We examined appropriate group size and related factors in a small-group learning system conducted in a single department with sociomedical themes. The students were randomly divided into 4-and 6-person groups, and results of evaluations of the students and teaching staff were compared. The results suggest that the smaller the group, the more committed the students are to studying. Furthermore, teaching staff should participate in group discussion to deal with inactive students or to improve group dynamics.
We introduced active educational methods in medical ethics education and evaluated their effect on medical students. Three methods were used: 1) small-group discussion to clarify the clinical ethical issues, 2) self-study to analyze examples of doctors' explanations to patients, and 3) self-study with videotapes to recognize informed consent. We asked students to write a report on each subject of the three studies. Before grading their reports, we determined a standard answer for each subject and marked their reports according to an absolute standard. We found the mean value and standard error of the students' scores in study 1 were significantly higher than those in study 2 or 3. These results suggest that small-group discussion is an effective educational method and useful in the analysis of clinical ethical issues.
I introduce my 12 years' experience in the medical education of physicians, nurses, and technicians in a general hospital. Three major principles are regular conferences, communication, and keeping the door of instructor's room open. Successful medical education can be achieved by establishing a training system and motivating the staff.
A questionnaire study was carried out from September through December 1998 to clarify the sex distribution of professorships at Japanese medical schools. Sixty-four (1.7%) professors in 32 medical schools were women. Thirty-five female professors had graduated from national and prefectural medical schools, and 29 had graduated from private medical schools. Twenty professors had careers in basic medical research, 8 in public health, and 36 in clinical medicine. Forty-seven (73.4%) of 64 female professors responded to the mailed questionnaires, and 18 had been promoted in the last 5 years. Although more than half of the female professors faced disadvantages because of their gender, many were fully supported by their supervisors or their families or both. The number of female professors reflects the status of female medical doctors.
Among the 55 medical residents who had completed the 2-year postgraduate medical training course at Tenri Hospital in the past 5 years, the postgraduate medical education committee analysed 9 residents whose clinical performance was considered inappropriate. The committee, composed of eight instructors, found that residents with initially poor medical knowledge were able to improve their medical performance and skills during their 2 years of training; however, other residents who lacked responsibility towards patients, communication skills, and medical ethics during training had great difficulty improving or altering their attitude or performance in the 2 years.
Our originally-developed clinical training system, specialty-based physical examination (SBPE), was introduced for 4th-year medical students to improve their clinical skills through instruction by specialists in each body region. We previously reported that SBPE has a beneficial effect on results of performance tests. This time, therefore, we studied the effects of SBPE on written tests by comparing test results before and after the introduction of SBPE. We found that SBPE did not have any beneficial effect on results of a written test, despite having improved results of a performance test. These results were confirmed by analyses of students' questionnaires and a correlation between the two. Thus, our results suggest that written tests and performance tests evaluate different things: written tests evaluate acquisition of diagnostic knowledge, and performance tests evaluate mastery of clinical skills, which seem not to affect each other at the initial stage of clinical education.
The small-group-learning course “Introduction to Medical English” was introduced to the 1st-year students' curriculum in 1994. The effects of this course were examined by analyzing students questionnaires and by comparing results of the term-end examination. The following results were obtained. 1) Results of the term-end examination (multiple-choice method) showed a normal distribution. 2) Results of the questionnaires suggest that although medical English seemed difficult at first, the course produced a good response from students which conventional courses could not. These results suggest that “Introduction to Medical English” has a valuable role at the start of medical education.
Our school of medicine began a new curriculum for medical students in April of 1999. In their final year medical students are allowed to schedule a 3-month clinical clerkship. This clerkship gives the students three 4-week periods to do rotations in their areas of interest. Our clinics have had a hard time finding the time to teach students evidence-based medicine (EBM) owing to their clinical workloads. Even when the divisions want to teach EBM there are few resources available for the students. Therefore, students are sometimes unable to receive adequate training in EBM. With the introduction of the new curriculum the Department of Hygiene and Public Health thought that the clinical clerkship program offered a good opportunity to teach students EBM with a one-to-one student-teacher relationship. We report here on our preliminary program that uses a scenario approach to EBM education. We determined the students' level of development by studying the detailed progress reports written by their teachers. The students were found to understand EBM when presented with its basic concepts which are then used in multiple discussions. Students will continue to use self-directed learning throughout their careers if they learn to think using EBM early in their training and practice it during their residency. We also show here a worksheet based on the Journal of the American Medical Association User's Guide series to use systematic EBM in daily clinics. Our program is just one of several methods we hope to develop to educate medical students in EBM.