A Qualitative Study on the Students' Perceptions of Elective Courses in Korean Medical Education

Hee Jun Park; Sung Uk Ma; Hye-Yoon Lee; Park, Hee Jun; Ma, Sung Uk; Lee, Hye-Yoon

doi:10.13048/jkm.25010

JKM > Volume 46(1); 2025 > Article

Park, Ma, and Lee: A Qualitative Study on the Students' Perceptions of Elective Courses in Korean Medical Education

Original Article

The Journal of Korean Medicine 2025; 46(1): 139-153.

Published online: March 01, 2025

DOI: https://doi.org/10.13048/jkm.25010

A Qualitative Study on the Students' Perceptions of Elective Courses in Korean Medical Education

Hee Jun Park¹^{, §}

, Sung Uk Ma¹^{, §}

, Hye-Yoon Lee²^{, *}

¹School of Korean Medicine, Pusan National University

²Division of Humanities and Social Medicine, School of Korean Medicine, Pusan National University

Correspondence to: Hye-Yoon Lee, 317, Busandaehak-ro 49, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Republic of Korea, 50612 Tel: +82-51-510-8409, Fax: +82-51-510-8419, E-mail: drlee@pusan.ac.kr

§ Hee Jun Park and Sung Uk Ma equally contributed to this work as first authors.

Received February 9, 2025 Revised February 16, 2025 Accepted February 16, 2025

Abstract

Objectives

This study aimed to investigate the perceptions and assess the satisfaction of Korean medical students regarding elective courses in Korean medical education

Methods

Two rounds of online surveys and a focus group interview were conducted with second- and third-year student groups, with a total of twelve students participating—six students in each group. The first survey (March 19–22, 2024) assessed students’ selection criteria and satisfaction levels using a 5-point Likert scale. Based on these results, a second survey (March 24–27, 2024) refined key topics for discussion. FGIs were held on March 25 and 26, 2024, with semi-structured questions. Interviews were recorded, transcribed verbatim, and analyzed using content analysis, applying In vivo and lean coding for categorization.

Results

Survey results showed that faculty reputation, course content, and assessment difficulty were key factors in course selection. While syllabi were often referenced, their reliability was questioned due to content discrepancies. Initially, online lectures were favored for flexibility, but concerns arose over limited availability and inconsistent evaluations. FGI analysis confirmed that teaching styles and assessment methods significantly influenced decisions. As students recognized the benefits of in-person classes, their preference for face-to-face learning grew. Overall satisfaction with electives was moderate, with students highlighting the need for more practical courses and better faculty-student communication.

Conclusions

Ensuring syllabus accuracy, standardizing evaluation criteria, incorporating student needs into course design, and enhancing faculty-student interaction may improve elective course selection.

Keywords: Korean medical education, Elective course, Student perception, Focus group interview (FGI)

Table 1

Demographic Characteristics of Study Participants (N=12)

Variables		N	Proportion
Gender	Male	8	0.67
Gender	Female	4	0.33

Age	23–26	3	0.25
	27–29	6	0.50
	30–33	2	0.17
	34–36	1	0.08

Grade	2nd	6	0.50
Grade	3rd	6	0.50

Previous University Major	Bachelor’s Program in Korean Medicine	7	0.58
	Engineering	1	0.08
	Natural Sciences	2	0.17
	Social Sciences	1	0.08
	Humanities	1	0.08

Table 2

Perceptions on Selection Factors and Efficiency of Elective Courses

Category	Item	Responses	1st		2nd

			N	Proportion	N	Proportion
Factors Influencing Course Registration	Key Factors in the Selection Process	Usefulness of the Content	4	0.33	3	0.25
		Interest of the Content	0	0.00	2	0.17
		Difficulty of the Content	1	0.08	0	0.00
		Difficulty of the Assessments	1	0.08	1	0.08
		Reputation of the Instructor	5	0.42	4	0.33
		No Specific Criteria	0	0.00	0	0.00
		Presence of Assignments and Exams, and Leniency in Grading	1	0.08	1	0.08
		Presence of Assignments	-	-	1	0.08

