Chan Woong Kim

Kwon YG, et al. J Korean Med Sci. 2027 Jan;42:e38. https://doi.org/10.3346/jkms.2027.42.e38

Objectives: This study aimed to develop a custom GPT-based, knowledge-guided documentation support system that drafts emergency department (ED) interdepartmental consultation requests from minimal free-text input and evaluate its feasibility, usability, and workflow integration.Methods: The system generates a patient summary, recommended consulting department, structured consultation draft, and clinical reference notes from brief natural language input, including age, chief concern, and key findings. Two public AI Hub datasets, the Essential Medical Knowledge Dataset (Dataset No. 71875) and the Specialized Medical Knowledge Dataset (Dataset No. 71874), were used to guide prompt construction and constrain output structure rather than for model training. Department recommendation concordance was assessed using 22 de-identified ED consultation scenarios purposively selected across multiple specialties. The documented department was removed from the input and compared with the system’s recommendation. A post-use survey of 10 emergency physicians and residents assessed workflow utility, clinical appropriateness, usability, reflection of relevant information, perceived patient safety, adoption intention, and editing requirements using 5-point Likert scales.Results: In the 22-case pilot set, the system’s recommended department aligned with the historically documented department in all cases under controlled conditions. Given the small sample size and study design, this finding represents preliminary evidence of workflow alignment rather than definitive validation of clinical performance.Conclusions: The proposed system demonstrates the feasibility of large language modelenabled documentation support for generating standardized ED consultation requests, potentially reducing documentation burden. The system is intended to support, not replace, clinical decision-making, and clinician review remains essential. With further validation, this approach may be adaptable to other clinical referral contexts.

Purpose: This developmental study explored the conceptual feasibility and applicability of a metaverse-based clinical assessment platform as a complementary tool to conventional objective structured clinical examinations in undergraduate medical education.Methods: A targeted literature review and expert consensus process were conducted to identify domains of clinical competence in which metaverse technologies could provide added value. Based on these findings, prototype virtual patient simulations were developed within a metaverse environment. Large language models (LLMs) were integrated to support dynamic, interactive history-taking simulations, and pilot modules for physical examination were also created.Results: Integration of LLMs into virtual patient scenarios enabled realistic, context-sensitive medical interviews, facilitating interactive dialogue between examinees and simulated patients. In contrast, physical examination modules faced technical limitations, particularly in replicating procedures requiring tactile or haptic feedback, such as palpation and percussion. Nevertheless, the metaverse environment enabled delivery of consistent and reproducible scenarios, supporting objective assessment of communication and diagnostic reasoning skills.Conclusion: Metaverse-based simulations augmented by LLMs offer a promising approach to scalable and standardized clinical assessment, particularly within cognitive and interpersonal competency domains. Although current technological constraints limit the fidelity of physical examination simulations, rapid advancements in immersive and haptic technologies may help overcome these barriers in the near future. Further research is needed to evaluate the educational efficacy, validity, and feasibility of deploying such platforms in summative, high-stakes assessment contexts.

Transitioning from multi-port to single-port robotic systems in urologic surgery requires significant team adaptation; however, the experience of clinicians during this shift remains underexplored. Therefore, this study aims to examine the effect of single-port transition training on learning experiences and perceived readiness among healthcare providers, using Kolb’s experiential learning theory. Eleven physicians and 22 operating room nurses completed phased single-port transition training at a university hospital in Seoul (February–May 2025) and responded to open-ended questionnaires analyzed using Braun and Clarke’s thematic analysis. Most experiences aligned with Kolb’s learning cycle: concrete experience with single-port articulation, reflective comparison of single- and multi-port routines, abstract conceptualization of single-cannula principles, and active experimentation with collision prevention and workflow strategies. Some experienced physicians reported limited learning gains, suggesting that prior expertise reduces engagement. Nurses emphasized docking efficiency and spatial management, whereas physicians prioritized articulation control and technique refinement. Both groups reported greater confidence and interprofessional coordination. These findings suggest that integrating hands-on practice with structured reflection supports adaptation; however, the relationship between perceived readiness and clinical performance requires further investigation.

Clinical and Experimental Emergency Medicine

Objectives This study aimed to analyse patient-initiated compliment letters from a single institution, identify the key elements that patients value and offer actionable insights to enhance patient-centred care. Design A retrospective, single-institution study using the Healthcare Complaints Analysis Tool (HCAT), text network analysis and latent Dirichlet allocation (LDA) topic modelling on patient compliment letters to pinpoint key valued care elements. Setting A newly established general hospital in Gwangmyeong, South Korea, opened on 22 March 2022. Participants A total of 1213 compliment letters were collected through the hospital’s feedback system, which accepted both online and on-site submissions between 25 March 2022 and 28 June 2024. Letters lacking substantive descriptive content and those containing purely administrative requests were excluded. Primary and secondary outcome measures The HCAT was adapted to categorise positive statements into clinical, management and relationship domains, along with six stages of care. Inter-rater reliability was evaluated using Gwet’s AC1 statistic. A text network analysis, applying a term frequency–inverse document frequency approach, was conducted to identify prominent keywords. Subsequently, LDA was performed to extract thematic topics. Results Most compliments concerned the ‘relationship’ domain (62%), particularly during the care in the ward stage (56%). Keyword analysis indicated that the most frequently mentioned terms were ‘gratitude’, ‘kindness’, ‘nurse’, ‘doctor’ and ‘heart/mind’, underscoring patients’ high valuation of positive interactions, professional competence and compassionate communication with medical staff. Topic modelling identified three primary topics, namely, ‘appreciation of nursing care’ (39%), ‘professionalism in surgery and treatment’ (35%) and ‘effective communication during consultations’ (26%). Conclusions Positive relationships with medical staff, particularly kindness, professionalism and effective communication, influence patient satisfaction. Patient compliment letters serve as important indicators of exceptional care and can inform quality improvement initiatives. Healthcare institutions should leverage these insights to enhance patient-centred services by strengthening patient–provider relationships and promoting a culture of excellence.

