bluuebunny/crossref_metadata_2025 huggingface dataset:
Can You Trust a Box Diet?
Authors: Orkusz Agnieszka , Dobrzyńska Daniela
Published: March 2023

In recent years the pace of human life has increased significantly. Sometimes, overworked people do not have time to prepare five meals a day by themselves, and use the services of catering companies offering ready-made meals that are delivered directly to the client’s place of work or residence in the form of a box.. This study aimed to evaluate the diet of individual customers based on the standard diet developed by one of the companies (the company was randomly chosen) engaged in dietary catering based in Lower Silesia. This evaluation was carried out based on menus prepared for ten days. For this purpose, the Diet 6D programme, developed by the Institute of Food and Nutrition in Warsaw, was used. The amounts of basic nutrients in the standard dietary menus adopted by the catering company did not comply with the recommendations for a rational diet. The advantage of the served meals was that the customers were offered a daily variety of meals rich in vegetables and fruit.
‘Making sense’ of urinary incontinence: A qualitative study investigating women’s pelvic floor muscle training adherence
Authors: Hay-Smith E. Jean C. , Pearson Mark , Dean Sarah
Published: March 2023

Urinary incontinence is common and disabling. Pelvic floor muscle training is recommended as first-line therapy for uncomplicated urinary incontinence. The effects of such behavioural therapies depend in part on adherence. We explored women’s experiences of incontinence treatment and training adherence in a longitudinal qualitative design. Six women (40–80 years) with stress, urgency or mixed urinary incontinence symptoms were interviewed twice; once at the start of treatment and again after discharge about 3 months later. Interviews were transcribed and analysed using principles of Interpretative Phenomenological Analysis. Experiences were represented by four themes: Past experiences and meanings of leakage; the supervised treatment period; going on and looking ahead; and the relationship with and experience of others. Variable adherence was explained by how women ‘made sense of it all’. Women with the least difficulty in making sense of their incontinence and in overcoming training inertia had the best self-reported outcomes. Conversely, variable adherence, poorer self-reported outcomes, and ambivalence about engaging in treatment were characteristic of women who struggled to make sense of their apparently intermittent or unpredictable condition. Helping women make sense of incontinence and overcome inertia and ambivalence could improve adherence, but this may be a prolonged process.
Rural Arizona Medication Therapy Management (RAzMTM) Program Field Notes
Authors: Lampley Katrice , Therrien Nicole
Published: March 2023

These Field Notes summarize the Rural Arizona Medication Therapy Management (RAzMTM) Program’s work toward assessing the effectiveness of telehealth pharmacy services in improving health indicators for people who are medically underserved, managing chronic disease, and reducing adverse drug events in patients.
Colorectal Cancer Incidence, United States—2003−2019
Authors: Ellington Taylor
Published: March 2023

U.S. Cancer Statistics data brief on colorectal cancer incidence in the United States during 2003 to 2019.
Identificación de pacientes de muy bajo riesgo de transición a la severidad en confirmados de covid-19. Cuba. 2020- 2021
Authors: Monzón-Peréz Maicel , Sanchez-Valdés Lizet , Lage-Dávila Agustín
Published: March 2023

Introducción: La pandemia de covid-19, amenaza para la salud mundial, desbordó los sistemas de salud en muchos países. Realizar una adecuada clasificación del riesgo de transmisión resulta de vital importancia. Objetivo: Identificar pacientes con muy bajo riesgo de transición a la severidad en pacientes  confirmados de covid-19 en Cuba. Métodos: Se realizó un estudio ecológico  que tuvo como base el registro nacional de pacientes confirmados de covid-19.  Se analizaron  10600 individuos entre el 11 de marzo de 2020 y el 31 de mayo de 2021. Las variables de respuesta seleccionadas fueron admisión en UCI y mortalidad, ambas medidas a los 30 días de la confirmación de la enfermedad. Los predictores fueron la edad  y la presencia de comorbilidades.  Se aplicó  un algoritmo de árboles de clasificación para identificar estratos de riego. Se determinó para cada estrato, su volumen, el riesgo de transición a la severidad y el riesgo explicado. Resultados: Se comprobó que los pacientes con  edad menor de 65 años y sin comorbilidades, que concentraba el 86,8% de la muestra, tenían muy bajo riesgo (0,2%)  de  admisión en UCI y de muerte. Los modelos demostraron una buena calibración y discriminación. Conclusiones: El estudio permitió identificar individuos con muy bajo riesgo de transición a la severidad seguidos desde la atención primaria de salud con  ingreso en el hogar y tratamiento sintomático. La metodología propuesta basado en la evidencia permitió perfeccionar los procedimientos de derivación hacia los distintos escenarios  y priorizar recursos de salud limitados.
From-Whom-to-Whom Relationships in the Financial Accounts of the United States A New Methodology and Some Early Results
Authors: Batty Michael M. , Holmquist Elizabeth , Kurtzman Robert J.
Published: March 2023

