There is no objection that the medical ethics enters basic matters of the undergraduate medical education. The curriculum plan of medical ethics in the medical school in our country is proposed. This curriculum aims at the participating education that the student personally chooses and discovers the result to be studied instead of the passive lecture like the boring preaching from the platform. This is the curriculum throughout a few years, because it is necessary to repeatedly study adjusting to the learning achievement.
Recently, as the practical training for clinical skills are extensively introduced in the curriculum of medical schools, the objective structured clinical examinations (OSCEs) is taken to assess the clinical skills of trainees. However, there have been very few papers mentioned about correlation between scores on a written examination of the clinical sciences and those on OSCE in Japan. In this study, to compare these of two kinds of examinations in year five medical students of Yamaguchi University, their scores of the stations of OSCE and those of the written examinations of clinical sciences which seemed to correlate stations of skill's examinations were studied statistically. As a result, there were no statistical significances in each scores between skill's evaluations and written tests. This results that these two examinations estimated the different abilities of students on the taxonomy of medical education. Moreover, OSCE is reconfirmed to be identical as an evaluative method of clinical skills. Now, new medical educational systems should be introducted for the training of skills and attitude for students.
The Ministry of Health and Welfare of Japan is planning a pooling system for multiple-choice questions (MCQs) for the national examination for medical practitioners. To clarify possible problems of such a system, a field study was performed by 10 medical schools in Japan using 90 MCQs from previous examinations. Nine hundred twenty-four 6th-year students participated in the field test. For each MCQ, the correct-response rates at the originating school and those obtained in the field test were significantly correlated. Thus, the correct-response rates to questions on the field test could be predicted from the rates at the originating schools. However, for each question the correct-response rate was significantly higher for students of the originating school than for students of other schools. In the national examination, care should be taken to prevent differences in scores on the basis of question sources.
To evaluate clinical courses at teaching hospitals outside of Osaka City University Hospital, we used a questionnaire to ask instructors and sixth-year students about practical problems immediately after the end of the semester. This course was conducted for 7 weeks during the first semester at 24 hospitals and for 5 weeks during the second semester at 23 hospitals. In each semester about 40% of clinical practice at teaching hospitals was done in the style of clinical clerkships. About 90% of students were mostly or completely satisfied with their instructors and hospitals. Furthermore, about 70% of instructors felt more or less fulfilled by working with students and about 60% of them felt working with students was rewarding. More than 95% of instructors would be willing to teach medical students again. In conclusion, most instructors and students felt that clinical courses at teaching hospitals outside of Osaka City University Hospital were conducted without problems.
We used questionnaires to assess training in the use of Kampo medicine which took place mostly at our outpatient clinic. Most of the 18 trainees (6 medical doctors and 12 medical students) felt that the quantity and the quality of the lectures and the amount of time spent in the outpatient clinic were satisfactory. In addition, all trainees thought that attending the outpatient clinic was the most instructive activity and made the deepest impression, but 14 of the 18 trainees (78%) thought that it was a difficult learning strategy. Fifteen trainees (83%) rated this training curriculum as good or very good. Sixteen trainees (88%) were conscious of a change in their study or work attitudes 3 to 6 months after training; this result suggests that this curriculum has an educational effect.
We investigated the effects on medical education of early exposure of undergraduate students to a summer camp for children with asthma. An objective evaluation by the editorial staff found final improvements in the following areas (in descending order of frequency): learning of basic medical behavior (91% of students); cooperative attitude of medical staff in general treatment with the patient and the patient's family (88%); understanding of childhood growth and development (80%); knowledge of childhood asthma (69%); and mastery of basic techniques for therapy and examination (41%). The differences in the ratio of improvement (%) before and after visiting the camp, were (in descending order of frequency): cooperative attitude of medical care staff in general medical treatment with the patient and the patient's family (47%); understanding of childhood growth and development (45%); knowledge of childhood asthma (38%); learning of basic medical manner (34%); and mastery of basic techniques for therapy and examination (25%). These findings suggest that a summer camp is useful for exposing undergraduate medical students to children with asthma and is effective for helping them understand patients and family-oriented pediatric medicine.
Practice in medical interviewing was held for 5th-and 6th-year medical students during their clinical clerkships. The purpose of the program was to acquire interviewing skills, to communicate with patients by considering the patient's point of view, and to obtain proper medical information. Communication skills and patients' medical problems were discussed after the interview. Students had difficulty obtaining appropriate medical information considering the patients' point of view. They professed an interest in communication skills and relationships between patients and doctors, but their concern after interview practice apparently shifted to collecting medical information and to their lack of knowledge essential for diagnosis. Students were satisfied with this training program and believed it was useful. Practice in medical interviewing in the last years of medical school is effective for teaching communication skills and for obtaining appropriate medical information.
The following is a report on the 20th annual meeting of the Association for Surgical Education (ASE) which was held in Toronto from May 3 through 6, 2000. Because Dr. Masahiro Tanabe (School of Medicine, Chiba University), Dr. Takao Morita (Saitama Medical School), and I were the first Japanese to attend this meeting, I will introduce the activities of the ASE and report on this meeting. The ASE was founded in 1980, and its members represent more than 160 medical schools and institutions throughout the United States and Canada. The president of the ASE from 2000 to 2001 is Dr. Nicholas Lang of the University of Arkansas. The educational clearinghouse is located at the Southern Illinois University School of Medicine. The activities include organizing the annual meeting, publishing Focus on Surgical Education, the quarterly newsletter and official publication of the ASE, and distributing resources for surgical education. The ASE's website is at www.surgicaleducation.com, and its official journal is the American Journal of Surgery. The 20th annual meeting was held at the Four Seasons Hotel, Toronto, under the organization of Dr. Richard Reznick, the president from 1999 to 2000. The meeting consisted of 18 oral and 19 poster presentations, special lectures, workshops, and panel discussions. The importance of education in endoscopic surgery was emphasized in workshops and presentations. We were greatly impressed by the meeting and enjoyed participating in it. The next meeting will be held in Nashville from March 27 through 31, 2001.
We four medical students (one in the 2nd year and three in the 3rd year) visited Thomas Jefferson University in Philadelphia for 2 weeks during spring vacation. We audited classes to study differences in medical education and visited the hospital to observe common medical practices in the United States. Because of this experience, we started to rethink medical care in Japan as well as our future commitment to medicine.