Sun Yong Baek

Immunohistochemical Characterization of Macrophage and Dendritic Cell Subpopulations of the Spleen, Thymus, Tongue and Heart in Cyclophosphamide‐induced Immunosuppressed Rat

This study was undertaken to investigate the immunohistochemical characterization of different subpopulations of macrophages and dendritic cells (DCs) of the spleen, thymus, tongue and heart in cyclophosphamide (CY)‐induced immunosuppressed rat. After CY treatment, remarkably, ED1+, ED2+ and ED3+ macrophage subpopulations, in general, exhibited signs of cellular activation such as an increase in number and size of cell, and an upregulation of the ED1, ED2 and ED3 reactive surface molecule expression in all the organs studied, except for some macrophage subpopulations including ED1+ macrophages in the non‐lymphoid tissues. Subpopulations of DCs showed a differential sensitivity to CY. Lymphoid DCs were more sensitive to CY than non‐lymphoid interstitial DCs. CY induced a conspicuous upregulation of intercellular adhesion molecule‐1 (ICAM‐1) expression in the vascular endothelial cells, splenic marginal zone and thymic cortex. In this study, we demonstrated the in vivo effects of CY treatment on subpopulations of macrophages and DCs as well as on ICAM‐1 expression in the rat spleen, thymus, tongue and heart. Moreover, our results shed more light on the activation effects of CY on certain subpopulations of macrophages, on the differential sensitivity of DCs to CY between the immature and mature ones, on the functional role of different subpopulations of macrophages, and on the significance of upregulated ICAM‐1 expression in the splenic marginal zone and thymic cortex after CY treatment.

Analysis of questioning technique during classes in medical education

BackgroundQuestioning is one of the essential techniques used by lecturers to make lectures more interactive and effective. This study surveyed the perception of questioning techniques by medical school faculty members and analyzed how the questioning technique is used in actual classes.MethodsData on the perceptions of the questioning skills used during lectures was collected using a self‒questionnaire for faculty members (Nu2009=u200933) during the second semester of 2008. The questionnaire consisted of 18 items covering the awareness and characteristics of questioning skills. Recorded video tapes were used to observe the faculty members’ questioning skills.ResultsMost faculty members regarded the questioning technique during classes as being important and expected positive outcomes in terms of the students’ participation in class, concentration in class and understanding of the class contents. In the 99 classes analyzed, the median number of questions per class was 1 (0–29). Among them, 40 classes (40.4u2009%) did not use questioning techniques. The frequency of questioning per lecture was similar regardless of the faculty members’ perception. On the other hand, the faculty members perceived that their usual wait time after question was approximately 10 seconds compared to only 2.5 seconds measured from video analysis. More lecture‒experienced faculty members tended to ask more questions in class.ConclusionsThere were some discrepancies regarding the questioning technique between the faculty members’ perceptions and reality, even though they had positive opinions of the technique. The questioning skills during a lecture need to be emphasized to faculty members.

Effects of Differences in Problem-Based Learning Course Length on Academic Motivation and Self-Directed Learning Readiness in Medical School Students

PURPOSEnProblem-based learning (PBL) is an educational approach in which complex authentic problems serve as the context and stimulus for learning. PBL is designed to encourage active participation during learning. The goal of this study was to study the effects of PBL on academic motivation and self-directed learning readiness in medical school students.nnnMETHODSnThe subjects of this study were 190 students in the 1st and 2nd grade of medical school. The period of the PBL course was two weeks for Year 1 and five weeks for Year 2 students. Students completed one module over one week. Academic motivation tests and self-directed learning readiness tests were performed before and after the PBL course. The differences between the two groups were analyzed using paired t-test and repeated measures MANCOVA.nnnRESULTSnPBL had positive effects on academic self-efficacy (self-control efficacy, task-level preference) and academic failure tolerance (behavior, task-difficulty preference) as academic motivation. PBL had a mildly positive effect on self-directed learning readiness. In addition, the five-week PBL course had greater positive effects on academic motivation than the two-week course but not with regard to self-directed learning readiness.nnnCONCLUSIONnMedical students engage in academic motivation and self-directed learning readiness during PBL, suggesting that the five-week PBL course has greater positive effects than the two-week course. Future studies are needed to confirm the most effective periods of PBL.

Effects of micro- and subtle-expression reading skill training in medical students: A randomized trial.

OBJECTIVEnto investigate the effectiveness of the Micro Expression Training Tool (METT) and the Subtle Expression Training Tool (SETT) to help improve the non-verbal communication skills of medical students.nnnMETHODSnIn a randomized controlled trial, all participants were randomly allocated to either a training (n=41) or control group (n=41) and were pre-tested before education with METT and SETT at baseline. Then, training students took second tests after a 1-h class about interpreting micro and subtle expressions and control students took the second tests without the class.nnnRESULTSnMETT pre-test scores were positively related with female gender, agreeableness, whereas SETT pre-test scores were negatively related with age and positively related with female gender. Mean METT score increases of 29.3% and mean SETT score increases of 36.2% were observed after training, whereas the control group achieved only a mean METT score increase of 11.0% at second testing. Increases in both test scores in the training group were significantly higher than in the control group.nnnCONCLUSIONnMETT and SETT are effective, simple tools for improving the micro- and subtle-expression reading skills of medical students.nnnPRACTICE IMPLICATIONSnMETT and SETT can be effective for improving the non-verbal communication skills of medical students.

Holistic rubric vs. analytic rubric for measuring clinical performance levels in medical students

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.

Structured Assessment to Evaluate a Family Medicine Clerkship Program

Eun Ju ParkᆞSang Yeoup LeeᆞSun Ju ImᆞSo Jung YuneᆞBeesung KamᆞSun Yong BaekᆞYun-Jin Kimᆞ Jae Seok WooᆞJeong-Gyu LeeᆞDong-Wook JeongᆞYoung-Hye ChoᆞYu-Hyeon YiᆞYoung Jin Tak Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan; Medical Research Institute, Pusan National University Hospital, Busan; Departments of Medical Education Unit, Family Medicine, and Physiology, Pusan National University Medical School, Yansan, Korea