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JKM > Volume 37(1); 2016 > Article
Lim, Han, Hong, and Kang: 2016 Competency Modeling for Doctor of Korean Medicine & Application Plans

Abstract

Objectives:

The purpose of this study was to develop a competency model for the Korean medicine doctors and find application plans for the future education in Korean medicine.

Methods:

Based on literature review, we drafted a competency model framework for modeling and defined competencies using generic model overlay method. Also we conducted a FGI with 20 extension specialists in Korean medicine to validate competency model.

Results:

Findings are 5 domains and 15 competencies. 5 domains have optimal patient care, reasonable communication skill, professionalism enhancement, performing social accountability, and efficient clinical management. 3 competencies are included in 5 domains each. With this model, 4 ways of application plans are shown to apply for the future competency-based education in Korean medicine.

Conclusion:

Developed 2016 competency model for the Korean medicine doctors can be a first huge step to innovate education in Korean medicine toward competency-based educational system.

Table 1.
2015 DKM* Competency Model
Competency Sub-competency
Clinical Examination & Diagnosis History Taking & Performing Physical Exam
Utilizing Medical Devices for Diagnosis
Objective Analysis of Patients’ Information
Understanding and Utilizing KCD
Treatment Applying Treatment Skills
Giving Instruction for Effectiveness, Side Effect & Cautions of Treatment
Patient-oriented & Evidence-based Care
Integrative Care
Health Improvement Conducting Teaching Materials for Patient self-care
Offering Discharge Information & Teaching to Prevent Diseases
Communication Skill Communication in between Doctors & Patients
Standardized Communication in between Korean Medicine Doctors
Communication in between Physicians/Medical Practitioners
Professionalism Establish & Maintain Occupational Identity
Keep up with Bioethics
Building Morality
Mutual Respect in between Physicians/Medical practitioners
Observe Research Ethics
Self-Directed Learning Obtaining Medical Knowledge & Improving Practice
Obtain Information of Recent & Advanced Technologies
Scholarship & Research
Teaching, Learning & Sharing
Clinical Management & Administration Keeping Medical Record
Setup Emergency System of Reaction
Prevention of Infection & Safety Management
Manage Medications & Supplements
Finance Management
Human Resources Management
Social Accountability Participating in Public Health Activities Locally & Nationally
Participating in International Cooperative Activities
Participating in Social Events
Participating in Developing Policies for Public Health

* DKM : Doctor of Korean Medicine

Table 2.
Competency Modeling Process Using Generic Model Overlay Method
jkm-37-1-101i01.tif
Table 3.
2016 DKM* Competency Model
Domain Competency Definition Behavioral Objectives
[1] Optimal Patient Care [1]-1 History taking & Physical Examination
  • ■ Grasping patient’s signs and symptoms through history taking and physical examination

  • ■ Selection and using of appropriate medical equipment needed for diagnosis objective analysis of patients’ information

  • ■ Grasp the patients’ signs and symptoms by performing four kinds of diagnosis; seeing, listening, asking, palpating, rightly.

  • ■ Utilize medical equipments needed for diagnosis appropriately, collecting objective information rightly through physical examination, and differentiating meaningful signs and symptoms.

  • ■ Analyze doctor’s opinion, examination record, and refer to them for final diagnosis.

Expertise Knowledge & Practice Skills
  • ■ Understanding the structure of classification of diseases and utilizing disease(pattern/syndrome) name that applies to patient’s signs and symptoms

  • ■ Using treatment technique appropriately

  • ■ Utilize structures and codes of International and Korean classification of diseases appropriately.

  • ■ Perform general treatment skills, mental treatment, rehabilitation treatment considering drug dosage, times and intensity of treatment.

[1]-3 Integrative Care
  • ■ Framing treatment plan respecting patient’s value criterion and applying treatment of high level of evidence preferentially

  • ■ Directing effects and side effects of treatment comprehensively and giving comprehensive caution

  • ■ Understanding knowledge and skills of related fields, applying them to treatment, and integrating them with traditional medicine

  • ■ Decide treatment method considering treatment skills, medical knowledge, sufficient medical experience, and patients’ value criterion comprehensively, and apply treatment of high level of evidence preferentially.

  • ■ Help patient understand by exact explanation about treatment skills.

  • ■ Elevate cure rate utilizing appropriate skills in need, in understanding of relevant academic fields.

[2] Reasonable Communication Skill [2]-1 Physician-Patient Communication
  • ■ Explaining patients’ condition and prognosis using concrete and easy terms for him/her to understand easily, and to form rapport with the patient

  • ■ Explain patients’ condition and expected prognosis of treatment with concrete and easy terms that match patient’s level of understanding.

  • ■ Offer introduction and information needed for patients utilizing linguistic communication tools such as text and phone call.

[2]-2 Standardized Communication in between Korean Medicine Doctors
  • ■ Communicating effectively in between Korean Medicine Doctors using standardized terms and filling in medical record using the terms

  • ■ Use standardized terms when filling in medical record for better understanding between Korean medical doctors and for quick and precise understanding of patient’s condition.

