untitled

J Dent Hyg Sci Vol. 17, No. 6, 2017, pp.523-532 https://doi.org/10.17135/jdhs.2017.17.6.523 RESEARCH ARTICLE 국내치위생 ( 학 ) 과임상치위생학교육과정운영현황분석 최용금ㆍ한양금 1 ㆍ배수명 2 ㆍ김진 3 ㆍ김혜진 4 ㆍ안세연 5 ㆍ임근옥ㆍ임희정 6 장선옥 3 ㆍ장윤정 7 ㆍ정진아 8 ㆍ전현선 9 ㆍ박지은 10 ㆍ이효진 11 ㆍ신보미 2, 선문대학교건강보건대학치위생학과, 1 대전보건대학교치위생과, 2 강릉원주대학교치과대학치위생학과및구강과학연구소, 3 한림성심대학교치위생과, 4 동의대학교치위생학과, 5 동남보건대학교치위생과, 6 을지대학교치위생학과, 7 호원대학교보건의료대학치위생학과, 8 광양보건대학교치위생과, 9 여주대학교치위생과, 10 이화여자대학교의과대학부속목동병원치과진료부, 11 서울대학교치의학대학원예방치학교실 Study on Current Curriculum Analysis of Clinical Dental Hygiene for Dental Hygiene Students in Korea Yong-Keum Choi, Yang-Keum Han 1, Soo-Myoung Bae 2, Jin Kim 3, Hye-Jin Kim 4, Se-Youn Ahn 5, Kun-Ok Lim, Hee Jung Lim 6, Sun-Ok Jang 3, Yun-Jung Jang 7, Jin-Ah Jung 8, Hyun-Sun Jeon 9, Ji-Eun Park 10, Hyo-Jin Lee 11, and Bo-Mi Shin 2, Department of Dental Hygiene, College of Health Science, Sun Moon University, Asan 31460, 1 Department of Dental Hygiene, Daejeon Health Institute of Technology, Daejeon 34504, 2 Department of Dental Hygiene, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung 25457, 3 Department of Dental Hygiene, Hallym Polytechnic University, Chuncheon 24210, 4 Department of Dental Hygiene, Dong-Eui University, Busan 47340, 5 Department of Dental Hygiene, Dongnam Health University, Suwon 16328, 6 Department of Dental Hygiene, Eulji University, Seongnam 13135, 7 Department of Dental Hygiene, College of Health and Medical Science, Howon University, Gunsan 54058, 8 Department of Dental Hygiene, Gwangyang Health Sciences University, Gwangyang 57764, 9 Department of Dental Hygiene, Yeoju Institiute of Technology, Yeoju 12652, 10 Dental Center, Ewha Womans University Mokdong Hosptial, Seoul 07985, 11 Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul 03080, Korea The purpose of this study was to provide basic data to standardize the clinical dental hygiene curriculum, based on analysis of current clinical dental hygiene curricula in Korea. We emailed questionnaires to 12 to investigate clinical dental hygiene curricula, from February to March, 2017. We analyzed the clinical dental hygiene curricula in 5 with a 3-year program and in 7 with a 4-year program. The questionnaire comprised nine items on topics relating to clinical dental hygiene, and four items relating to the dental hygiene process and oral prophylaxis. The questionnaire included details regarding the subject name, the grade/semester/credit system, course content and class hours, the number of senior professors, and the number of patients available for dental hygiene clinical training purposes. In total, there were 96 topics listed in the curricula relating to clinical dental hygiene training, and topics varied between the. There was an average of 20.4 topic credits, and more credits and hours were allocated to the 4-year program than to the 3-year program. On average, the ratio of students to professors was 21.4:1. Course content included infection control, concepts for dental hygiene processes, dental hygiene assessment, intervention and evaluation, case studies, and periodontal instrumentation. An average of 2 hours per patient was spent on dental hygiene practice, with an average of 1.9 visits. On average, student clinical training involved 19 