The Financial Accounts of the United States (the Accounts or FAUS) provide data on the financial assets and liabilities of major sectors of the United States economy, disaggregated by financial instrument. The Accounts can thus serve many purposes, such as sizing sectors and instruments, analyzing changes in credit flows, and assessing the net worth of households.
Nonresidential construction spending is likely not as weak as it seems
Authors: Brandsaas Eirik , Garcia Daniel , Nichols Joseph , Sadovi Kyra
Published: March 2023

Unlike any other major component of GDP, private investment in nonresidential structures excluding drilling and mining (henceforth "NRS") has steadily declined since the start of 2020. Figure 1 shows the evolution of GDP as well as the main components of private domestic final demand since 2019.
Conceptualization of the task of information support of strategic planning processes at the regional level
Authors: Nizamutdinov M. M. , Oreshnikov V. V.
Published: March 2023

At present, improving the quality of strategic planning at the regional level is one of the top priority tasks for the government authorities in the Russian Federation. It is mainly connected with the necessity of improving information maintenance of the process as the key element of the management cycle (analysis, planning, execution) determining the target parameters of social and economic development of the region. The study involves analysis of the legal and regulatory framework of strategic management and the system of strategic planning instruments in the Russian Federation. The authors point out that their development includes both official procedures and content stages of determining parameters of strategic management of the regional development. Improvement of the effectiveness of their implementation may be achieved by applying formalized methods for describing the object of management and the process of strategic planning itself. The study highlights and describes its main stages: goal setting (determines the directions of the region’s development with the consideration of numerous levels of administration, goals of development and the criteria for their achievement), scenario forecasting (considers probable variants of changes in internal and external factors), creating an indicative plan (provides for the quantitative characteristics of the desired state of the regional system) and regulating (determines the vector of control actions directed towards correction of the indicator values observed). It is pointed out that in practice the above mentioned stages can overlap in time and be repeated many times in order to update the process. The stages are directly implemented through the set of functions described in the article with the key stages involving development of strategic decisions and making strategic choices. Thus, it is these functions that are very often the least formalized ones and that demand appropriate information support. Within the study, a number of groups of sources of structured and poorly structured information were identified (including the results of surveys, expert evaluation, etc.). As a whole, the formed information environment of the decision-maker involves both information sources and the interrelation between the stages of strategizing, as well as the strategic planning instruments.
Commodity market profiling methodology
Authors: Gribkov A. A.
Published: March 2023

The article considers the methodology of commodity markets research, which includes the assessment of the volume and structure of supply and demand according to a wide range of indicators. The information on formation of system representations of markets on the basis of segmentation of markets, marketing profiling of markets and their clients is generalized. The market profiling approach is discussed in depth. This approach consists in the representation of the market as a multidimensional array of data on the type of goods, price ranges, the distribution of buyers and sellers by region, industry and other characteristics on the basis of available reliable, but incomplete data. The article considers the problem of obtaining reliable data to determine their reliable sources and organization of data collection in the framework of consulting services. The relevance of the task of forming the correct sample for consulting markets research, which provides in conjunction with data from public sources, a representative representation of the commodity market. Specific features of commodity markets, which causes the variability of approaches to the market dependence on imports, the share of direct deliveries, transport channels of supply and other factors have been considered; features of profiling in the express-analysis of commodity markets have been determined. As an example of practical realization of commodity markets profiling methodology, the market of hot-rolled stainless steel sheets with thickness of 2.0–13.0 mm and width up to 1600 mm is considered. This market is characterized by high import dependence and, therefore, the Federal Customs Service database was used as a source of information for it. Market profiling, performed in accordance with the proposed methodology, provided detailed information on the distribution of imports and consumption of individual groups of stainless steel sheets. Estimates of the commodity market obtained as a result of the study using market profiling have been verified by independent consulting studies.
Digital inequality of the Russian regions: strategic opportunities and threats
Authors: Vlasyuk L. I.
Published: March 2023

The article presents evaluation of digital inequality of the Russian regions – the subjects of Russia. Digital inequality has been assessed according to access to the Internet and digital technology which corresponds to the first level digital divide concept. Also, the Russian regions’ inequality in the effectiveness of use of digital technologie has been evaluated by the gross value added under the section “Information and communication activities”. During the first stage of the study the author analyzed 37 indicators characterizing the digital technology development in the regions to select 12 of them and perform the cluster analysis. The cluster analysis engaged indicators which had high variation coefficients and were not related to each other. The indicators with correlation coefficient exceeding 0.75 were excluded. The second stage of the study involvedk-means clustering of 85 regions of Russia with the use of STATA econometric package. As a result of cluster analysis the author identified four groups of homogenious regions varying by the level of access to digital technologies, strategic opportunities and threats of further development. The next stage of the study involved evaluation of digital inequality of the regions by means of the Theil index. The author used the “Information and communication activity” indicator’s value as the resulting indicator to make the Theil index calculation. The calculations were made for all the 85 regions as well as for the four groups of the regions for 2016 and 2020. The decomposition of the Theil index made it possible to assess the intra-group and intergroup inequality. It has been stated that digital inequality in the regional perspective is increaing in spite of the fact that the general penetration of digital technologies is rather high for the country. One of the factors determining the digital inequality is lack of finance for the implementation and use of digital technologies. Each of the group of regions identified has been suggested a scheme of strategic priorities to overcome the digital inequality.
Percepción del riesgo y su incidencia en el comportamiento digital entre estudiantes universitarios
Authors: Maza-Ávila Francisco , Torres-Fernández Melissa Andrea , Romero-Solano Vanessa Paola
Published: March 2023

