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2012 Volume 52 Issue 11 Pages
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2012 Volume 52 Issue 11 Pages
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Article type: Index
2012 Volume 52 Issue 11 Pages
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Article type: Index
2012 Volume 52 Issue 11 Pages
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
986-989
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Hideaki Amayasu
Article type: Article
2012 Volume 52 Issue 11 Pages
990-991
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[in Japanese]
Article type: Article
2012 Volume 52 Issue 11 Pages
992-
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Koji Tsuboi, Miyuki Odawara
Article type: Article
2012 Volume 52 Issue 11 Pages
993-1000
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Professionalism has become a hot topic in medicine, especially in medical education, because it is one of the important core competencies of physicians. Recently, medical professionalism might be taught and evaluated during undergraduate and/or residency. Otherwise medical professionalism has been notoriously difficult to define and remains poorly understood. Historically, 'professionalism' was defined by the social structures of medicine, but has moved on to represent the expected behaviors and attributes of practitioners. Three organizations of internal medicine then issued a "physician charter of professionalism" that spelled out three fundamental principles (primacy of patient welfare, patient autonomy, and social justice) and ten commitments. At present, the medical profession is confronted with an explosion of technology, changing market forces, problems in health care delivery, bioterrorism, and globalization. As a result, physicians find it increasingly difficult to meet their responsibilities to patients and society. In these circumstances, reaffirming the fundamental and universal principles and values of medical professionalism, which remain ideals to be pursued by all physicians, becomes all the more important. On the other hand, a large number of today's medical students, residents, and young physicians seem to want more time for themselves. They want to limit time commitments to medicine. The future of medicine as a profession is a bit shaky.
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Yuichi Amano, Masahiro Hashizume, Koji Tsuboi
Article type: Article
2012 Volume 52 Issue 11 Pages
1001-1007
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Recently, the medical professionalism is discussed frequently. The concepts of professionalism vary in medicine. In particular, the Physicians Charter made by American Board of Internal Medicine, American College of Physicians-American Society of Internal Medicine, European Federation of Internal Medicine is often taken up as a definition. This charter consists of three fundamental principles (Principle of primacy of patients' welfare, Principle of patients' autonomy and Principle of social justice) and 10 debts. This charter provides an ethical, educational, and practical framework to guide physicians in their relationships with patients, colleagues, and also society. So this charter is a contract with no document with the society. A role model is important in education of professionalism. It is necessary for the educator and medical staff to understand medical professionalism. Furthermore, professionalism based on Narrative becomes important in education of professionalism. I think that more discussion is indispensable to professionalism in psychosomatic medicine.
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Hiroki Okada
Article type: Article
2012 Volume 52 Issue 11 Pages
1008-1013
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Because patients come to doctors with "problems" not "diseases", we should have an ability of problem solving to carry out medical practices. However, most of medical students cannot master the ability from usual didactic teaching. So in the field of medical education, a current "From sage on the stage to guide on the side" has been spreading. One of the methods is PBL tutorial. In PBL, the students are introduced to think and discuss about a medical problem (s) (complaints and/or symptoms) in a small number of groups by the guidance of a tutor. The merit of PBL is expected to improve the students' ability of thinking. On the other hand, it has some faults. One is necessity of a grate number of tutors, and the second is that one PBL session cannot cover wide areas of medicine for its spending time. In contrast, TBL (Team-Based Learning) needs only one teacher in one TBL session and can teach more contents than PBL. One TBL session consists of three phases, preparation for the lesson, readiness assurance process, and application. In the second phase, IRAT (individual readiness assurance test) and GRAT (group readiness assurance test) are performed. Group discussion should be made for GRAT and an applied question (phase three). A peer review for each student's accountability for the group is done at the end of the session and the evaluation is expected to promote a student's motivation for studying. In order to introduce PBL or TBL to psychosomatic medical education, materials are desirable to be prepared by societies of psychosomatic medicine and psychosomatic internal medicine.