[2]-3 Communication in between Physicians/Medical Practitioners
  • ■ Grasping condition of patient and communicating effectively with medical practitioners of other fields when needed, and performing jobs concerned with joint treatment

  • ■ Differentiate patients’ condition clearly for integrative treatment and communicate in between medical practitioners effectively using appropriate procedure and method.

[3] Professionalism Enhancement [3]-1 Establish Job Identity
  • ■ Establishing identity through continuous introspection of qualification, attitude and values required for Korean medicine doctors

  • ■ Establish job identity and manage own health to perform professionalism well.

  • ■ Recognize duty of promoting social health clearly and manage appropriate dignity.

[3]-2 Emphasis on Ethical Awareness
  • ■ Attitude that accords with life ethics which respects dignity of life

  • ■ Attitude which accords with ethics in job performance

  • ■ Having morality basically required for doctors

  • ■ Attitude obeying research ethics in case reports and research activities

  • ■ Respect and consider patient’s dignity, values, autonomy, and right.

  • ■ Sublate excess treatment and false, exaggerated advertisement.

  • ■ Be aware of relevant acts (ex regarding personal information) when conducting research and obey relevant ethics in performing case report or in writing academic paper.

[3]-3 Learning & Research
  • ■ Acquiring medical knowledge and skills continuously and self-directed, and developing and applying them

  • ■ Educating, passing on, and sharing medical knowledge and experience through announcement and discussion in formal academic societies or through internship

  • ■ Acquire medical professional knowledge such as medical priority, necessity, safety, effectiveness.

  • ■ Learn basic knowledge of Korean medicine such as classic treatises (classic medical texts), medical history, and philosophy of medicine.

  • ■ Acquire latest research accomplishments through Pubmed, Embase, Web of Science, &etc.

  • ■ Contribute to development and expansion of Korean medicine by proposing treatment experience and research outcomes with objective index.

[4] Performing Social Accountability [4]-1 Participating in Public Health Events Locally & Nationally
  • ■ Attitude that contributes to health examination, health promotion, and disease prevention by participating in local community health activities or public health activities spontaneously

  • ■ Participating in various activities which civil society or local communities require

  • ■ Offer health lecture to encourage health consciousness and for improvement of quality of life of local community.

  • ■ Participate in civil society and local community organizations as health professional.

[4]-2 Participating in International Cooperative Activities
  • ■ Having interest and participating in international cooperation on health problems

  • ■ Have interest continuously and participate actively in global cooperation on health problems which become widespread gradually.

[4]-3 Participating in Developing Policies for Public Health
  • ■ Participating in policy and law draft actively for improvement of medical and health environment and development of Korean medicine

  • ■ Have interest in acts, policies, and systems needed for Korean medical society, and make effort continuously for necessary change.

[5] Efficient Clinical Management [5]-1 Patient-Care Management
  • ■ Managing patients’ major information and records including medical records which includes personal information, patient consent forms, by due process of law, and offering introduction and information needed to patients

  • ■ Establishing crisis management and response system, maintaining and managing hospital and clinic clean according to infection management rule, and coping with safety accidents

  • ■ Write and mange medical record and patient consent forms in accord with legal and ethical criteria.

  • ■ Be aware of infection prevention directions and prevent self and cross infection.

[5]-2 Manage medications & supplements
  • ■ Checking defects of medicinal herbs and equipments regularly, and managing them efficiently for easy use and storage

  • ■ Manage medicinal herbs effectively by listing of herbs, etc.

  • ■ Be aware of expiration date of medicinal herbs, storage methods, operation manual of medical equipments and examine them regularly.

[5]-3 Finance & Human Resources Management
  • ■ Managing finance effectively based on understanding of demand for insurance, taxation, etc

  • ■ Recruiting, placing, utilizing medical assistant and hospital management manpower effectively, and educating and managing them

  • ■ Understand how to demand for insurance and manage them.

  • ■ Understand change of overall system precisely.

  • ■ Share visions and values with your assistants.

  • ■ Teach assistants’ attitude to patients regularly.

* DKM : Doctor of Korean Medicine

Table 4.
Competency component in Educational Objectives
School Educational Objectives Competency component
Kyunghee Univ. To acquire values, knowledge, and skills necessary for promoting health by preventing diseases and appropriately treating disease To acquire values, knowledge, and skills necessary for promoting health by preventing diseases and appropriately treating disease [1] Optimal Patient Care

[3] Professionalism Enhancement

To develop strong thinking power and spirit of inquiry and to obtain the latest information for creative research and education To develop strong thinking power and spirit of inquiry and to obtain the latest information for creative research and education [3] Professionalism Enhancement

To foster basic knowledge and the ability to understand western medicine and related fields for establishing a third, integrated medicine To foster basic knowledge and the ability to understand western medicine and related fields for establishing a third, integrated medicine [1] Optimal Patient Care