Objetivo: Analizar la percepción de riesgo que tienen los estudiantes universitarios frente al uso de medios digitales, así como la incidencia en su comportamiento digital. Métodos: Los datos fueron obtenidos de un cuestionario estructurado aplicado, mediante la técnica de encuesta, a una muestra de 329 estudiantes de programas presenciales de grado de una institución pública ubicada en la ciudad de Cartagena de Indias, Colombia, asumiendo un nivel de confianza del 95% y un error muestral del 5%. Resultados: a) El 50,15% de los jóvenes universitarios considera tener una alta exposición a riesgos al desarrollar sus actividades en los medios digitales; b) El 47,72% señala que los riesgos inciden, de forma notable, en su comportamiento digital; C) Las estrategias más adoptadas para su protección ante riesgos son: el actuar con prudencia al recibir mensajes de desconocidos (57,75%), bloquear de páginas sospechosas (53,19%), y solo conectarse desde un dispositivo que considere seguro (52,58%). Conclusiones: Los jóvenes universitarios son conscientes de la existencia de riesgos en el entorno digital, así como de su incidencia en su comportamiento digital; sin embargo, siguen accediendo a éstos con gran frecuencia, aunque adoptando estrategias para su seguridad, puesto que se han convertido en parte de su cotidianidad.
Incidencia de Factores Socioemocionales en el Rendimiento Académico de Estudiantes de Secundaria
Authors: Soto-Romero Omar , Venegas-Linares Diana , Medina-Hernández Edith
Published: March 2023

Objetivo: Estudiar cómo el desarrollo de las habilidades sociales y la inteligencia emocional, influyen en el desempeño académico de los estudiantes de secundaria.  Método: En este artículo se busca analizar de forma cuantitativa y mediante las técnicas de análisis no supervisado: Análisis de Componentes Principales (PCA), Clúster Jerárquicos y Reglas de Asociación, la incidencia en el rendimiento académico, de factores socio-emocionales y de estilos de aprendizaje, para una muestra de 494 estudiantes de secundaria de la Institución Educativa Ciudad Verde de Soacha Cundinamarca, Colombia. Resultados: Desde los resultados del estudio se concluye heterogeneidad en el desarrollo de las habilidades sociales, la inteligencia emocional y los estilos de aprendizaje de los estudiantes, de forma que se observan distintos niveles de asociación entre estos factores y el rendimiento académico. Discusión y Conclusiones: También se identifican tres grupos o clusters de estudiantes, desde los cuales es posible plantear sugerencias para la implementación de estrategias en la institución educativa, que buscan fortalecer su formación integral y mejorar su calidad educativa.
Censos agropecuarios, territorios inmateriales y procesos de mercantilización El caso de las explotaciones sin límites definidos en Argentina
Authors: Paz Raúl
Published: March 2023

Las explotaciones sin límites definidos (ESLD) son parte de la estructura agraria Argentina, en especial de las regiones semiáridas habitadas por campesinos y pueblos originarios e indígenas. El período entre los censos nacionales agropecuarios (CNA 2002/2018), muestra la desaparición de 10.337 ESLD para cuatro de las  províncias (Santiago del Estero, Salta, Jujuy y Neuquén) ubicadas en la región semiárida y con mayor número de ESLD. La expansión territorial del capital sobre estos territórios, se da en estas províncias sobre el avance de la frontera agropecuaria, la adquisición de tierras para el turismo, la megaminería y la extracción de hidrocarburos con la participación de grandes inversiones de capital nacional e internacional. Ese proceso es esperable y deseado por parte del capitalismo, puesto que responde al territorio imaginado por el pensamiento colonizante, materializado en el agronegocio y el extractivismo. En esa línea y puesto que los datos confirman este proceso, no hay  preocupación alguna sobre el grado y calidad de cobertura estadística con respecto al  universo de estudio, tomando la información que arroja el CNA 2018 como cierta y verás.

