency-based steps and present systematic development steps to evaluate all courses. [Conclusion]In order to establish systematic development of competency-based education from a practical and effective perspective, it is necessary to develop a curriculum based on backward design.
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