	Impact of Major on Elective Course Selection in Korean Medicine	Interest	-	-	1	0.17
		No Interest	-	-	3	0.50
		Similar to Major	-	-	1	0.17
		Career Path	-	-	1	0.17

	Factors Influencing the Judgment of Instructors' Reputation	Usefulness of the Lecture	3	0.25	1	0.10
		Enjoyment of the Lecture	0	0.00	0	0.00
		Difficulty of Exams	2	0.17	3	0.30
		Difficulty of Assignments	0	0.00	0	0.00
		Grades	2	0.17	3	0.30
		Early Class Dismissal	3	0.25	1	0.10
		Strict Attendance Monitoring	0	0	0	0.00
		Flexibility	1	0.08	1	0.10
		Elective Course (e.g., Presence of Exams, Instructor’s Leniency, etc.)	1	0.08	1	0.10

	Syllabus Reference Level	Very High	1	0.08	2	0.17
		High	7	0.58	5	0.42
		Neutral	3	0.25	3	0.25
		Low	1	0.08	2	0.17
		Very Low	0	0	0	0.00

	Primary Source of Assistance for Course Registration	Own Decision	6	0.5	6	0.50
		Recommendation from Friends	2	0.17	2	0.17
		Senior Students in the Department	4	0.33	4	0.33
		Senior Students in a Club	0	0.00	0	0.00
		Consultation with Parents	0	0.00	0	0.00
		Guidance from Academic Advisor	0	0.00	0	0.00
		University Online Community Apps	0	0.00	0	0.00

Efficient Course Format	Satisfaction with the Format of Elective Courses	Very High	1	0.08	1	0.08
		High	6	0.50	6	0.50
		Neutral	3	0.25	4	0.33
		Low	1	0.08	1	0.08
		Very Low	1	0.08	0	0.00

	Preferred Course Format(More Clarified on the 2nd Survey)	Asynchronous Online Course with Video Lectures (Online Video Lecture)	8	0.67	1	0.09
		Live Online Course via Zoom	0	0.00	2	0.18
		In-Person Classroom Lecture	4	0.33	2	0.18
		Experiential Learning	-	-	1	0.09
		Lecture + Discussion	-	-	2	0.18
		Interactive Class	-	-	1	0.09
		Lecture-Based Class	-	-	2	0.18

	Course Format with High Satisfaction	Watching Only Pre-Recorded Videos Weekly	4	0.33	-	-
		Primarily Video-Based with 2–3 Live Zoom Sessions as Needed	3	0.25	-	-
		Primarily Video-Based with 2–3 In-Person Sessions as Needed	1	0.08	-	-
		Primarily In-Person with 2–3 Zoom or Video Sessions as Needed	2	0.17	-	-
		Live Zoom-Based Online Course Every Week	0	0.00	-	-
		In-Person Classroom Course Every Week	2	0.17	-	-

	Effective Teaching Method for Online Courses with Video Lectures	Lecture-Style Video with Instructor's Movements in the Classroom	3	0.25	-	-
		PPT Video with Instructor's Face Included	7	0.58	-	-
		PPT Video with Voice Narration Only	2	0.17	-	-
		PPT Slides Provided Without Voice Narration	0	0.00	-	-
		Use of External Materials with Minimal Instructor Involvement	0	0.00	-	-

	Ideal Teaching Method for In-Person Classes	Lecture-Based Instruction	12	1.00	-	-
		Video Lectures Provided, with Supplemental Explanations During Class	0	0.00	-	-
		Video Lectures Provided, with Discussions and Group Activities During Class	0	0.00	-	-

	Effective Teaching Methods	Lecture-Based Class	-	-	3	0.27
		In-Person Class	-	-	3	0.27
		Participation-Based Class	-	-	1	0.09
		Discussion-Based Class	-	-	1	0.09
		Primarily Online with In-Person Sessions as Needed	-	-	1	0.09
		Online Class	-	-	1	0.09
		Didactic Teaching	-	-	1	0.09