Este artículo buscará demostrar que el CNA 2018 presentó falencias en el barrido censal y que el mismo impactó en la subvaloración de las ESLD. También intentará reflexionar sobre el significado de esa subvaloración y la necesidad por parte de los movimientos sociales campesinos e indígenas, en extender su lucha al territorio de las ideas, en especial en la generación de información por parte del sistema estadístico nacional.
Conservación neoliberal en el norte argentino. El caso de las luchas indígenas por la selva y el desarrollo turístico en la Reserva de Biosfera Yabotí
Authors: Ferrero Brián G.
Published: March 2023

Los procesos de mercantilización de la naturaleza se asocian a formas de privatización, cercamiento, alienación, individualización y valoración de territorios y recursos. En la Reserva de Biosfera Yabotí, en el noreste argentino, tiene lugar un incipiente de un proceso de valoración turística de la selva, llevado adelante por empresas forestales con apoyo estatal y de organizaciones conservacionistas. Pero que también es apoyado por las comunidades mbya-guaraní que durante décadas se han enfrentado a la explotación del monte llevada adelante por esas mismas empresas. De manera que aquí la participación de las comunidades indígenas en el proceso de valoración turística y mercatilización de la naturaleza no puede explicarse tan sólo como el paso a una nueva forma que toma la expansión del capital, sino que deviene de una larga trayectoria de luchas indígena. En este trabajo proponemos que la mercantlización se alcanza como parte de un acuerdo dado en términos desiguales pero donde las comunidades encuentran en este mecanismo una forma de cierta resolución de una disputa territorial.
Mercados como cultura: Los lazos sociales, crédito rural y ferias de alimentos
Authors: Colpari Cruz Otto , Cassol Abel
Published: March 2023

La sociología económica contemporánea defiende la idea de que los mercados son resultado de lazos interpersonales y los significados sociales. Esto en contraposición a una visión hegemónica de estudiar los mercados desde la perspectiva de la teoría económica, donde la cultura y la vida social son disociadas de los fenómenos económicos. En ese sentido, el objetivo del presente artículo es comprender como los mercados tienen un profundo enraizamiento en la cultura y los lazos sociales. Para dicha tarea se describe dos experiencias de investigación de mercados latinoamericanos: La primera, la formación de un mercado de crédito rural en comunidades indígenas Chibuleo del Ecuador y la segunda experiencia se refiere a las tradicionales ferias de Campina Grande y Caruaru ubicadas en el Nordeste del Brasil. Las evidencias empíricas se sustentan en los resultados de las investigaciones doctorales de los autores, que reflejan que los mercados están enraizados en circuitos interpersonales.
Áreas naturales protegidas y cogestión: aspectos críticos en el Parque Nacional Cofre de Perote (Veracruz, México)
Authors: Vallejo Román Janett , Rodríguez-Torrent Juan-Carlos
Published: March 2023

En este artículo se desarrolla una discusión sobre las Áreas Nacionales Protegidas (ANP), desde la perspectiva de las alteraciones de los sistemas de vida de las poblaciones que viven en ellas. Mediante una investigación cualitativa de corte etnográfico, se analizan intereses, acciones y resistencias de actores relevantes en esquemas de gestión de ANP. Se describen las estrategias y los intereses sobre el Parque Nacional Cofre de Perote (PNCP), que corresponde a un área protegida con poblaciones de estancia, usufructo y dependencia permanente de algunos recursos forestales, y que brinda un conjunto de servicios ecosistémicos a una vasta región. Entre ellos destacan la generación de humedad y lluvia, así como el abasto de agua para consumo humano y actividades productivas. Se concluye que, desde su decreto como área protegida, se han experimentado diversas formas de intervención estatal, en las cuales la agencia, el conflicto y las tensiones entre habitantes, burócratas y funcionarios técnicos han sido una constante. Ello obliga a replantear las formas de intervención en estos espacios necesarios, cuyo número crece a escala mundial. La cogestión es un camino de responsabilidad compartida frente a los ecosistemas amenazados, con un balance de poder e interacciones entre los involucrados, y transparencia en la información, lo cual posibilitaría optimizar la gestión y contribuir de manera efectiva a combatir el cambio climático.

Abstract

This article discusses the National Protected Areas (NPA), focusing on the alterations of the life systems of people who live therein. Throughout qualitative ethnographic research, the interests, actions, and resistance of relevant actors in NPA are analyzed. The article explores the strategies and interests surrounding the Cofre de Perote National Park (CPNP), a protected area with populations who permanently live there, enjoy usufruct rights, and have a perpetual dependence on various forest resources. The park offers a set of ecosystemic services to a vast region: it generates humidity and rain while supplying water for human consumption and productive activities. It is concluded that, since the establishment of the CPNP, the State has intervened in various ways. Participation, conflict, and tensions between inhabitants, bureaucrats, and technical officials have been ongoing. This situation leads to revisiting critically the ways of intervention in these spaces, which are growing at the global level. Co-management is a path of shared responsibility for threatened ecosystems, with a balance of power and interaction among stakeholders, and transparency in information that would substantially improve management and make a real contribution to fighting climate change.
Álgebra matricial
Authors: Arias Rueda Jhon Herminson , Romero Romero Carlos Alberto
Published: March 2023