patients and 26.6 patients in the 3-year and 4-year programs, respectively. The average participation time per student per topic was 38.0 hours and 53.1 hours, in the 3-year and 4-year programs, respectively. Standardizing the clinical dental hygiene curricula in Korea will require consensus guidelines on topics, the number of classes required to achieve core competencies as a dental hygienist, and theory and practice time. Key Words: Clinical dental hygiene curriculum, Dental hygiene school, Dental hygiene students Received: October 16, 2017, Revised: November 14, 2017, Accepted: November 21, 2017 Correspondence to: Bo-Mi Shin Department of Dental Hygiene, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung 25457, Korea Tel: +82-33-640-2860, Fax: +82-33-642-6410, E-mail: purplebom@gwnu.ac.kr ISSN 1598-4478 (Print) / ISSN 2233-7679 (Online) Copyright 2017 by Journal of Dental Hygiene Science This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

J Dent Hyg Sci Vol. 17, No. 6, 2017 서론 임상치위생학 (clinical dental hygiene) 이란임상영역의전공학문으로치위생관리과정을수행하기위한치위생사정, 판단, 계획, 수행, 평가를위한모든이론과실습을교육하는통합적인개념의교과목이다 1). 특히치위생사정, 판단, 계획, 수행평가등은치위생관리과정으로인간욕구에기반하여치과위생사가대상자의건강문제및구강과관련된욕구를파악하는데필요한핵심적인틀이라고할수있다 2,3). 이러한치위생과정의틀은임상치위생학이근거중심의학문으로서국제적인교육과정임을반영한다 4,5). 미국에서는표준화된임상치위생학교육과정으로치위생관리과정의이론과실무를교육하고, 이러한교육이제대로운영되고있는지를관리및평가하기위하여교육기관인증제를실시하고있다 6). 따라서임상치위생학교육과정에서치과위생사로서의전문성과자질을갖추도록임상영역과관련된표준핵심역량과세부역량을제시하여이를졸업전까지반드시달성할수있도록교육해야한다 7). 또한캐나다에서도 5개의캐나다치과위생사조직 (Canadian Dental Hygienists Association [CDHA] 8), Commission on Dental Accreditation of Canada [CDAC] 9), Dental Hygiene Educators Canada [DHEC] 10), Federation of Dental Hygiene Regulatory Authorities [FDHRA] 11), National Dental Hygiene Certification Board [NDHCB] 12) ) 이공동논의하여치위생관리과정에근거하여치위생학과를졸업하는데필요한임상역량을제시하였고, 이를임상치위생학교육과정을통해달성할수있도록표준화하기위해교육기관인증항목으로포함하여평가하고있다 13). 이러한제도적장치는임상치위생학교육과정이표준화된교육과정으로서치과위생사주도의치위생관리수행능력을향상시키고, 역량중심의통합적사고를함양할수있도록하는데기여할수있다 14). 우리나라에서는치위생학교육과정에대한표준화작업이미흡한상황이며, 특히임상치위생학교육과정은학제뿐아니라각학교에따라다르게운영하는것으로나타난다 14). 특히치위생과정에근거한임상치위생학교육이제대로이루어지지못하고있으며, 치위생사정과수행에비중을두고운영되고있는것으로나타난다 1). 또한임상치위생학영역교과목명칭도학교마다다르게사용되고있으며, 학제나학교의상황에따라임상치위생학, 임상치위생실습, 치면세마론, 포괄치위생학, 예방치학등다양한교과목명을사용하고있는실정이다 15). 따라서우리나라임상치위생교육과정이국가적수준에서표준화된내용이제시되어야하 며, 각학교에서는이에근거하여졸업시점에서의치과위생사의핵심역량과세부역량을제시하고, 이를평가할수있는치위생관리과정중심의임상치위생학교육과정의필요성이제기되고있다 2). 치위생 ( 학 ) 과의임상치위생학교육과정표준화를위해서는현재국내치위생 ( 학 ) 과의임상치위생학교육과정현황을파악하여이를근거로향후교육과정의개선안을마련할수있도록해야한다. 따라서본연구에서는국내치위생 ( 학 ) 과를대상으로하여임상치위생학교육과정에대해심층분석함으로써우리나라임상치위생학교육과정의표준화를위한기초자료로활용하고자한다. 연구대상및방법 1. 연구대상전국 83개의치위생 ( 학 ) 과중연구참여에동의한 12개의치위생 ( 학 ) 과를대상으로 2017년 2월 7일부터 3월 17일까지전자메일을통해학제별임상치위생학교육과정운영현황에대한자료수집을진행하였다. 총 3년제 5개교, 4년제 7 개교의자료를최종분석자료로활용하여임상치위생학영역교과목운영현황을분석하였다. 본연구는선문대학교기관생명윤리위원회승인 (SM-201701-001-2) 을얻은후진행되었다. 2. 자료수집및연구방법교육내용체계화및표준화작업을위해서국내치위생 ( 학 ) 과임상치위생학교육과정에대한조사지를작성하였다. 조사항목은임상치위생학및관련교과목운영현황에대한조사 9문항, 치위생관리과정및치면세마모형및대상자실습운영내용에대한조사 4문항으로구성하였다. 임상치위생학및관련교과목 의조작적정의는치과위생사의스케일링및구강병예방관련법적업무를학습하기위해운영되는교과목으로기존의예방치학, 임상치위생학, 포괄치위생학, 치면세마등의과목명으로운영되는교과목을포함하도록하였다. 치위생관리과정및치면세마대상자실습 의조작적정의는스케일링을포함하여실제사람을대상으로포괄적인구강건강증진서비스를수행하는실습으로, 학교별로치위생관리과정, 스케일링, 치면세마, 포괄치위생관리등의용어로사용되는실습을의미한다. 세부적인조사항목으로는임상치위생학및관련교과목의이름, 각교과목을운영하는학년 / 학기, 학점, 강의내용및시간, 교과목별담당교수수와학기별치위생관리과정및치면세마대상자실습케이스수및대상자 1인당평균 524