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Seiji Saito
Article type: Article
2012 Volume 52 Issue 11 Pages
1014-1021
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There is a good possibility that psycho-somatic medicine contribute the medical professionalism curricula because of commonality of their bio-psycho-social orientation. However, there have been scarce discussions about the theories and methodologies how to teach virtues necessary for a good physician, e.g. altruism, compassion, reflectivity etc., rather than knowledge and skills. Recently, narrative-based professionalism has been argued, including effective teaching methods which can directly approach the central paradox in medicine. One of the key concepts of narrative-based professionalism is narrative competence, defined as the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. To establish the teaching strategy of narrative competence, the concept of narrative skills and the method of narrative training should be clarified. In the present report, the author describes some concrete examples of educational practices as narrative training, e.g. parallel chart in USA, story-making exercise from the different view point, and experiential learning through reflective writings in the Web-based system for sharing stories, in Japan.
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Kazuhiro Yoshiuchi, Hiroshi Nishigori
Article type: Article
2012 Volume 52 Issue 11 Pages
1022-1025
Published: November 01, 2012
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Medical professionalism is considered as professional ethics to practice medicine competently. Recently, medical professionalism has also gained an increasing public attention in Japan. Methods for assessing professionalism should be developed for teaching it properly. Although some methods for assessing medical professionalism have been developed, medical professionalism is still a challenging area to assess. In this brief review, we tried to introduce the current state of this area while the professionalism in the field of "Psychosomatic Medicine" has to be defined first.
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Tsuguo Mizuno
Article type: Article
2012 Volume 52 Issue 11 Pages
1026-1033
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Patients on dialysis tend to have mental disorders including depression which is related to limit actions of everyday life, experiences of loss and stress in the face of death. I have been engaged in a dialysis medical care not only as a specialist in dialysis but also as a psychosomatic physician. From such a standpoint of mine, I viewed the therapeutic importance of mental disorder in the dialysis spot by presenting 5 cases I was concerned with. Five cases consist of 3 patients of depression and 2 of panic disorder. Recovery from their psychiatric symptoms was made in all these cases by interviews from the psychosomatic viewpoint and administration of SSRI. It seems to be important that we grasp mental disorders of patients on dialysis in the early stage and cure them adequately. Dialysis medical care in Japan has achieved the world highest standard in physical treatment, but an approach to its psychological aspect is still insufficient. It seemed that further study in the field of so-called Psychonephrology was necessary.
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Yasuko Iwamura, Yukio Fujimi, Toshio Ishikawa
Article type: Article
2012 Volume 52 Issue 11 Pages
1034-1046
Published: November 01, 2012
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The Background of Making Subject Maturing Model : We propose the perspective that Levels of Personality Organizaion, Five Steps of Psychosomatic Treatment and M. Mahler's Developmental Model are different types of scale rating Subject Maturing Stages. We combined and integrated these three paradigms into one comprehensive model of whole healing process : Subject Maturing Model. We intended this to help psychosomatic doctors, nurses and therapists make their interventions more suitable for patients' levels of personality organization and developmental stages. Naturally, the treatment satisfying this comprehensive paradigm was expected to be more effective than those satisfying only one paradigm of the three. We tested this hypothesis by analyzing a case whose pain attacks had disappeared under treatment. Case Study : In the period while the author's treatment was effective, the combination of therapeutic interventions were considered to satisfy Subject Maturing Model. Hypothetical therapeutic interventions satisfying only one of the three paradigms were considered to be less effective than those which had really been made. In contrast, in the period while our treatment was ineffective, the combination of therapeutic interventions were considered not to satisfy Subject Maturing Model.
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Hiroaki Kumano
Article type: Article
2012 Volume 52 Issue 11 Pages
1047-1052
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[in Japanese]
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2012 Volume 52 Issue 11 Pages
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2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
1055-1056
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Article type: Article
2012 Volume 52 Issue 11 Pages
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2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
1056-1057
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Article type: Article
2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
1057-1058
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2012 Volume 52 Issue 11 Pages
1058-
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2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
1059-
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Article type: Article
2012 Volume 52 Issue 11 Pages
1059-
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Article type: Article
2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
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Article type: Article
2012 Volume 52 Issue 11 Pages
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
1062-1070
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
1071-1073
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
1074-1075
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
1076-1078
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
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2012 Volume 52 Issue 11 Pages
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
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Article type: Appendix
2012 Volume 52 Issue 11 Pages
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Article type: Cover
2012 Volume 52 Issue 11 Pages
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