	Least Preferred Course Format	Presentation-Based Class	-	-	4	0.33
		In-Person Class	-	-	2	0.17
		Discussion and Participation-Based Class	-	-	1	0.08
		Lecture-Based Class	-	-	2	0.17
		Online Zoom Lecture	-	-	0	0.00
		In-Person Class	-	-	2	0.17
		Group Projects	-	-	1	0.08

-: Not Applicable (Not Asked)

Table 3

Meaningful Statements in the Focus Group Interview

Domain	Category	Subcategory (Frequency of Meaningful Statements)	N	Proportion
Course Syllabus	Reliability	Distrust	4	0.40
		Formality	4	0.40
		Trust	2	0.20

	Utilization	Reference	3	0.60
	Utilization	High	2	0.40

Elective Course-Related Matters	Application Criteria	Instructor	13	0.25
		No Exams	10	0.19
		Interest	10	0.19
		Usefulness	4	0.08
		Assignments	3	0.06
		Convenience of Completion	3	0.06
		Syllabus	2	0.04
		Short Class Duration	2	0.04
		Video Lectures	1	0.02
		Senior Students, Grades	1	0.02
		Research Advisor	1	0.02
		Graduation Thesis	1	0.02
		Topic	1	0.02

	Satisfaction	Satisfied	8	0.73
	Satisfaction	Dissatisfied	3	0.27

	Operational Issues	Variability Depending on Instructor	10	0.91
	Operational Issues	Unfairness	1	0.09

Teaching Methods	In-Person vs. Online	Preference for In-Person Classes	8	0.67
Teaching Methods	In-Person vs. Online	Preference for Online Classes	4	0.33

Student Needs and Complaints	Complaints	Lack of Engaging Courses	6	0.33
		Instructor-Interest-Oriented Courses	3	0.17
		Courses Ignoring Student Demand	3	0.17
		Lack of Uploaded Course Materials	2	0.11
		High Difficulty Level	1	0.06
		Course Cancellation Due to Low Enrollment	1	0.06
		Formalistic Classes	1	0.06
		Insufficient Number of Available Courses	1	0.06

	Student Needs	Light Workload	5	0.29
		Clinical-Related Courses	4	0.24
		Diverse Experiences	2	0.12
		Student Demand-Driven Courses	2	0.12
		Practicality	1	0.06
		Advanced Learning	1	0.06
		Engaging Courses	1	0.06
		Courses Open to Multiple Year Levels	1	0.06

Others	Type of Assistance Received During Course Registration	Club Activities	2	0.25
		Gatherings	2	0.25
		Senior Students	2	0.25
		Syllabus	1	0.13
		Reputation	1	0.13

	Communication	Low Communication	1	0.50
	Communication	Need for Student-Instructor Mutual Understanding	1	0.50