최용금외 : 국내임상치위생학교육과정운영현황분석 실습시간, 예방진료및전문가치면세균막관리실습수행횟수 ( 마네킹, 상호실습포함 ) 등을조사하였다. 각교과목별교육내용은모든임상치위생학및관련교과목의 15 16 주차별강의주제및내용, 각주제별강의시간을주관식으로작성하여수합하였다. 총 1,439개항목의주차별강의주제를목록화하였고, 구강질환, 대상, 치료 ( 처치 ) 방법, 재료및도구, 개념등핵심키워드를중심으로범주화하였다. 예를들어, 전문가치면세정술의이론, 전문가치실질, 와타나베칫솔질, Eva tip을이용한전문가치면세균막관리등의주제는 전문가치면세균막관리 로범주화하였고, 심혈관계질환과구강건강의이해, 임신과구강건강, 당뇨환자의구강건강관리등의주제는 전신질환자의구강건강관리 로범주화하였고, 치위생관리과정의단계별개념, 프로토콜, 수행과정, 챠트및문서작성, 치위생관리과정리뷰등의주제는 치위생관리과정의개념과과정에대한이해 로범주화 하였다. 최종적으로임상치위생학및관련교과목교육내용을 47개항목으로정리하였고, 각강의주제별강의시간현황을분석하였다. 자료분석은수집된자료를 IBM SPSS ver. 20.0 (IBM Co., Armonk, NY, USA) 을이용하여빈도분석및기술통계분석을수행하였다. 결과 1. 학제별임상치위생학영역교과목개설현황연구대상학교에서운영하고있는임상치위생학영역교과목은전체 96개과목으로확인되었다 (Table 1). 각교과목에서운영하고있는내용은감염관리, 예방치학이론및실습, 치위생관리이론및실습, 치주기구조작법이론및실습, 대상자실습등으로동일한내용을교육하고있으나교과목명은학교별로다르게나타났다. 전체교과목중 60.5% 가 Table 1. Subject Name of Clinical Dental Hygiene Area Subject name Total 3-year 4-year Infection control 3 (3.1) 1 (33.3) 2 (66.7) Dental infection control practice 1 (1.0) 1 (100) 0 (0) Health assessment and dental infection control practice 1 (1.0) 0 (0) 1 (100) Preventive dentistry 7 (7.3) 4 (57.1) 3 (42.9) Preventive dentistry practice 4 (4.2) 4 (100) 0 (0) Case studies in dental hygiene 1 (1.0) 0 (0) 1 (100) Basic dental hygiene practice 2 (2.1) 2 (100) 0 (0) Dental prophylaxis and practice 10 (10.4) 10 (100) 0 (0) Periodontal instrumentation 1 (1.0) 1 (100) 0 (0) Dental hygiene practice 4 (4.2) 4 (100) 0 (0) Dental hygiene practical technique 1 (1.0) 1 (100) 0 (0) Clinical dental hygiene theory 23 (24.0) 0 (0) 23 (100) Clinical dental hygiene practice 14 (14.6) 4 (28.6) 10 (71.4) Clinical dental hygiene theory and practice 21 (21.9) 6 (28.6) 15 (71.4) Comprehensive dental hygiene practice 2 (2.0) 2 (100) 0 (0) Dental management and practice 1 (1.0) 0 (0) 1 (100) Total 96 (100) 40 (41.7) 56 (58.3) Values are presented as n (%). Table 2. Status of Clinical Dental Hygiene Area Course a by School System School system subjects Credit Total school hours b students per professor Total (n=12) 7.9 (6 11) 21.1 (15 45) 471.3 (360 675) 21.4 (8 40) 3-year (n=5) 8.4 (6 11) 20.0 (15 23) 420.0 (360 465) 31.3 (24 40) 4-year (n=7) 8.0 (6 11) 21.9 (18 31) 507.9 (420 675) 17.4 (8 23) Values are presented as mean per school (range [minimum~maximum]). a Mean credits and time of classes related to clinical dental hygiene (dental prophylaxis, preventive dentistry, clinical dental hygiene, basic dental hygiene) per semester. b Calculated by the class-hours of 15 weeks. 525

J Dent Hyg Sci Vol. 17, No. 6, 2017 임상치위생학또는임상치위생학및실습, 임상치위생학실습교과목명칭을사용하고있는것으로나타났다. 2. 학제별임상치위생학영역교과목수, 학점및전체운영시간현황졸업시점까지학제별임상치위생학영역교과목수, 학점, 시간등운영현황은 Table 2와같다. 학교별운영하는임상치위생학영역평균교과목수는 7.9개였고, 졸업시점까지평균 21.1학점을이수하는것으로나타났다. 교과목별 15주차의수업을운영하는것으로가정하였을때평균 471.3시간수업을운영하는것으로확인되었다. 교수 1인당학생 21.4명을담당하여임상치위생학영역교과목을운영하고있었다. 졸업시점까지학기별로 1.0 2.0개의임상치위생학영역교과목을지속적으로운영하고있었고, 주당최소 2시간에서최대 10시간으로배정하여운영하고있었다 (Table 3). 3. 임상치위생학영역교육내용및시간현황학제별임상치위생학영역교육내용및시간은 Table 4와같다. 임상치위생학영역의교과목에서교육하고있는주요교육주제는감염관리, 치위생관리를위한기초개념의이해, 치위생사정, 중재및평가, 증례연구, 치주기구조작법등이었다. 치위생관리과정의 5단계 ( 사정, 판단, 계획, 수행, 평가 ) 의단계별개념, 치위생관리과정의프로토콜, 수행과정, 챠트및문서작성, 치위생관리과정이해를위한문제해결토의등과같은치위생관리과정의개념과과정에대한이해를위해평균 15.5시간수업을운영하고있었고, 특히 4년제학제에서는평균 20.9시간을운영하는것으로나타났다. 치위생중재에서는심혈관계질환, 골다공증, 임신, 당뇨, 고혈압, 호흡기질환, 암등과같은전신질환자의구강건강관리에대하여 4년제학제에서만평균 7.8시간수업을진행하는 것으로나타났고, 장애인, 섭식장애등과같은특별환자의구강건강관리에대하여 3년제에서는평균 5.4시간을, 4년제에서는평균 13.5시간을교육하는것으로나타났다. 