To cultivate the spirit of service and the capability to understand and solve medical and health problems of the community To cultivate the spirit of service and the capability to understand and solve medical and health problems of the community [4] Performing social Accountability

Wonkwang Univ. Educational goal of this university is to train skillful and servable medical practitioners through enforcement of morality education, for succession and development of traditional medicine and globalization of Korean medicine, since this university pursues “moral university”, whose goal is to train talented people who foster their virtues practice moral principles, and serve to society, based on founding ideal of Won Buddhism. Training of skillful medical practitioners
Training of medical practitioners who have spirit of service
[3] Professionalism Enhancement

Succession and development of traditional medicine
Training of skillful medical practitioners
[1] Optimal Patient Care

Globalization of Korean medicine
Training of medical practitioners who have spirit of service
[4] Performing socialaccountability
Table 5.
Illustration of qualitative difference between specialties in describing reasonable communication skills
Domain Competency Definition Specialty Behavioral Objectives
[2] Reasonable communication Skills [2]-1 Communication in between doctors & patients Explaining patient’s condition and prognosis using concrete and easy terms for him/her to understand easily, and to form rapport with the patient Ophthalmology, Otorhinolaryngology & Dermatology
  • Explain disease to patients visually and plainly using Ophthalmology, Otorhinolaryngology & Dermatology models and graphic data

Internal medicine
  • Explain the cause, signs, treatment, management, prognosis, and prevention of patient’s current complaint to the patient and guardians plainly, and inspire activeness and will which are helpful in treatment and management

Neuropsychiatry
  • In case of mental disorder, doctors should relate patient’s narrative of accidents with symptoms for the evaluation of cause of the outbreak, and induce the patient to medical communication

  • When making final diagnosis, doctors should set appropriate relationship range which allows therapeutic approach to diagnosed disease, and maintain flexible doctor-patient relationship continuously

  • Induce patient’s interest to Korean medical treatment by making western medicine-based diagnosis and Korean medicine-based(pattern differentiation-based) diagnosis simultaneously

[2]-2 Standardized communication in between Korean Medicine Doctors Communicating effectively in between Korean Medicine Doctors using standardized terms and filling in medical record using the terms Ophthalmology, Otorhinolaryngology & Dermatology
  • Use contemporary medical terms such as of anatomy, physiology, and pathology, excepting for Korean medical terms that are hard to explain in modern terms

Internal medicine
  • Make contents and forms standardized in transfer and consultation of patient, and in case report, to deliver information of patient, disease, and treatment precisely

Neuropsychiatry
  • Gain standardization and objectivity of diagnosis by describing basic pattern differentiation in diagnosis

  • We can narrow diagnosis gap between Korean medical doctors by standardizing basic formats of medical record for newly visiting patients

[2]-3 Communication in between physicians/medical practitioners Grasping condition of patient and communicating effectively with medical practitioners of other fields when needed, and performing jobs concerned with joint treatment Ophthalmology, Otorhinolaryngology & Dermatology
  • Use contemporary medical terms such as of KCD (excepting for pattern differentiation code), anatomy, physiology, and pathology.

Internal medicine
  • Standardize contents and forms of patient’s medical information to deliver it precisely to medical practitioners of other fields

Neuropsychiatry
  • Deliver (to other doctors) feelings of clinic by describing patient’s narrative of symptoms he/she appeals

참고문헌

1.. Kim YJ, Lim CI. Competency-Based Medical Education: Possibilities and Limitations Korean medical education review. 2011; 13:1. 13–23.


2.. Yoon BY, Choi IS, Kim SJ, Park HJ, Ju HJ, Rhee BD, et al. Recommendations for the Successful Design and Implementation of Competency-Based Medical Education in Korea. 2015; 17:3. 110–121.


3.. Ahn DS. Korean Doctor’s Role. Journal of Korean Medicine Association. 2014; 57:1. 3–7.
crossref

4.. Kim NI, Ko SG, Kim JW, Park HJ, Baek YS, Bu YM, et al. A study on Development of Korean Oriental Medical Education in New Paradigm. National Research Foundation of Korea. 2011.


5.. Shin SW. Development of Standardized Road-Map in Korean Medicine Education & Training. Seoul: Ministry of Knowledge Economy;2012.


6.. Lim CI, Kang YS, Kim YJ, Han HJ, Hong JS, Han RE, et al. Development of General Competency Model for the Korean Medicine Doctors Institute of Korean Medicine Education & Evaluation. 2015; (In Press).


7.. Baek SJ, Song HD. Characteristics of strategic job analysis: comparison with traditional job analysis and competency modeling. 2014; 16:2. 145–167.


8.. Kim JM, Ju DJ, Lee JH, Kil DH, Ju HM, Lee JE. Developing Competency Model for Rural Extension Workers Using Generic Model Overlay Method. 2007; 39:2. 115–138.


9.. Dubois DD. Competency-based performance improvement: A strategy for organizational change. HRD press, Inc.


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