Table 4

Students’ Satisfaction Regarding Elective Courses on the 1st Survey

Students’ Satisfaction	5*	4*	3*	2*	1*
Satisfaction with Elective Courses	1 (0.08)	5 (0.42)	4 (0.33)	1 (0.08)	1 (0.08)
Satisfaction with the Diversity and Number of Elective Courses Offered	2 (0.17)	1 (0.08)	7 (0.58)	2 (0.17)	0 (0)
Satisfaction with the Number of Students per Elective Course	2 (0.17)	6 (0.5)	2 (0.17)	2 (0.17)	0 (0)
Satisfaction with the Required Number of Elective Courses for Graduation	1 (0.08)	6 (0.5)	3 (0.25)	1 (0.08)	1 (0.08)
Perceived Difficulty of Elective Courses Compared to the Core Curriculum	2 (0.17)	7 (0.58)	2 (0.17)	1 (0.08)	0 (0)
Degree to which Elective Courses Reflect Student Needs	1 (0.08)	3 (0.25)	5 (0.42)	2 (0.17)	1 (0.08)
Clarity of Elective Course Learning Objectives	2 (0.17)	5 (0.42)	5 (0.42)	0 (0)	0 (0)
Clarity of Elective Course Assessment Criteria	1 (0.08)	4 (0.33)	4 (0.33)	3 (0.25)	1 (0.08)
Adequacy of Learning Materials Provided by the Instructor, Including Textbooks and Reference Materials	2 (0.17)	8 (0.67)	2 (0.17)	0 (0)	0 (0)
Utilization of Various Teaching Methods by the Instructor	2 (0.17)	6 (0.5)	3 (0.25)	1 (0.08)	2 (0.17)
Utilization of Various Teaching Media by the Instructor	1 (0.08)	5 (0.42)	5 (0.42)	1 (0.08)	0 (0)
Effectiveness of Communication with the Instructor Outside of Class Hours	1 (0.08)	6 (0.5)	5 (0.42)	0 (0)	0 (0)

* Likert 5-point Scale, 5=Very High, 4=High, 3=Neutral, 2=Low, 1=Very Low

Table 5

Students’ Satisfaction Regarding Elective Courses on the 2nd Survey

Satisfaction	5*	4*	3*	2*	1*
Satisfaction with Elective Courses	1 (0.08)	5 (0.42)	4 (0.33)	1 (0.08)	1 (0.08)
Clarity of Elective Course Learning Objectives	1 (0.08)	6 (0.5)	5 (0.42)	0 (0)	0 (0)
Clarity of Elective Course Assessment Criteria	1 (0.08)	5 (0.42)	3 (0.25)	3 (0.25)	0 (0)
Adequacy of Learning Materials Provided by the Instructor	1 (0.08)	6 (0.5)	4 (0.33)	1 (0.08)	0 (0)
Utilization of Various Teaching Methods by the Instructor	1 (0.08)	5 (0.42)	5 (0.42)	1 (0.08)	0 (0)
Utilization of Various Teaching Media by the Instructor	1 (0.08)	6 (0.5)	5 (0.42)	0 (0)	0 (0)

Reasons for Dissatisfaction				n	proportion

Course Registration Issues				2	0.29
None				1	0.14
Lack of Improvement Despite Feedback				1	0.14
Significant Disparities Between Courses				2	0.29
Physical Exhaustion				1	0.14

* Likert 5-point Scale, 5=Very High, 4=High, 3=Neutral, 2=Low, 1=Very Low

Table 6

Students’ Demands Regarding Elective Courses

Students’ Demands	Responses on the 1st Survey	Responses (1st)		Responses (2nd)

		N	Proportion	N	Proportion
Primary Consideration in Designing Elective Course Curriculum and Course Offerings	Academic Value	3	0.25	3	0.25
	Practical Value	2	0.17	2	0.17
	Diverse Experiences	5	0.42	3	0.25
	Relevance to Career Path	0	0.00	2	0.17
	Relevance to Major	1	0.08	1	0.08
	Practical Help for Employment	1	0.08	1	0.08

Aspects that Need Improvement in Elective Courses(Multiple Responses Allowed)	Reducing Disparities Among Elective Courses	3	0.27	2	0.12
	Incorporating Student Preferences (Student Demand)	1	0.09	1	0.06
	Practical Content (Engagement/Interest)	1	0.09	1	0.06
	Unclear Grading Criteria	1	0.09	1	0.06
	Course Syllabus	1	0.09	2	0.12
	Diverse Course Offerings	1	0.09	-	-
	Usefulness	1	0.09	-	-
	Course Registration	1	0.09	-	-
	Elective Courses Accessible to Multiple Year Levels	1	0.09	-	-
	Difficulty Level	-	-	1	0.06
	Exam-Centered Approach	-	-	1	0.06
	More Clinical-Related Courses	-	-	2	0.17
	Avoidance of Presentation and Assignment-Heavy Classes	-	-	1	0.06
	Insufficient Teaching Ability	-	-	1	0.06
	Classroom Size	-	-	1	0.06
	Pre-Class Preparation	-	-	1	0.06
	Lack of Learning Materials	-	-	1	0.06
	None	-	-	1	0.06

