Medical Students' Perceptions of Patient-Doctor Relationship in South Korea: Concept Mapping Analysis.

Introduction: The patient-doctor relationship has evolved from early paternalism to a consumerism and partnership model that emphasizes cooperation. Patient-doctor relationships might vary with the socio-cultural environment, because the medical environment affects such relationships. Method: We investigated the patient-doctor relationship among medical students through concept mapping analysis. Twenty-six fourth-grade Korean medical students wrote a reflection journal and participated in the concept classification and the importance evaluation of the derived concept. ALSCAL multidimensional scaling and Ward hierarchical cluster analysis were performed. Also, the 5-point Likert scale was used to evaluate the importance of the concept. Results: Sixty-six statements about the patient-doctor relationship were extracted and grouped into six clusters. The x-axis is the dimension of "Information-Respect," and the y-axis is "Changeability-Persistence." Six patient-doctor concepts were derived and students evaluated "Patient-centered" as the most important. Conclusions: Medical students express various concepts of the patient-doctor relationship. Considering that they may encounter various medical conditions and patients, it is necessary that they understand deeply the complex patient-doctor relationship.

Medical education trends for future physicians in the era of advanced technology and artificial intelligence: an integrative review.

BACKGROUND: Medical education must adapt to different health care contexts, including digitalized health care systems and a digital generation of students in a hyper-connected world. The aims of this study are to identify and synthesize the values that medical educators need to implement in the curricula and to introduce representative educational programs. METHODS: An integrative review was conducted to combine data from various research designs. We searched for articles on PubMed, Scopus, Web of Science, and EBSCO ERIC between 2011 and 2017. Key search terms were "undergraduate medical education," "future," "twenty-first century," "millennium," "curriculum," "teaching," "learning," and "assessment." We screened and extracted them according to inclusion and exclusion criteria from titles and abstracts. All authors read the full texts and discussed them to reach a consensus about the themes and subthemes. Data appraisal was performed using a modified Hawker 's evaluation form. RESULTS: Among the 7616 abstracts initially identified, 28 full-text articles were selected to reflect medical education trends and suggest suitable educational programs. The integrative themes and subthemes of future medical education are as follows: 1) a humanistic approach to patient safety that involves encouraging humanistic doctors and facilitating collaboration; 2) early experience and longitudinal integration by early exposure to patient-oriented integration and longitudinal integrated clerkships; 3) going beyond hospitals toward society by responding to changing community needs and showing respect for diversity; and 4) student-driven learning with advanced technology through active learning with individualization, social interaction, and resource accessibility. CONCLUSIONS: This review integrated the trends in undergraduate medical education in readiness for the anticipated changes in medical environments. The detailed programs introduced in this study could be useful for medical educators in the development of curricula. Further research is required to integrate the educational trends into graduate and continuing medical education, and to investigate the status or effects of innovative educational programs in each medical school or environment.

Sip1, a conserved AP-1 accessory protein, is important for Golgi/endosome trafficking in fission yeast.

We had previously identified the mutant allele of apm1(+) that encodes a homolog of the mammalian µ 1A subunit of the clathrin-associated adaptor protein-1 (AP-1) complex and demonstrated that the AP-1 complex plays a role in Golgi/endosome trafficking, secretion, and vacuole fusion in fission yeast. Here, we isolated a mutant allele of its4(+)/sip1(+), which encodes a conserved AP-1 accessory protein. The its4-1/sip1-i4 mutants and apm1-deletion cells exhibited similar phenotypes, including sensitivity to the calcineurin inhibitor FK506, Cl(-) and valproic acid as well as various defects in Golgi/endosomal trafficking and cytokinesis. Electron micrographs of sip1-i4 mutants revealed vacuole fragmentation and accumulation of abnormal Golgi-like structures and secretory vesicles. Overexpression of Apm1 suppressed defective membrane trafficking in sip1-i4 mutants. The Sip1-green fluorescent protein (GFP) co-localized with Apm1-mCherry at Golgi/endosomes, and Sip1 physically interacted with each subunit of the AP-1 complex. We found that Sip1 was a Golgi/endosomal protein and the sip1-i4 mutation affected AP-1 localization at Golgi/endosomes, thus indicating that Sip1 recruited the AP-1 complex to endosomal membranes by physically interacting with each subunit of this complex. Furthermore, Sip1 is required for the correct localization of Bgs1/Cps1, 1,3-ß-D-glucan synthase to polarized growth sites. Consistently, the sip1-i4 mutants displayed a severe sensitivity to micafungin, a potent inhibitor of 1,3-ß-D-glucan synthase. Taken together, our findings reveal a role for Sip1 in the regulation of Golgi/endosome trafficking in coordination with the AP-1 complex, and identified Bgs1, required for cell wall synthesis, as the new cargo of AP-1-dependent trafficking.