We used questionnnaires to study the present status of the workshop for faculty development at medical schools in Japan in February 2001. All the questionnaires were filled and returned by 100%(80) of 80 medical schools. Although only 50%(40) of schools had the workshop in 1996, the workshop of teaching staff for faculty development was carried out at 92.5%(74) of schools in 2001. But, the rate of teaching staff worked the curriculum planning as the principle of medical education, was only about 10 to 20%.
In accordance with the advisory statement by the International Liaison Committee on Resuscitation and the Guidelines for Cardiopulmonary Resuscitation of the American Heart Association, we developed an advanced cardiac life support (ACLS) course for undergraduate medical students and assessed the effectiveness of and issues related to this program. A 2-day ACLS course with a special emphasis on MEGA code training was provided to 93 fifth-year medical students, after which evaluation testing was performed. Knowledge about airway management using airway adjuncts (correct response rate, 78.1% to 98.4%) and the treatment algorithms for ventricular fibrillation (81.3% to 95.3%) were well retained. However, knowledge about pharmacologic intervention was poorly learned. Most of the problems in the MEGA code algorithms for asystole and pulseless electrical activity were associated with drug administration. We conclude that this ACLS course for undergraduate medical students is effective but may not be sufficient for teaching certain aspects of ACLS.
To develop problem-solving skills and to motivate learning, The Jikei University School of Medicine started a tutorial educational program for fourth-year preclinical students in April 1999. Student doctors' patient-care models focused on discovery learning and acquiring strategies for general medicine through problem-solving skills. After information was first provided by prepractice handouts, one or two tutorial sessions were performed each week. Minimum requirements for each step were established, and instructors provided printed materials, display materials, and detailed oral information to facilitate discovery learning. This program is based on problem-finding and problem-solving through selfdirected learning and feedback systems for tutorial sessions. Examinations used multiple stations to reconfirm program aims and to reinforce problem-solving skills. On a questionnaire survey, 85% of fifth-year students taking part in practical clinical education thought that the tutorial education was needed to acquire problem-solving skills necessary for fifth-year clinical training.
The effectiveness of role play in large classes for terminal-care education was through written comments of students. We analyzed written comments after the role-play scenario “Anger Toward the Nursing Attendant” in which an irritated and anxious patient who cannot accept the terminal stage of cancer shows anger toward a nurse. Eighty-three percent of students noted the importance of mental care for terminally ill patients; 80% noted the difficulty of giving such care; 70% noted the importance of acceptance, empathy, and support of terminally ill patients; and 22% of students referred to the method of mental care.
In 1996 we started an early exposure program of nursing and care for medical school freshmen at University of Tsukuba. The program consisted of out-of-hospital practice and in-hospital practice; 195 medical students completed the program in the 1999-2000 academic year. We analyzed students' questionnaires about satisfaction with the program after each practice and studied better settings for early exposure. Students were randomized to three out-ofhospital settings (nursing home, facilities for the elderly, and home-visit nursing) and also randomized the order of the practice (in-hospital or out-of-hospital first). The mean satisfaction score for setting was the highest for the home-visit nursing and lowest for nursing homes. The mean satisfaction score for order of practice was higher when in-hospital practice was done first.
We performed a survey to assess the positions and activities of Japanese women physicians in medical societies. In June 2000, questionnaires were sent to 92 medical societies of the Japanese Association of Medical Science. The response rate was 92.4%. Fifty-four societies (63.5%) failed to provide the number of women physicians. According to the questionnaires that were fully completed and returned, women physicians were more likely to belong to societies of internal medicine, pediatrics, ophthalmology and dermatology. Women physicians were less likely to hold board positions and were underrepresented in leadership positions, even in societies with high percentages of women members. Board positions failed to provide for maternity or child-care leave, and few societies offered childcare facilities at annual meetings. Gender-disaggregated data should be made readily available and additional surveys need to be made to identify obstacles to activities in medical societies.