Monday, December 14, 2015

Two New Papers

Shin Y, Shin JS, Lee J, Lee YJ, Kim M, Ahn YA, Park KB, Shin BC, Lee MS, Kim JH, Cho JH, He IH.  survey among Korea Medicine doctors (KMDs) in Korea on patterns of integrative Korean Medicine practice for lumbar intervertebral disc displacement: Preliminary research for clinical practice guidelines. BMC Comple Alternative Med 201515:432, DOI: 10.1186/s12906-015-0956-1

Background: Patients seek Korean Medicine (KM) treatment for a broad range of complaints in Korea, but predominantly for musculoskeletal disorders. We investigated lumbar Intervertebral Disc Displacement (IDD) practice patterns of Korean Medicine doctors (KMDs) within a hospital/clinic network specializing in KM treatment of spinal disorders through survey of diagnosis and treatment methods.

Methods: Questionnaires on clinical practice patterns of KM treatment for lumbar IDD were distributed to 149 KMDs on January 25th, 2015. The questionnaire included items on sociodemographic characteristics, clinical practice patterns, and preferred method of lumbar IDD diagnosis and treatment. KMDs were asked to grade each treatment method for absolute and relative importance in treatment and prognosis, and safety.
Results: A total 79.19 % KMDs (n = 118/149) completed the survey, and results showed that integrative care mainly consisting of acupuncture, herbal medicine, Chuna manipulation, and pharmacopuncture was administered to IDD patients. The participant KMDs largely relied on radiological findings (MRI and X-ray) for diagnosis. ‘Eight principle pattern identification’, ‘Qi and Blood syndrome differentiation’ and ‘Meridian system syndrome differentiation’ theories were generally used for KM syndrome differentiation. The most frequently prescribed herbal medication was Chungpa-jun, and most commonly used Chuna technique was ‘sidelying lumbar extension displacement treatment’. IDD patients received 1.9 ± 0.3 treatment sessions/week, and KMDs estimated that an average 9.6 ± 3.5 weeks were needed for 80 % pain relief.

Conclusions: This is the first study to investigate expert opinion on KM treatment of IDD. Further randomized controlled trials and clinical guidelines based on clinical practice patterns of KM are called for

Hung CH, Lin CY. Using concept mapping to evaluate knowledge structure in problem-based learning. BMC Med Educ201515:212, DOI: 10.1186/s12909-015-0496-x

Background: Many educational programs incorporate problem-based learning (PBL) to promote students’ learning; however, the knowledge structure developed in PBL remains unclear. The aim of this study was to use concept mapping to generate an understanding of the use of PBL in the development of knowledge structures.
Methods: Using a quasi-experimental study design, we employed concept mapping to illustrate the effects of PBL by examining the patterns of concepts and differences in the knowledge structures of students taught with and without a PBL approach. Fifty-two occupational therapy undergraduates were involved in the study and were randomly divided into PBL and control groups. The PBL group was given two case scenarios for small group discussion, while the control group continued with ordinary teaching and learning. Students were asked to make concept maps after being taught about knowledge structure. A descriptive analysis of the morphology of concept maps was conducted in order to compare the integration of the students’ knowledge structures, and statistical analyses were done to understand the differences between groups.

Results: Three categories of concept maps were identified as follows: isolated, departmental, and integrated. The students in the control group constructed more isolated maps, while the students in the PBL group tended toward integrated mapping. Concept Relationships, Hierarchy Levels, and Cross Linkages in the concept maps were significantly greater in the PBL group; however, examples of concept maps did not differ significantly between the two groups.
Conclusions: The data indicated that PBL had a strong effect on the acquisition and integration of knowledge. The important properties of PBL, including situational learning, problem spaces, and small group interactions, can help students to acquire more concepts, achieve an integrated knowledge structure, and enhance clinical reasoning.



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