Este libro surge de la necesidad que tienen los estudiantes de los primeros niveles de una carrera de ingeniería de aplicar los conocimientos que van adquiriendo directamente en lo que a futuro será su campo laboral. Tradicionalmente los libros de álgebra se enfocan en dar solución a problemas que están fuera de un contexto directamente relacionado con el estudiante. Y aún, cuando podemos encontrar textos que aplican el álgebra a problemas de ingeniería, estas aplicaciones suelen ser enfocadas en distintos ámbitos, sirviéndole al estudiante solo para tener un panorama general de las diferentes aplicaciones que tiene el álgebra dentro de la ingeniería. Sin embargo, la experiencia nos ha demostrado que sería más productivo para un estudiante enfocarse sobre todo en las aplicaciones que tiene el álgebra específicamente dentro de su carrera de ingeniería. Es así como surgió la idea de escribir un libro de álgebra matricial orientado a aquellos estudiantes que desean especializarse en las actividades agropecuarias titulado: El álgebra matricial aplicada a la actividad agropecuaria. El álgebra matricial puede aplicarse en las actividades agropecuarias que están relacionadas con la producción, ingreso o ganancia por venta de productos lácteos y cosechas, área de superficies, volumen de depósitos, equilibrio estático, entre otros.
Does Viral Anxiety Influence the Insomnia Severity Among Patients With Insomnia Disorder During COVID-19 Pandemic?
Authors: Sleiman Jana , Cho Eulah , Lee Dongin , Cho Inn-Kyu , Chung Seockhoon , Uygur Omer Faruk
Published: March 2023

Background and Objective We aimed to investigate whether viral anxiety affects insomnia severity in patients with insomnia disorder during the coronavirus disease 2019 (COVID-19) pandemic. In addition, we examined whether viral anxiety mediates the influence of dysfunctional beliefs about sleep on insomnia severity.Methods The medical records of 111 patients who visit the sleep clinic from September 2021 to May 2022 were reviewed. Patients’ symptoms were rated with rating scales including Insomnia Severity Index (ISI), Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Dysfunctional Beliefs and Attitudes about Sleep-16 items (DBAS-16), Patient Health Questionnaire-9 items (PHQ-9), Epworth Sleepiness Scale, and discrepancy between desired time in bed and desired total sleep time (the DBST index).Results The SAVE-6 score was not significantly correlated with ISI score among insomnia patients. Linear regression analysis showed that the ISI score was expected by PHQ-9 (β = 0.21, p = 0.038) and DBAS-16 (β = 0.42, p < 0.001). Mediation analysis showed that viral anxiety did not mediate the influence of dysfunctional beliefs about sleep on insomnia severity.Conclusions We could not observe the mediating effect of viral anxiety on the association between dysfunctional beliefs about sleep on insomnia severity. Though COVID-somnia was one of big issues in this COVID-19 pandemic, the influence of virus on the severity of insomnia among insomnia patients needs to be interpreted cautiously.
Teaching Portfolios in Medical Education
Authors: Chae Su-Jin
Published: March 2023

The purpose of the study was to investigate the concept and content of teaching portfolios and to consider the use of teaching portfolios in medical education. The concept of teaching portfolios has several implications and has been used in multiple approaches in teaching-learning processes. The ten foreign universities chosen for this study employ teaching portfolios in their professorship and teaching achievement evaluation as a means of deciding promotions or incentivizing employees. However, domestic universities have not yet implemented this system. It is proposed that in order to improve the quality of education programs, teaching portfolios should be used much more frequently than syllabus. Medical school professors should apply what is called “Copernicus’s Thinking” to their teaching preparations.
Correlations of Information Gathering Scores between Checklists and Interstation Works in a Clinical Performance Examination
Authors: Kim Jong Hoon
Published: March 2023

Purpose: Until now, students wrote only differential diagnoses and plans during the interstation work (IW) portion of clinical performance examinations (CPX). The contents of history taking (Hx) and the physical examination (PE) were only evaluated using checklists. This study addressed the correlations of Hx and PE scores from the checklists and the subsequent IW to research the necessity of adding Hx and PE sections in to the IW. Methods: One hundred and thrity-three students participated in a ten case CPX, and eight cases were used in this study. Immediately following the 12 minute patient encounter, students were given 6 minutes to write the IW. For the Hx and PE section, students were instructed to write the findings that they considered key information in approaching the patient’s problem. The Hx and PE sections of the IW were scored using the same items that appeared on the SP checklist. Calculations of Spearman’s rho were performed to find the relationship between the checklist scores and IW scores of Hx and PE sections. Results: Correlations of Hx and PE scores between the SP checklists and IW were low to moderate. Across the eight cases, the median Spearman’s rho was 0.37 with a range of 0.14 to 0.54. Conclusion: We suggest that, because SP checklist scores measure only what information the students gather, but not their reasons for doing so (e.g.: relative importance), students tend gather very specific information from the patients. By analyzing of their IW, we were able to explore how students prioritize the important information they have obtained from the patients.
Cognitive Load and Instructional Design in Medical Education
Authors: Oh Sun A , Kim Yeon Soon , Chung Eun Kyung
Published: March 2023

