This study is to investigate the historical characteristics of medical education and healthcare environment in Korea and to suggest the desirable direction for future medical education. We draw a consensus through the literature analysis and several debates from the eight experts of medical education. There are several historical characteristics of medical education: medical education as vocational education and training, as a higher education, rapid growth of new medical schools, change to the medical education system, curriculum development, reinforcement of medical humanities, improvement of teaching and evaluation methods, validation of the national health personnel licensing examination, accreditation system for quality assurance, and establishment of specialized medical education division. The changes of health care environment in medical education are development of medical technologies, changes in the structures of the population and diseases, growth of information and communication technology, consumer-centered society, and increased intervention by the third party stakeholder. We propose five suggestions to be made to improve future medical education. They are plan for outcome and competency-based medical education, connection between the undergraduate and graduate medical education, reinforcement of continuous quality improvement of medical education, reorganization of the medical education system and construction of leadership of ”academic medicine.“
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Schools of public health are graduate level higher educational institutions training students who will be engaging in educational, research and service activities in the field of public health after completing the educational programs.
To meet this institutional goal, the schools of public health should provide diverse academic and professional courses and programs to the students based on their educational objective s.
Educational objective s of schools of public health, of course, should well reflect the working definition of public health : public health is the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts.
There are 13 schools of public health in Korea an of 1999 including occupational and environmental schools.
However, most of them were opened in 1980s and 90s, and therefore, do not have properly described educational and learning objective s.
This paper proposes that Korean schools of public health should review their institutional goals and have clearly stated educational objective s. This also proposes development of standardized learning objective s of core subjects such as epidemiology, statistics, environmental health, health education and public health administration.
Important units of these core subjects are also provided.
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Multiple Choice Question(MCQ) method of examination has long been used as the national medical licensing examination in Korea. If properly used, the MCQ method of examination has considerable value fo r evaluation, and in fact, it has become popular due to its economy of scale, ease of marking and consistency. Moreover, with this method of examination, a large number of candidates can be tested at once and the marking can even be read by automatic readers. However, MCQ does not lend itself so well to problem-solving, which is a far more real-life situation than having to choose between a number of pre-formed alternatives. This, again, however, can be much improved by increasing the proportion of question items associated with interpretation and problem solving level of cognitive domain, and adopting various types of MCQ. This study was planned to examine the proportions of question items by their levels of cognitive domains and the types MCQ together with the contents of medical knowledge of the Korean National Medical Licensing Examinations (NMLE) conducted in 1992 and 1993. All 880 question items (440 question items in each year) were reviewed one by one by three medical education specialists and the levels of cognitive domains, types of MCQ and contents of questions were judged by test subjects. Major findings obtained from the study are as follows: 1) In both years of 1992 and 1993, recall level question items formed 68.0% of all MCQ question items of NMLE. Problem-solving level question items were only 77.% in 1992 and 11.1% in 1993. 2) Major types of MCQ were 'best answer type' one correct answer type'. They were 40.7% and 30.9% of all respectively in 1992, and 35.0% and 32.0% respectively in 1993. Some subjects such as urology and internal medicine were adopting more 'combined response type' MCQ than other subjects. 3) Knowledge contents asked in the NMLE varied very much from subject to subject.
However, the names of diseases were the most prevalent answers asked and they were 21.6% in 1992 and 18.2% in 1993.
This study suggests that the Korean NMLE should increase the proportion of question items measuring the interpretation and/or problem-solving level of knowledge, and adopt several different types of MCQ.
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