Objectives: Peer role-play (PRP) has been used in health care training simulations because standardized patient training requires considerable time and expense. This study described the implementation of clinical simulation using PRP and examined the effect.Methods: Final year students from a single college of Korean medicine engaged in PRP as part of clinical skills practice. Education tools from clinical practice guidelines were used to structure the PRP. Communication competency was assessed with the Korean Version of the Self-Efficacy Questionnaire (KSE-12). Whether this training helped to achieve graduate outcomes was evaluated on a five-point scale.Results: Fifty-nine students (53.2%) participated in the survey. Among 12 items on the KSE-12, the score for "How certain are you that you are able to successfully listen attentively to the patient?" was the highest. Further, PRP was found to be helpful for self-directed learning, establishment of one's professional identity, and the ability to communicate and manage patients. Three themes ("Benefits of role-play", "The importance of positive feedback", "Limitations and problems of role-play"), 15 categories, and 16 central meanings were derived by categorizing learners' subjective opinions about PRP.Conclusions: Study findings indicate that PRP may contribute to improving communication skills and establishing a professional identity for future Korean medicine doctors. We suggest using PRP in clinical education in colleges of Korean Medicine.

This study aimed to report the specific methods and investigate the educational effects of diagnostic musculoskeletal ultrasound training and the Objective Structured Clinical Examination (OSCE) for traditional medicine students. Scanning volar wrist and diagnosing carpal tunnel syndrome were selected for musculoskeletal ultrasound to train students to use the basic functions of the ultrasound device and scan various structures including tendons, nerves, and arteries. The students were divided into two groups: one group had 8 weeks of training with mock OSCE experience and received feedback about their scan images, and the other group had 3 weeks of training with flipped learning. The OSCE was implemented on the last day of the training. The subjective learning outcomes were analyzed as students’ evaluation with a 5-point scale, and the objective learning outcomes were analyzed using OSCE scores evaluated with a pre-validated checklist. Of the 111 students, 60 (54.1%) responded to the questionnaire. Overall satisfaction with this ultrasound training was high (4.5 ± 0.60). The average OSCE score in the 8-week group was significantly higher than that in the 3-week group. The students’ self-assessment showed no significant differences between the two groups. Proficiency in using ultrasound is affected by the practice time and feedback. Ultrasound training should be further expanded as a required curriculum to meet students’ needs and achieve learning objectives in the clinical skills education of Korean medicine colleges. Further studies are needed on ultrasound education, especially guided interventions for traditional medicine students.

Background: The objective structured clinical examination (OSCE) is a widely used method to assess the clinical performance of students in clinical practice. Although OSCE has been used for undergraduate students of Korean medicine, this has not been widely reported. Methods: In 2020, the practical course for acupuncture and moxibustion medicine (acupuncture, electroacupuncture, pharmacopuncture, auricular acupuncture, and burning acupuncture) was taught using flipped learning, according to clinical practice guidelines, and assessed by the OSCE. The appropriateness of this model of education and its evaluation using OSCE were evaluated using a 5-point Likert scale, and the results were analyzed. Results: Of the respondents, 67% reported that the OSCE accurately reflected their competency, and 82% reported that online video lectures helped them to improve their clinical skills. The average adequacy score of the model was > 3.7/5, and the average adequacy score of the checklist used in the OSCE was > 4.1/5 for all 5 clinical application skills. The difference in the mean self-efficacy score between students who had taken the OSCE and those students who had not taken the OSCE, was highest in the burning acupuncture group (0.923). Conclusion: This study showed that students’ satisfaction with the OSCE was high and flipped learning was an effective education model. In the future, models representing the human body or simulated patients should be used to evaluate students’ skills and attitude.