Suggestions or Areas for Improvement in Elective Course Registration	None	-	-	1	0.10
	Small Class Size for Each Course	-	-	1	0.10
	Course Syllabus	-	-	1	0.10
	Standardization and Fairness	-	-	1	0.10
	Usefulness	-	-	2	0.20
	Flexible Schedule	-	-	1	0.10
	Variety of Courses	-	-	1	0.10
	Less Academic Burden (Exams, Assignments)	-	-	1	0.10
	Presence or Absence of Exams	-	-	1	0.10

Areas for Improvement in the Syllabus for Better Reference	Very high	-	-	0	0.00
	High	-	-	5	0.42
	Neutral	-	-	7	0.58
	Low	-	-	0	0.00
	Very low	-	-	0	0.00

참고문헌

1. Kim, Do-Hwan., et al (2017). Evaluation of Process and Satisfaction for Selective Courses in a Medical School. Korean Medical Education Review, 19(2), 90-100.

2. Park, Roh-Gook. (2001). A Study on Selection Alternatives of Basic and Major Courses for College Students. Journal of the Korea Industrial Information Systems Research, 6(1), 48-55.

3. Jong-Wook, Oh. (2022). Exploring College Students’ Perceptions Regarding Elective-centered Curriculum. Korean Educational Research Journal, 43(2), 41-72.

4. Ryu, Kiung., & Shin, Won-Sug. (2012). Analyses of the Satisfaction with General Education and Factors Influencing the Selection of Courses. The Journal of Research in Education, 0(45), 31-54.

5. Lee, Ji-Hye., et al (2009). Differences in Factors Affecting Medical Specialty Choices between Medical College Students and Graduate Medical School Students. Korean J Med Educ, 21(4), 393-402.

6. Agarwal, A., et al (2015). Elective courses for medical students during the preclinical curriculum: a systematic review and evaluation. Medical Education Online, 20(1), 26615.

7. Ramalho, AR., et al (2020). Electives in the medical curriculum–an opportunity to achieve students’ satisfaction? BMC Medical Education, 20, 1-13.

8. Koksalmis, GH. (2018). Factors Affecting Selection of elective courses: the Use of Multi-criteria Decision Making Model. Journal of Business Administration Research, 01(1), 1-7.

9. Moser, A., & Korstjens, I. (2018). Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis. European journal of general practice, 24(1), 9-18.

10. Kim, Hyunsook., & Kim, Kyungmi. (2022). A Study on Factors Affecting the Course Registration Decision Making of MZ Generation University Students. The Journal of Humanities and Social Sciences 21, 13(4), 2329-2341.

11. Lee, Hyo-Jun., Yoon, Ga-Young., & Park, In-Woo. (2017). A Study on College Student’s Course Selecting Standards: Focusing on electives and major courses. The Korea Educational Review, 23(4), 79-99.

12. Jeong, Seon-Hyung., et al (2020). A Survey of Recognitions and Satisfaction with Education in Traditional Korean Medicine. Journal of Society of Preventive Korean Medicine, 24(3), 49-56.

13. Cho, M-K., & Kim, MY. (2017). Effects of learner motivation and teacher-student interaction on learner satisfaction in nursing students. The Journal of the Korea Contents Association, 17(4), 468-477.

14. Çolak, T., et al (2024). The Impact of Elective Courses on Student Satisfaction and Attitudes in Medical Education: A Case Study of Kocaeli University Faculty of Medicine. Acta Medica Nicomedia, 7(1), 84-91.

15. Lee, Young-Mee., Ahn, Duck-Sun., & So, Yeon-Hee. (2001). Lessons Learned from Optional Elective Course. The Korean Society Medical Education, 13(2), 213-220.