반면, 치주치료유지관리와같은치위생평가영역에대한교육은일부학교에한하여유지관리및계속관리관련주제에대하여평균 5시간이내로운영되고있었다. 치위생증례연구수업은전체평균 31.0시간운영되고있었고, 학생이직접수행한치위생관리대상자분석에대한 case presentation 수업은전체평균 9.9시간운영되는것으로나타났다. 치주기구조작법주제의경우, probe의이론및실습은전체평균 6.6시간운영되고있었고, 스케일러및큐렛등의수기구적용을위한이론및실습은 64.4시간운영되며, 실제대상자실습은평균 100.4시간운영되는것으로나타났다. 또한이와는별개로국가시험실기시험에대비한연습및모의평가는전체평균 34.1시간운영되는것으로나타났다. 4. 학교별치위생관리대상자실습운영현황학교별치위생관리대상자실습운영현황은 Table 5와같다. 치위생관리대상자실습은학교별로치위생관리과정, 스케일링, 치면세마, 포괄치위생관리등의용어로사용되고있는실습으로, 스케일링을포함하여실제사람을대상으로포괄적인구강건강증진서비스를수행하는실습을의미한다. 대상자실습은대상자 1인당평균 2시간소요되었고, 평균 1.9회내원하도록하여실습을진행하고있는것으로나타났다. 졸업시점까지필수적으로진행하는대상자실습은 3년제의경우평균 19개의케이스를, 4년제의경우평균 26.6개케이스를실습하고있었고, 가장적게는 15개, 많게는 35개케이스의대상자실습을수행하였고, 학생 1인당대상자실습에참여하는시간은 3년제의경우평균 38.0시간, 4년제에서는평균 53.1시간으로나타났다. 3년제의경우 2 학년 2학기부터대상자실습을운영하였고, 4년제의경우 Table 3. Status of Clinical Dental Hygiene Area Course by Semester Grade-semester 3-year (n=5) 4-year (n=7) subjects Credit Hours per week subjects Credit Hours per week 1-1 1.0 (1 1) 2.0 (2 2) 2.0 (2 2) - - - 1-2 1.8 (1 4) 4.8 (3 9) 5.6 (3 10) 1.5 (1 2) 3.0 (2 4) 4.0 (2 6) 2-1 2.0 (1 4) 4.8 (3 8) 6.6 (4 8) 1.4 (1 2) 4.0 (3 5) 5.3 (4 7) 2-2 1.4 (1 2) 3.4 (2 4) 5.4 (4 8) 1.4 (1 2) 4.1 (3 9) 5.4 (4 7) 3-1 1.0 (1 1) 2.4 (2 3) 4.0 (3 5) 1.0 (1 1) 3.1 (2 5) 4.6 (4 6) 3-2 1.4 (1 2) 2.6 (1 5) 4.0 (2 8) 1.3 (1 2) 3.9 (2 7) 5.3 (4 8) 4-1 - - - 1.3 (1 2) 4.1 (2 11) 5.3 (4 7) 4-2 - - - 1.1 (1 2) 3.7 (3 8) 4.9 (4 6) Values are presented as mean per school (range [minimum~maximum]). 526

최용금외 : 국내임상치위생학교육과정운영현황분석 Table 4. Clinical Dental Hygiene Area Course Contents and Hours by School System Contents Total 3-year 4-year Infection control Understanding of infection control 6 4.2 (1.0 12.0) 2 3.0 (2.0 4.0) 4 4.8 (1.0 12.0) Understanding of infectious diseases 4 2.3 (1.0 4.0) 2 3.0 (2.0 4.0) 2 1.5 (1.0 2.0) Individual infection control theory and practice 6 4.0 (2.0 6.0) 3 4.7 (2.0 6.0) 3 3.3 (2.0 4.0) Dental waste management 4 1.8 (1.0 2.0) 2 2.0 (2.0 2.0) 2 1.5 (1.0 2.0) Infection control at dental office 10 9.7 (4.0 26.0) 4 12.5 (4.0 26.0) 6 7.8 (4.0 18.0) Basic concepts Concept of health and oral health 2 2.5 (2.0 3.0) 2 2.5 (2.0 3.0) 0 0.0 (0.0 0.0) Management principles of oral diseases 4 3.0 (2.0 5.0) 2 2.5 (2.0 3.0) 2 3.5 (2.0 5.0) Prevention of other oral diseases 3 4.3 (3.0 6.0) 3 4.3 (3.0 6.0) 0 0.0 (0.0 0.0) Formation and structure of dental plaque 6 3.7 (2.0 6.0) 1 3.0 (3.0 3.0) 5 3.8 (2.0 6.0) Dental deposit 8 4.6 (2.0 8.0) 5 5.0 (3.0 6.0) 3 4.0 (2.0 8.0) Theory and principle of dental caries 8 5.5 (2.0 9.0) 3 7.0 (6.0 9.0) 5 4.6 (2.0 8.0) Theory and principle of periodontal disease 8 4.6 (2.0 8.0) 3 5.7 (3.0 8.0) 5 4.0 (2.0 8.0) Understanding of dental hygiene care 12 15.5 (4.0 44.0) 5 8.0 (4.0 15.0) 7 20.9 (7.0 44.0) Dental hygiene assessment Extraoral and intraoral clinical assessment 11 5.2 (2.0 12.0) 4 4.3 (2.0 6.0) 7 5.7 (2.0 12.0) Oral bacterium assessment 8 4.9 (2.0 10.0) 3 3.3 (2.0 4.0) 5 5.8 (4.0 10.0) Instruction of digital camera 4 3.8 (2.0 5.0) 2 3.0 (2.0 4.0) 2 4.5 (4.0 5.0) Health histories 4 7.8 (2.0 16.0) 2 6.0 (4.0 8.0) 7 6.6 (4.0 16.0) Assessment of the dentition 5 4.6 (4.0 6.0) 0 0.0 (0.0 0.0) 5 4.6 (4.0 6.0) Dental charting 7 5.6 (2.0 14.0) 4 2.8 (2.0 4.0) 3 9.3 (4.0 14.0) Dental caries