Before Chuna manual therapy (CMT), a manual therapy applied in Korean medicine, CMT spinal diagnosis using palpation or X-ray is performed. However, studies on the inter-rater concordance of CMT diagnostic methods, concordance among diagnostic methods, and standard CMT diagnostic methods are scarce. Moreover, no clinical studies have used artificial intelligence (AI) programs for X-ray image-based CMT diagnosis. Therefore, this study sought a feasible and standard CMT spinal diagnostic method and explored the clinical applicability of the CMT-AI program. One hundred participants were recruited, and the concordance within and among different diagnostic modalities was analyzed by dividing them into manual diagnosis (MD), X-ray image-based diagnosis (XRD) by experts and non-experts, and XRD using a CMT-AI program by non-experts. Regarding intra-group concordance, XRD by experts showed the highest concordance (used as a gold standard when comparing inter-group concordance), followed by XRD using the AI program, XRD by non-experts, and then MD. Comparing diagnostic results between the groups, concordance with the gold standard was the highest for XRD using the AI program, followed by XRD by non-experts, and MD. Therefore, XRD is a more reasonable CMT diagnostic method than MD. Furthermore, the clinical applicability of the CMT-AI program is high.

Background: Non-small cell lung cancer (NSCLC) exhibits low survival rates. Although immune checkpoint inhibitors (ICIs) have become first-line treatment for NSCLC, their limited response to ICI monotherapy has led to exploration of combination treatments. However, the high incidence of treatment-related adverse events associated with conventional drug combinations has highlighted the need for alternative herbal therapy. Bojungikki-tang (BJIKT), a traditional herbal medicine, has been used to treat gastrointestinal disorders and enhance immune function. Our preclinical studies have demonstrated that BJIKT combined with anti-PD-1 or anti-PD-L1 antibodies exhibits significant efficacy in suppressing tumor growth by modulating the immunosuppressive tumor microenvironment. Building on these preclinical findings, this study aims to evaluate the efficacy and safety of BJIKT with pembrolizumab combination therapy compared to pembrolizumab monotherapy in advanced NSCLC patients. Methods: 70 individuals with stage IV NSCLC scheduled for first-line pembrolizumab monotherapy will be randomly assigned to intervention or control groups. The primary outcome will be progression-free survival, with secondary outcomes including disease control rate, overall survival, and quality of life assessment. Adverse events will be monitored for safety. This study will explore the synergistic mechanism of combinatorial therapy using immune profiling and multi-omics analysis, and the possibility for personalized integrative therapy based on cold-heat syndrome differentiation (SD) types in East Asian medicine. Discussion: This study will provide novel evidence regarding survival outcomes, quality of life, and safety profiles of combined ICI and BJIKT therapy for advanced NSCLC. The exploratory data will contribute to tailoring treatments to immune-based SD types in NSCLC patients.

Previous research has mainly focused on the adverse events (AEs) of individual medicinal plants rather than those of herbal formulas. This study investigated AEs associated with herbal formulas composed of two or more herbs by summarizing existing systematic reviews (SRs). We aimed to identify common AEs to develop a comprehensive reporting form for clinical practice and research, improving herbal medicine safety monitoring in South Korea. Four international (MEDLINE, EMBASE, CENTRAL, CINAHL) and three Korean databases (KISS, ScienceON, OASIS) were searched for SRs on AEs associated with herbal formulas from inception to September 13, 2024. Inclusion criteria were SRs focusing on AEs of herbal formulas composed of two or more herbs. Two researchers independently conducted the search, selection, and data extraction. Methodological and reporting quality were evaluated using A MeaSurement Tool to Assess systematic Reviews 2 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist. AEs were classified using the System Organ Class of the Medical Dictionary for Regulatory Activities. Thirteen SRs were selected. The most frequently reported organ system was hepatobiliary (9 SRs), followed by nervous and gastrointestinal systems (3 SRs each). Common symptoms in primary studies were nausea (n = 102), diarrhea (n = 80), and vomiting (n = 70). Causality was analyzed in 7 SRs using various scales. The methodological quality of the included SRs was critically low. Our findings provide a foundation for developing a standardized AE reporting form for herbal formulas. Further high-quality reports with specific patient conditions, herbal constituents, and causality assessments are required to enhance herbal medicine safety monitoring and understanding. PROSPERO, CRD42023478440.