TThe purpose of this study was to review the definition of cognitive load (CL), the relationship between CL and instruction- al design, and to provide a viewpoint of CL in curriculum and instructional design in medical education. Cognitive load theory (CLT) makes use of three hypotheses about the structure of human memory: working memory (WM) is limited in terms of the amount of information it can hold, in contrast with WM, long term memory is assumed to have no limits and organizes information as schemata. CL indicates the mental load on the limitation of WM. CLT has been used to design instructional interventions that help to ease the learning process. Extraneous CL is related to irrelevant instructional interventions, while intrinsic CL is the complexity of the information itself. Germane CL is the cognitive process for acquiring schema formation. It is a necessary CL to achieve deeper comprehension and solve problems. The range of medical education includes complex, multifaceted and knowledge-rich domains with clinical skills and attitudes. Therefore, CLT may be used to guide instructional design in medical education in terms of decreasing extraneous CL, adjusting intrinsic CL and enhancing the germane CL.
Does Practicing Communication Skills with Standardized Patients or Completion of Elective Course of Communication Skills Affect the Scores of Clinical Performance Examination?
Authors: Kim Jong Hoon
Published: March 2023

Purpose: Communication skills are considered as one of the essential requirements in medical education, and the training often involves exercising medical interviews with standardized patients(SP) or role play. This study investigated the helpfulness of the communication skills training programs for students’ performance on the clinical performance examination (CPX). Methods: Fourth-year students who have taken one of two communication skills programs(exercising communication skills with SP or elective communication skill course with role play) completed a questionnaire on their evaluation of the helpfulness of communication skills programs immediately after finishing the CPX. Then, the programs were objectively assessed by comparing all fourth-year students’ CPX scores between program participants and non-participants. Results: About 70% of participants answered that the programs were helpful to perform clinical clerkship and CPX. However, there was no difference in either the total CPX score or 2 categorical scores(integrated clinical encounter, communication and interpersonal skill) between program participants and non-participants. Conclusion: Although the students felt that the communication skills programs were helpful to their clinical activities, this study failed to find objective evidence of any effect of the programs on the CPX results. Communication skills training should be continued during clinical clerkship to maintain or enhance the skills, and it is necessary to introduce more effective methods for precise evaluation of students’ communication skills.
The Effectiveness of an Instructor’s Intervention Using Questioning Strategy in Physiology Class
Authors: Ann Duck Sun , Hwang Eun Young , Yang Eunbae
Published: March 2023

T his study was done to analyze students’ learning and its lasting effect by teaching strategy involving questioning. This study was performed with 68 students who were enrolled in a physiology class of the Yonsei University College of Medicine in Seoul, Korea, in 2003. The students were randomly divided into 2 groups. One group was taught in a way where students asked questions and the instructor answered the questions. For the other group of students, the instructor asked questions, and the students answered the questions. We performed a pre-test before the study begins and post-tests immediately, 3 weeks, and 6 weeks after the study. The results were analyzed by using analysis of covariance and repeated measures analysis of variance. A higher learning effect was observed in a group where questions were asked by students compared with the other group. The post-test results showed no significant difference in the lasting effect of learning according to the teaching strategy. Students’ learning significantly improved when students asked questions and the instructor answered the questions compared with the strategy of the instructor asking questions and students answering to the questions
The Impact of Tutors’ Domain and Teaching Expertise on Medical Students’ Learning Outcomes in a PBL Environment
Authors: Kang Myunghee , Lee Sujie , Kim Minjeong , Kim Minji
Published: March 2023

T his study aimed to investigate the effects of tutors’ domain and teaching expertise on learning outcomes in a problem based learning (PBL) environment. Four tutors and 25 first-year medical students participated in this study. Tutors’ domain expertise was classified by clinical or non-clinical which is basic medicine and teaching expertise by previous tutoring experiences or not. The results showed a statistically significant difference in achievement depending on the tutors’ domain expertise. Students grouped with an experienced clinical tutor attained higher achievement scores than those with an experienced non-clinical tutor, while those with an inexperienced non-clinical tutor attained higher scores than those with both inexperienced clinical tutors and experienced non-clinical tutors. Students with clinical medicine tutors also showed higher satisfaction scores than those with non-clinical medicine tutors. In particular, students grouped with an experienced clinical tutor gained higher satisfaction scores than those with inexperienced non-clinical tutors, and among the inexperienced tutors, students tutored by a clinical tutor showed higher scores than those with a non-clinical tutor. Different intervention styles were also found depending on tutors’ domain and teaching expertise. Experienced tutors gradually reduced the tutoring intervention, whereas the novice provided more as the semester proceeded. Moreover, experts with a clinical medicine degree preferred direct teaching, whereas, non-clinical tutors preferred facilitating. Also, experienced tutors in the clinical medicine facilitated critical awareness than the other tutors. These results show the importance of developing a program for novice tutors to improve PBL in medical education.
Reflection on the Experience of Medical Professionalism Education at Yonsei University College of Medicine
Authors: An Shinki , Bu Sunghee
Published: March 2023