risk assessment 11 7.9 (4.0 12.0) 4 8.0 (4.0 11.0) 7 7.9 (5.0 12.0) Periodontal disease risk assessment 4 8.5 (4.0 12.0) 1 4.0 (4.0 4.0) 3 10.0 (6.0 12.0) Dental hygiene intervention Oral health and diet 11 5.3 (3.0 8.0) 4 6.3 (5.0 8.0) 7 4.7 (3.0 6.0) Oral health education 5 4.4 (3.0 6.0) 2 4.0 (4.0 4.0) 3 4.7 (3.0 6.0) Toothbrushing method 8 5.8 (2.0 12.0) 4 6.8 (3.0 12.0) 4 4.8 (2.0 7.0) Oral health care products 11 9.5 (4.0 18.0) 4 10.2 (6.0 18.0) 7 9.0 (4.0 18.0) Pit and fissure sealant 11 6.7 (2.0 11.0) 4 7.5 (5.0 11.0) 7 6.3 (2.0 10.0) Professional fluoride application 11 8.2 (2.0 14.0) 4 9.0 (6.0 12.0) 7 7.7 (2.0 14.0) Evaluation of dental plaque 10 6.9 (2.0 14.0) 4 4.0 (2.0 6.0) 6 8.8 (4.0 14.0) Professional dental plaque control 11 8.5 (4.0 15.0) 4 7.0 (6.0 8.0) 7 9.4 (4.0 15.0) Tooth polishing 6 6.0 (2.0 10.0) 4 5.5 (2.0 7.0) 2 7.0 (4.0 10.0) 527

J Dent Hyg Sci Vol. 17, No. 6, 2017 Table 4. Continued Contents Total 3-year 4-year Evaluation and management of halitosis 7 2.8 (1.5 4.0) 3 3.2 (2.0 4.0) 4 2.5 (1.5 4.0) Dentinal hypersensitivity management 6 3.0 (1.5 4.0) 3 3.2 (1.5 4.0) 3 2.8 (2.0 4.0) Smoking and tobacco cessation 6 3.7 (2.0 5.0) 1 2.0 (2.0 2.0) 5 4.0 (3.0 5.0) Oral health care of individuals with systemic diseases 5 7.8 (2.0 16.0) 0 0.0 (0.0 0.0) 5 7.8 (2.0 16.0) Oral health care of individulas with special needs a 11 9.6 (3.0 30.0) 5 5.4 (3.0 11.0) 6 13.5 (4.0 30.0) Dental emergency treatment 1 8.0 (8.0 8.0) 0 0.0 (0.0 0.0) 1 8.0 (8.0 8.0) Dental hygiene care practice 12 100.4 (42.0 164.0) 5 78.6 (42.0 115.0) 7 116.0 (72.0 164.0) Ergonomics 9 4.9 (2.0 8.0) 5 4.2 (2.0 6.0) 4 5.8 (4.0 8.0) Explorer: basic concepts and technique practice 11 8.4 (4.0 20.0) 5 11.2 (4.0 20.0) 6 6.0 (4.0 10.0) Probe: basic concepts and technique practice 12 6.6 (4.0 12.0) 5 7.8 (4.0 12.0) 7 5.7 (4.0 10.0) Scaler and curet: basic concepts and technique practice 12 64.4 (36.0 108.0) 5 71.6 (49.0 108.0) 7 59.3 (36.0 84.0) Dental prophylaxis: basic concepts and technique practice 6 5.5 (2.0 12.0) 4 4.8 (3.0 6.0) 2 7.0 (2.0 12.0) Periodontal instrument sharpening 10 5.4 (2.0 10.0) 5 5.8 (2.0 10.0) 5 5.0 (4.0 6.0) Practice and evaluation for state examination 12 34.1 (4.0 64.0) 5 32.8 (16.0 48.0) 7 35.0 (4.0 64.0) Dental hygiene evaluation Maintenance 2 3.5 (2.0 5.0) 1 2.0 (2.0 2.0) 1 5.0 (5.0 5.0) Case studies and analyses Case studies in dental hygiene b 7 31.0 (18.0 52.0) 1 18.0 (18.0 18.0) 6 33.2 (24.0 52.0) Case presentation c 10 9.9 (2.0 28.0) 3 8.0 (3.0 16.0) 7 10.7 (2.0 28.0) Values are presented as number only or mean per school (range [minimum~maximum]). a Persons with disabilities, adolescents, women and their children/pregnant women, the older adult, persons with implant, persons with disordered eating, pain management, dental phobia management, etc. b Case analysis and problem solution in dental hygiene based on case study text book. c Case presentation about students clients for dental hygiene care. 528