Purpose: This study quantitatively examined the portrayal of physician assistant (PA) nurses in Korean media by integrating text network analysis with latent Dirichlet allocation (LDA) topic modeling.Methods: A total of 3,564 news articles published by nine major Korean media outlets between 2020 and 2024 were analyzed. Content analysis was conducted using term frequency-inverse document frequency calculations, network centrality analysis, and LDA topic modeling to extract key terms, map discourse structures, and identify latent topics.Results: The analysis identified four primary topics in Korean media discourse: “healthcare workforce expansion policies” (30.4%), “hospital clinical practice and operational management” (23.5%), “institutionalization of the PA nursing role” (17.8%), and “COVID-19 response and public health crisis management” (28.3%). High-centrality keywords included “hospital,” “medical,” “patient,” “physician,” “government,” and “nurse,” indicating that the discourse primarily focused on clinical settings. Topic modeling revealed a major shift from pandemic-centered coverage in 2020 to a focus on healthcare workforce policy and PA nurse institutionalization in 2024, coinciding with the passage of the Nursing Act.Conclusion: This study provides empirical evidence suggesting that the portrayal of PA nurses in Korean media discourse evolved from a peripheral regulatory issue to a central healthcare delivery solution, particularly in the contexts of workforce management, clinical practice, and crisis response. Our findings suggest that PA nurse institutionalization received broader attention when positioned as part of systemic healthcare improvements addressing concrete clinical needs. These results offer valuable insights for policymakers and administrators in framing and implementing workforce policy reforms.

Objectives To analyse patient complaints from an early-stage hospital in South Korea using the Healthcare Complaints Analysis Tool, identify harm patterns across care stages and provide insights for resource allocation and risk management. Design Retrospective analysis of patient complaints (22 March 2022–28 June 2024). Setting A newly established general hospital with approximately 700 beds in the metropolitan area of Gyeonggi-do, South Korea, which was established during the COVID-19 pandemic. Participants A total of 1113 patient complaints comprising 1952 discrete complaint issues were collected, with submissions originating from patients themselves (64%), family members or friends (21%) and individuals with unclear relationships to patients (15%). Primary and secondary outcome measures Primary outcome measures comprised occurrence and severity of patient harm. Secondary outcome measures included distribution of complaints across clinical, management and relationship domains, and identification of healthcare stages with concentrated harm using hotspot analysis and logistic regression. Results Of the complaints, 78% did not result in harm. Among those that did, 52%, 40% and 7% were of low, moderate and high severity, respectively. Hotspot analysis indicated that harm was concentrated during diagnosis (stage 2), ward care (stage 3) and operation/procedure (stage 4) stages, with stage 4 exhibiting the highest Pearson residual value of 9.56. Logistic regression indicated that clinical domain complaints had the strongest association with patient harm (OR=32.25, 95% CI=20.88 to 51.01, pConclusions This study highlighted the critical care stages in which harm was concentrated, emphasising the need for proactive risk management particularly during operations and procedures. The findings provide valuable insights into resource allocation and underscore the importance of patient complaints in improving healthcare quality and safety across healthcare institutions.

Background: Patient complaints are critical indicators for improving healthcare quality and patient safety, offering insights into systemic issues within medical institutions. Newly operational hospitals, owing to operational instability and limited resources, are more prone to frequent complaints, reflecting several service delivery problems. Despite the significance of these complaints, systematic analyses of how they evolve and how each complaint domain influences patient harm in new South Korean hospitals have been scarce. Methods: We analysed 1113 patient complaints collected from March 2022 to June 2024 from a newly operational hospital in South Korea. These complaints were categorized into three major domains: Clinical (Quality, Safety), Management (Environment, Institutional Processes), and Relationship (Listening, Communication, Respect and Patient Rights) using the Healthcare Complaints Analysis Tool. Based on a vector autoregression model, we employed dynamic time warping to examine temporal patterns among the complaints and impulse response function analysis to assess the influence of these factors on patient harm over time. Results: The results identified that in the early stages of hospital operations, Clinical Safety and Patient Harm were closely clustered, indicating a strong association between clinical factors and patient harm. In the mid-term period (September 2022–February 2023), Respect and Patient Rights and Environment became major clusters, indicating a shift towards Management and Relationship issues as primary causes of complaints. In the later term (March 2023–June 2024), Environment became clustered with Listening and Communication, whereas Patient Harm became more independent. Impulse response function analysis showed that Clinical factors had a strong, immediate positive impact (0.91017, P < .01 on Day 1) on patient harm that gradually decreased over the subsequent 10-day period. Management factors exhibited a smaller initial effect (0.00756, P < .05 on Day 1) but demonstrated a gradual, cumulative pattern over time. Relationship factors initially had a minimal impact (0.04551, P < .1 on Day 1) but became more significant in later days (0.06566, P < .01 on Day 3). Conclusion: Clinical safety has an immediate, significant negative impact on patients in new hospitals, requiring prompt attention. As hospitals stabilize, Management and Relationship factors play a significant role in patient safety. Our findings underscore the need for dynamic resource allocation and strategic planning that evolves from focusing on clinical safety to incorporating management improvements and patient-centred communication strategies to enhance patient safety and service quality in new hospitals in South Korea.