For decades medical educators have continually emphasized medical professionalism, which is reflective response to the challenges of a rapidly changing medical environment. This study aimed to review the experience of implementing medical professionalism education at Yonsei University College of Medicine (YUCM). YUCM introduced a new curriculum in 2004 designed by Curriculum Development Project 2004 (CDP2004), a project that was launched in 2001. CDP2004 reorganized lectures as organ-based integrated lectures, introduced an introductory course for clinical medicine and medical humanities courses for premedical and medical students. Problem-based learning (PBL), elective courses, and self-study sessions in the afternoon were implemented in order to equip students with a self-directed learning attitude as medical professionals. Professors were asked by the CDP2004 curriculum to spend more time on student education and to adopt new teaching methods. Experiences of the CDP2004 curriculum reveals 1) difficulty of motivating professors to be PBL tutors 2) students’ dissatisfaction with the medical humanities course (major critique was that the course was impractical and unrealistic), and 3) students’ optimistic understanding about their future role as medical professionals in influencing and helping people in spite of their perception of the general medical environment not as promising. To foster professionalism, the following are necessary in our experiences: 1) faculty development of medical humanities and medical professionalism, 2) establishment of an environment throughout the whole institution to support medical professionalism education and to integrate the concept into praxis, 3) emphasis on the fact that medical professionalism education is not contradictory to biophysical medical education.
A Study on Direction for the Development of Global Health Education in Korea
Authors: Oh Seung Min
Published: March 2023

As a result of the globalization of diseases and the delivery of health care, physicians today are required to understand global health (GH) including the global burden of disease, health inequities, and effective medical aid. Interest in GH among medical students has also increased significantly. To meet these needs and to reflect an increasing focus on social accountability in medical education, global health education (GHE) programs have already been well-established, particularly in North America. Korea’s official developmental aid (ODA) volume almost tripled from 2006 to 2011. Korea has committed to double its ODA/gross national income ratio over the next three years. With these increases, interest in GH among medical students has significantly increased. Despite significant interest among medical students, GHE programs have not been properly established in Korea. To develop GHE programs in Korea, proposed GHE curriculum frameworks were reviewed and core values, guiding principles, and GH competencies were identified in the context of the current literature. To identify key themes essential to the development of GHE programs in Korea, the curriculum frameworks should be focused on a global context and should be taught from the perspective of the social, political, and economic causes of ill health.
Issues Related to the Objectivity of Student Assessment in Medical Education
Authors: Min Kyung-Seok , Yang Kil-Seok
Published: March 2023

This paper addressed various issues related to the objectivity of student assessment in medical education. The objectivity of assessment was related to all the steps of test development, administration, and results reporting in terms of reliability and validity. Specifically, the objectivity of item formats, representativeness of test content, standardization of test administration, consistency of scoring procedures, and appropriateness of reporting test results were discussed by comparing performance assessment with traditional paper-and-pencil tests. The conclusions were derived from current measurement theories such as standards-based assessment, evidencebased design, and outcome-based assessment. Further, based on Shepard’s propositions (2006), the objectivity of student assessment could be achieved by improving the concordance between educational objectives and assessment components such as item types, test contents, and test administration, scoring, and reporting.
The Concept and Background for Introducing Longitudinal Integrated Clerkships
Authors: Lee Young-Mee
Published: March 2023

A traditional clerkship consists of a series of short rotations in specialty disciplines and is usually based in tertiary, urban teaching hospitals. Shortened inpatient stays and the shift toward ambulatory management have had a negative impact on student learning. There have been growing concerns that the traditional specialty-based clerkship in fragmented and highly specialized clinical environments may not be the optimal choice for basic clinical education. As a result, a new model of clinical clerkship called longitudinal integrated clerkships (LICs) has emerged. There is increased interest in LICs due to the growing evidence of positive outcomes for students, patients, and supervising clinicians. Emphasizing continuity as one of the main organizing principles of an LIC, this article reviews the introduction of LICs into medical education, the key concepts and educational theories which underpin LICs, and the typology of LICs. The author also offers some personal suggestions for contemplation before clerkship programs in Korea adopt LICs.
Factors That Influence Educational Effectiveness and Learning Satisfaction in Biomedical Research Programs during Premedical School
Authors: Yune So-Jung , Park Yong-Sang , Cho Jung-Ho , Han Jong-Min , Hwa Hee-Min , Lee Sang-Yeoup , Im Sunju
Published: March 2023