최용금외 : 국내임상치위생학교육과정운영현황분석 Table 5. Status of Dental Hygiene Care Practice to Practice Patients School Average practice hours per practice patients patients visits required practice cases per semester 1-1 1-2 2-1 2-2 3-1 3-2 4-1 4-2 Total cases Total practice hours per student a Total 2 1.9 0.0 0.0 0.0 5.8 7.1 6.5 12.0 5.8 23.4 46.8 3-year 2 1.4 0.0 0.0 0.0 8.8 9.8 2.8 - - 19.0 38.0 A 1-2 1.0 0.0 0.0 0.0 10.0 8.0 2.0 - - 20.0 40.0 B 2 1.0 0.0 0.0 0.0 12.0 12.0 0.0 - - 24.0 48.0 C 2 1.0 0.0 0.0 0.0 5.0 10.0 0.0 - - 15.0 30.0 D 2-4 1.0 0.0 0.0 0.0 8.0 10.0 0.0 - - 18.0 36.0 E 2 3.0 0.0 0.0 0.0 0.0 9.0 9.0 - - 18.0 36.0 4-year 2 2.3 0.0 0.0 0.0 0.0 3.8 8.7 12.0 5.8 26.6 53.1 F 1-2 2.0 0.0 0.0 0.0 0.0 0.0 4.0 10.0 10.0 24.0 48.0 G 2 3.0 0.0 0.0 0.0 0.0 0.0 6.0 9.0-15.0 30.0 H 2 2.0 0.0 0.0 0.0 0.0 0.0 2.0 10.0 12.0 24.0 48.0 I 1-2 2.0 0.0 0.0 0.0 0.0 0.0 8.0 10.0 6.0 24.0 48.0 J 1-2 2.0 0.0 0.0 0.0 0.0 0.0 15.0 16.0 4.0 35.0 70.0 K 2 3.0 0.0 0.0 0.0 0.0 9.0 12.0 15.0 3.0 30.0 60.0 L 2 2.0 0.0 0.0 0.0 0.0 6.0 14.0 14.0 0.0 34.0 68.0 a Total hours for care practice=the sum of (the number of required pracitce cases per semester average practice hours per practice patients). 빠르면 3 학년 1 학기부터실습을운영하는것으로나타났다. 고찰 본연구에서는임상치위생학교육과정의표준화를위한기초자료로활용하고자국내일부치위생 ( 학 ) 과에서운영하고있는임상치위생학교육과정에대해심층분석하였다. 우리나라치위생학교육이장기적이고, 국제적인수준에서선진치위생학학문으로발전하기위해서는치위생학교육과정의체계적인개선을바탕으로표준화가반드시이루어져야한다 15). 임상치위생학교육과정은치위생관리과정에근거하여환자중심의포괄적인진료제공에초점을맞춘치위생사정-판단-계획-수행-평가과정으로서국제적인표준치위생임상실무의바탕이된다 16). 따라서학생들이치위생 ( 학 ) 과의교육과정을마치는졸업시점에서임상실무수행역량을갖출수있는교육과정으로구성되는것이전제되어야한다 17). 교육과정의표준화를위해서는운영하는교과목명칭과내용에대한표준화가이루어져야한다. 교과목명칭은그과목의포괄적인특성과내용을함축할수있어야하며, 이는곧치위생학의학문적체계를반영한다. 교과목영역의명명은교과목명칭을그대로반영할수있어야하는데, 이는기본적으로교육목적및교육목표의방향설정및근거가될수있기때문이다 18,19). 본연구결과, 12개치위생 ( 학 ) 과에서운영중인임상치위생학영역의교과목은전체 96개과목으로확인되었다. 관련교과목명칭으로는임상치위생학, 임상치위생학및실습, 감염관리학, 기초치위생실습, 예방치과학, 임상치위생증례연구, 치면세마론, 치면세마학및실습, 치주기구활용, 포괄치위생실습, 포괄치위생학등매우다양하게나타났다. 가장큰비율로사용되고있는교과목명칭으로는임상치위생학또는임상치위생학및실습이 60.5% 로나타났다. 선진치위생교육의대표적인국가인미국과캐나다의현황을살펴보면모두임상치위생학또는임상치위생학실습을사용하고있다 14,20). 따라서임상치위생학교육과정에서다루는일부내용만을반영하는교과목명칭을사용하기보다는국제적수준에걸맞고, 임상치위생학영역의전체를포괄할수있는개념이반영된교과목명칭인임상치위생학또는임상치위생학실습이라는교과목명칭을사용하는것이바람직할것으로생각된다. 임상치위생학영역교과목에서는치과위생사의표준업무를다루며, 이론뿐아니라실습이이루어짐에따라치위생학교육과정에서가장큰비중을차지한다. 그럼에도불구하고학교별로운영방식과체계가다르면그에따라운영시간과내용이달라지게된다. 본연구결과, 졸업시점까지각학교에서평균 7.9개의임상치위생학영역교과목을운영하고있었고, 과목별 15주차의수업을운영하는것으로가정하였을때졸업시점까지평균 471.3시간수업을운영하는것으로확인되었다. 학제에따른차이를확인한결과, 529

J Dent Hyg Sci Vol. 17, No. 6, 2017 평균학점과총수업시간은 3년제에비해 4년제에서더많은학점과시간을배정하여운영하고있는것으로나타났다. 대다수의 4년제학교에서는 34 40학점에해당하는교양학점을필수적으로이수하여야함을고려하였을때, 4년제교육과정에서 3년제에비해많은시간을투입하고있는것으로나타났다. 이와더불어, 동일학제내에서도교육과정운영방식의차이가있는것으로나타났다. 3년제교육과정내에서도교육시간이최소 330시간과최대 465시간운영하는것으로나타나차이가크게나타났다. 임상치위생학교육과정의심층적인선행연구가부족한상황에서세부적인학점과교육운영시간등을비교하기에는어려움이있지만 Choi 등 14) 의연구에서보면미국의치위생학교육과정은임상치위생학에가장큰비중을두어집중적으로교육이이루어지기때문에주당 14 21시간에걸쳐교수자 1명당학생 5 6명으로구성하여운영되고있다 1,20). 임상치위생학은내용과시간의비중이큰만큼효율적이고효과적으로운영하기위해필수교육내용및교육시간을통합적이고체계적으로고안하여표준화될필요가있다. 학점의배안은학교사정에따른차이가존재함을인정하더라도, 실습시간의확대와임상치과위생사로서필요한역량을달성하기위한최소한의교육시간에대한표준화가시급하며, 실습교육및지도의질을담보할수있는교수 1인당적정학생수가반드시고려되어야하겠다. 교육시간과교육의질차이는결과적으로치과위생사업무수행의질의차이로이어지며, 이는나아가치과의료서비스의질에영향을미치기때문에이에대한치위생학계내부의검토와논의가필요할것으로생각된다. 임상치위생학영역의교육내용에는감염관리, 치위생관리를위한기초개념의이해, 치위생사정, 중재및평가, 증례연구, 치주기구조작법등으로나타났다. 3년제및 4년제교육과정에서모두유사한교육주제를다루고있었지만, 구강질환위험도평가의경우 3년제학제에서는치아우식증에, 4년제학제에서는치주질환위험도평가에보다많은시간을투입하고있었고, 전신질환및특별환자관리에대한내용을보다많은시간에걸쳐다루고있었다. 그러나전체적으로치위생관리에대한철학적개념, 전신질환자및특별환자관리에대한교육내용이부족하였으며, 치주기구조작법등에대한국가고시실기대비위주의수행중심교육내용이많은부분차지하고있었다. Han 등 1) 의연구에서도치위생과정기반교육에서치위생판단, 계획, 평가단계에대한교육이치위생사정및수행단계에비하여적게이루어지고있다고보고하였다. 