The aim of this study is to clarify the present situation of activities of continuing medical education (CME) for the primary care physicians to whom the leading hospitals, such as universities and clinical trainee hospitals perform CME in their regions. A questionaire was designed for main 4 parts, as following: 1) On the purpose of CME for the physicians. 2) On the organization (office) managing CME in the hospitals. 3) On the strategies of CME. 4) On the evaluation of CME. Answers to a questionaire were replied from 234 institutions (58.1%). Analyzing the results, we recognized that the leading hospitals actively carried out CME for the primary care physicians in the community. Furthermore, conversion to experiential learning from passive learning and establishment of evaluation methods should be promoted in CME.
Medical students in the second to fifth years evaluated all classroom lectures and laboratories in 1998. To clarify the faculty's opinions on student evaluations, in 2000 a questionnaire survey was given to 420 members of the teaching staff, of whom 137 (33%) responded. One hundred three (81.1%) instructors immediately checked the questionnaires after the classroom lecture or laboratory session, of whom 100 reported that the questionnaires were helpful for preparing subsequent lectures. One hundred nine faculty members replied that student evaluations of faculty teaching were meaningful, and 109 supported similar surveys in the future. Although conducting surveys of many students requires considerable time and cost, an effective feedback system plays an important role for both faculty and students.
Background and Method: To identify the cause of conflicts between medical residents and nurses during daily care practices in a general medicine ward, we observed and conducted interviews with 12 residents in their second postgraduate year. Results: We found three typical situations that are likely to lead to conflicts. 1) Both residents and nurses, especially when they are less experienced, are too occupied with their daily tasks to understand their counterpart's difficulties. 2) Nurses push residents to make quicker decisions beyond their discretion and ability. 3) The medical priority of making a precise diagnosis conflicts with the nursing priority of keeping patients comfortable.
Teamwork is increasingly important for high-quality patient care, and education in multiprofessional or interdisciplinary teamwork has recently been proposed as an essential subject in the core curriculum of Japanese medical schools. We developed a course in teamwork in which medical students devised diagnostic, therapeutic, and support programs from a written patient scenario with the help of a multiprofessional staff, including subspecialty physicians and surgeons, nurses, a counselor, a social worker, and a dietician. The course promoted understanding of mutual roles and the ideal relationship between physicians and comedical staff. Active discussion is necessary for understanding interdisciplinary and transdisciplinary teamwork.
Clinical instruction is a important component of nursing and allied health education. We aimed to identify clinical teaching behaviors considered by three different groups of clinical instructors to be most important for facilitating learning. The survey tool used contained 73 items, each of which described a clinical-instructor behavior. The participants were 230 clinical instructors (107 nursing instructors, 66 physical therapy instructors, and 57 occupational therapy instructors) who were asked to rate the importance of each item on a five-point scale. Using factor analysis, 10 factors were measured: “teaching ability:clear”, “teaching ability:level”, “teaching ability: enhancement of thinking”, “regulation of psychological environment in clinical learning”, “provide learners with opportunities to practice”, “fairness”, “role model as professional”, “accessibility”, “recognition of individual differences”, and “supervise”. The clinical teaching behaviors rated as most important included “fairness”, “role model as professional”, and “recognition of individual differences”.
A 21-hour education program for fifth-year medical students in terminal care was started at Kyushu University in 1991 with the participation of more than 20 lecturers from different specialties. Problems encountered as this curriculum was introduced are discussed. We believe that establishing a professorship in terminal care is essential for improving this curriculum.