Although student research programs have been implemented worldwide, research programs during premedical school have unique characteristics. The purpose of this study is to evaluate factors that influence the effects of premedical school research programs. Eighty second-year premedical students at Pusan National University were included in the study. Effect elements and influential factors were extracted through reference reviews and in-depth individual interviews. A Likert scale questionnaire was developed using the extracted elements and factors, and Cronbach’s alpha coefficient was used to analyze the reliability of the survey. The mean value and the standard deviation for each question were calculated to evaluate education effectiveness and learning satisfaction, and the influence of each factor on effect was analyzed using correlation analysis. Students’ research skills and knowledge were improved in the short term; however, interest in research or in a career as a researcher did not increase. Student interest, participation, and contributions were important factors. Among professors, passion, considerateness, and teaching method including the level of lesson were influential factors. Implementation of curriculum and support and guidance were influential as well, whereas evaluation system was not a factor. To improve student research programs, several factors that influence education effectiveness and learning satisfaction should be considered.
Individual and School Factors Affecting Critical Thinking Ability among Nursing Students
Authors: Shin Sujin , Park Inhee , Hwang Eunhee , Jung Dukyoo , Kim Kon Hee
Published: March 2023

The purpose of this study was to investigate factors associated with the critical thinking ability of nursing students at the individual and school levels. The study adopted a descriptive design and recruited 465 nursing students from four nursing schools from November 2014 to September 2015 through convenience sampling. The Clinical Critical Thinking Skill Test was used to measure critical thinking ability, and the data were analyzed with the SAS ver. 9.4 program (SAS Institute Inc., Cary, NC, USA) for descriptive statistics, t-test, analysis of variance, and multi-level model. The results showed that clinical practicum experience (β=-0.72, p=0.025), taking critical thinking courses (β=0.63, p=0.010), and taking simulation courses (β =0.56, p=0.035) improved critical thinking ability in the individual level model. In the school level model, the interaction effect between the years of clinical practice done by the student and the presence of full-time clinical instructors was significant (β=1.29, p=0.011). These results suggest that critical thinking ability improves with the more years of clinical practice individual nursing students have, and this improvement is greater with the presence of full-time clinical instructors in the school. Therefore, it is recommended that nursing students undergo critical thinking and simulation courses to develop their critical thinking ability, and dedicated clinical instructors in nursing schools should play a vital role.
A Survey of Medical Students’ Social Participation and Direction in Medical Education
Authors: Lee Song I , Chang Dong-ho , Park So Youn , Yoon Tai Young , Kwon Oh Young
Published: March 2023

In the ever-changing medical environment, the social participation of medical doctors is becoming more necessary. Currently, there is not enough participation or action by doctors within our society due to reasons such as a lack of educational curriculum in this area. This study aimed to investigate medical students’ opinions and attitudes about social participation and action. A total of 438 medical students were surveyed about their attitudes toward doctors’ relations with the public, social participation, social action, and medical education for social participation or action. Regarding doctors’ relations with the public, participants responded that the government (73.5%) and the media (82.0%) were causing social distrust of doctors, and more than 70% of the respondents answered that doctors were passive when it comes to social participation. When asked about social participation and social action, 76.7% of the students surveyed had experienced social participation, and 28.3% had experienced taking social action. A total of 73.4% of the students answered that medical education needs to be changed, and it is necessary to introduce subjects such as sociology and law to improve social participation and action. The results are significant in that they show medical students thoughts on social participation and social action as doctors in the Fourth Industrial Revolution. We believe that a change of medical curriculum to promote active and collaborative social participation by doctors is necessary.
The Influence of Death Education on Medical Students’ Attitudes towards End‐of‐Life Care: A Preliminary Study
Authors: Kim Hae Won , Park Joong Chul
Published: March 2023

End-of-life care competencies have been perceived as important and essential, so it has been suggested that end-of-life care be studied in undergraduate medical education. However, end-of-life care curriculum has mostly focused on acquisition of knowledge and skills rather than attitudes. Therefore, we aimed to explore whether education about death affects medical students’ attitudes towards care for dying patients and perception of death anxiety, meaning in life, and self-esteem. A total of 15 first- or second-year medical students were surveyed with questionnaires before and after completing a 6-week death education course. Paired data analysis showed that participants’ attitudes towards caring for terminally ill patients and their caregivers improved significantly (t=-2.84, p=0.013) with an effect size of 0.73. In contrast, no significant changes were found in death anxiety, meaning in life, or self-esteem. All participants agreed that formal teaching about death and dying must be encouraged in medical schools. Our results suggest that death education may positively influence attitudes towards end-of-life care. Although replication with larger samples is necessary, this preliminary finding may support the importance of developmentally appropriate end-of-life care education in medical schools.