치과위생사표준업무인치위생관리는구강질환의예방과건강증진을중심철학으로하며, 이는인간의행동변화를통해이루어지기때문에기존의술기중심의교육내용을확장하여인간 환자에대한이해, 치과위생사의전문가적태도 윤리적행동, 행동변화의이해, 치위생관리과정의기본개념에대한철학적의미를전달할수있는교육이추가될필요가있고, 치위생사정과중재중심의교육과정은판단, 계획, 평가의각단계에대한내용이균형을이루며, 선후수체계를고려하여학년별 학기별로구성하는것이필요할것으로생각된다. 치위생관리대상자실습의운영현황을확인한결과, 대상자 1인당평균 2시간실습시간이소요되었고, 평균 1.9회내원하도록하여실습을진행하고있는것으로나타났다. 학생 1인당대상자실습에참여하는시간은 3년제의경우평균 38.0시간, 4년제에서는평균 53.1시간으로나타났다. 대상자실습운영에있어절대적시간은비교하기어렵지만미국과캐나다의경우, 임상치위생학 I, II의경우주당최소 8 12시간으로운영되고, 임상치위생학 III, IV의경우에는주당 12 21시간의대상자실습이진행된다 14,20). 계속관리를기반으로포괄적인치위생과정을수행할수있는대상자실습교육의시간이외국과비교하였을때상대적으로적게운영되고있는실정이다. 특히임상치위생학에서대상자실습은환자에게제공되는포괄적인치위생관리서비스를제공하는실습으로, 실제임상에서도매우중요한부분을차지한다. 따라서대상자실습교육의시간확대와운영지침에대한기본적인가이드라인이반드시마련되어야한다. 미국의경우우리나라와는달리임상치위생학의교육목표와임상역량은 American Dental Hygienists Association 에서제시하는표준임상치위생가이드라인에기반하여설정되고, 이를바탕으로각치위생 ( 학 ) 과에서는졸업을위한핵심역량 (core competencies) 을반드시성공적으로달성해야함을목표로하고있다 7,14). 따라서임상실무의표준틀인치위생관리과정에대한기본적인이론과술기를임상치위생학교육과정을통해확장할수있어야하며, 대상자에게성공적인치위생관리를제공하기위한인지적, 정서적, 심리적사고및기술을함양시키는데필요한교육내용으로운영하고있다. 우리나라는치위생교육과치과임상현장의괴리가큰것이현실이다. 국제적인치위생임상실무의표준인치위생관리과정을우리나라임상현장에서적용하는데한계가있고, 학교에서학습한내용을학생들은실제임상현장에서적용하는데현실적인제약이있다 20,21). 따라서치위생계는학계와임상현장의차이를줄이고치위생임상업무의국제적표준인치위생관리과정이활용될수있는방안과법적, 제도적마련을통해변화를꾀하는것이필요할것으로본다. 530

최용금외 : 국내임상치위생학교육과정운영현황분석 본연구에서는일부치위생 ( 학 ) 과를대상으로임상치위생학교육과정을조사하였기에연구결과를우리나라전체임상치위생학교육과정으로일반화하기는어려운한계를갖는다. 또한연구가교육목적및목표에따른학교별개설교과목의세부적인내용을분석을하고있지못하고개설교과목의명칭을중심으로분석하는구조적분석에머무르고있다는한계점이있다. 따라서추후임상치위생학수업운영방식, 실습평가방법, 교과목선후체계등다양한측면에서심도있는연구가계속적으로필요하며, 무엇보다먼저임상치위생학교육과정의표준화측면에서학년별 학기별각과정에서요구되는최소한의핵심교육과정 (core curriculum) 이제시될필요가있다. Han 등 1) 은교육과정의표준화를위해서는치위생관련기관에서주도적인역할을담당해야하며치위생학계교수들의공감대형성이무엇보다필요하고, 연구자개인의목소리가아닌치위생계의공식적인기관에서교육과정표준화에대한시급성을판단하고, 개선할수있는방안을모색해야한다고하였다. 최근대한치과위생사협회 22) 와대한치위생 ( 학 ) 과교수협의회 23) 에서는한국치위생학교육평가원설립추진위원회를구성하고치위생학교육인증체계를정립하여모든치위생학교육과정에대해표준화되고, 일관성있는질관리를통해경쟁력있는우수한치과위생사를양성하고자제도마련에노력하고있다. 이러한맥락에서학계는교육과정표준화에대한연구근거를바탕으로지속적으로관련자료를제공하고치위생계의교육적질을높이는데적극적인참여와검토, 논의가필요할것으로생각된다. 요약 국내치위생 ( 학 ) 과를대상으로하여임상치위생학교육과정운영현황을조사하고, 심층분석한결과첫째, 임상치위생학영역의교과목명칭은전체 96개과목으로확인되었으며, 학교별로매우다양하게나타났다. 그러나전체교과목중 60.5% 가임상치위생학또는임상치위생학및실습이라는명칭으로사용하고있었다. 둘째, 임상치위생학교과목운영은졸업시점까지평균 21.1학점을이수하고, 15주차수업으로평균 471.3시간수업을운영하는것으로나타났다. 또한교수 1인당학생수는 21.4명을담당하였으며, 3년제에비해 4년제에서더많은학점과시간을배정하여운영하고있는것으로조사되었다. 셋째, 임상치위생학의교육주제와내용에서는감염관리, 치위생관리를위한기초개념의이해, 치위생사정, 중재및평가, 증례연구, 치주기구조작법등으로나타났다. 그러나치위생관리과정의개념, 치위 생사정, 치아우식증, 치주질환위험도평가, 특별환자관리, 전신질환자의구강건강관리등에대한수업운영내용은 3, 4년제학제간차이가컸으며, 사정과수행중심의교육내용으로운영되며, 학제내에서도교육운영내용의차이가있는것으로조사되었다. 넷째, 대상자실습은대상자 1인당평균 2시간소요되었고, 평균 1.9회내원하도록하여실습을진행하고있는것으로나타났다. 졸업시점까지필수적으로진행하는대상자실습은 3년제의경우평균총 19개의케이스를, 4년제의경우평균 26.6개케이스를실습하고있었고, 가장적게는 15개의, 많게는 35개케이스를실습하였고, 학생 1 인당대상자실습에참여하는시간은 3년제의경우평균 38.0시간, 4년제에서는평균 53.1시간으로나타났다. 본연구는일부치위생 ( 학 ) 과를대상으로조사한연구라한계점은있지만임상치위생학교육과정의전체적인흐름과운영방식을파악할수있었다. 학제를떠나임상치위생학의교육과정표준화를위해서는교과목명칭, 졸업생수준에서치과위생사로서달성해야할역량에기반한최소한의수업운영내용, 이론과실습시간, 학생수대비지도교수자의수등에대한치위생계내합의또는가이드라인이반드시필요할것으로판단된다. 이러한과정은공적인기관을통해서제도적마련에근거하여변화할수있도록노력해야함을확인하였다. 감사의글 이연구는 2016년대한치위생 ( 학 ) 과교수협의회에서연구비를지원받아수행하였기에이에감사드린다. References 1. Han SY, Kim NH, Yoo JH, Kim CS, Chung WG: Current status of clinical dental hygiene education based on dental hygiene process of care. J Dent Hyg Sci 9: 271-278, 2009. 2. Lee SY, Cho YS: Review on theoretical background and components of dental hygiene process. J Dent Hyg Sci 5: 25-32, 2005. 3. MacDonald L, Bowen DM: Theory analysis of the dental hygiene human needs conceptual model. Int J Dent Hyg 15: e163-e172, 2017. 4. Michele LD, Margaret MW: Dental hygiene theory and practice. 3th ed. Saunders, St. Louis, pp.1-37, 2010. 5. American Dental Hygienists Association: Dental hygiene diagnosis position paper. American Dental Hygienists 531

J Dent Hyg Sci Vol. 17, No. 6, 2017 Association, Chicago, pp.1-6, 2010. 6. Communication on Dental Accreditation: Accreditation standards for dental hygiene education program. Commission on Dental Accreditation, Chicago, pp.15-29, 2016. 7. Choi DS, Kim SH, Kim JS: A comparative analysis of competencies American Dental Education Association and American Dental Hygiene Schools. J Korean Soc Dent Hyg 15: 547-553, 2015. 8. The Canadian Dental Hygienists Association: About CDHA. Retrieved June 30, 2017, from http://www.cdha.ca/cdha/about _folder/about_cdha/cdha/about/about_cdha.aspx. 9. Commission on Dental Accreditation of Canada: Welcome to CDAC. Retrieved June 30, 2017, from https://www.cda-adc. ca/cdacweb/en. 10. Canadian Dental Hygienists Association: 2016 educators survey report. Retrieved June 30, 2017, from http://files.cdha. ca/profession/educatorssurvey2016.pdf(2016). 11. Canadian Dental Regulatory Authorities Federation: About C DRAF. Retrieved June 30, 2017, from http://cdraf.org/home?l= en-us. 12. Joint Commission on National Dental Examinations: Examinations. Retrieved June 30, 2017, from https://www.ndhcb.ca/ ndhce-policies. 13. Commission on Dental Accreditation of Canada: Accreditation requirements. Retrieved November 7, 2017, from http://www. cda-adc.ca/cdacweb/en/accreditation_requirements. 14. Choi YK, Lim KO, Han YK, et al.: Study on clinical dental hygiene in Korea based on analysis of clinical dental hygiene curriculum of Fones School in the United States. J Dent Hyg Sci 17: 123-133, 2017. 15. Kim SH, Kim MK, Oh SH, Mann NK: The implement status of dental hygiene curriculum in Korea and the comparison with the US ADA standard. J Korean Acad Dent Hyg Educ 9: 229-247, 2009. 16. American Dental Hygienists Association: Standards for clinical dental hygiene practice. American Dental Hygienists Association, Chicago, pp.3-15, 2008. 17. Bae SM, Shin SJ, Jang JH, Chung WG, Chin BM: Analysis of current status of a dental hygiene science curriculum according to the dental hygienist competency. J Dent Hyg Sci 16: 173-183, 2016. 18. Park ES, Yang SO, Yang S, et al.: Analysis of the nursing curricula in graduate program in Korea. J Korean Acad Nurs 32: 100-113, 2002. 19. Lee HY: Nursing education system in Korea: now and then. J Nursing Query 15: 68-88, 2006. 20. Cho YS, Kim YJ, Ahn GS: An analysis of pre-dental hygiene curriculum of dental hygiene programs in USA and in Canada. J Dent Hyg Sci 6: 41-45, 2006. 21. Shin SJ, Kim MJ, Yang JY, Yu JS, Jeong AY, Shin MS: Study of clinical practice standardization in dental hygiene. J Dent Hyg Sci 17: 1-11, 2017. 22. Korean Dental Hygienists Association: Korean Dental Hygienists Association Press. Retrieved July 15, 2017, from http://www.kdha.or.kr/news/oldmagazineview.aspx(2016, April 1). 23. Korean Association of Dental Hygiene Professors: News of workshop 2017. Retrieved June 30, 2017, from http://www. kadhp.org/kadhp/board.php?board=kkknewsmain& config=2 &command=body&no=298(2017, June 24). 532