A questionnaire presenting examples of doctor-patient communication was used to determine which of 5 response styles were preferred by 93 medical students not trained in communication. The students' psychobehavioral traits were also assessed with four scales. The results show that many medical students have their own way of communicating. Preferred response styles correlated with specific psychobehavioral traits. These results suggest that communication instructors should attempt to understand each student's communication level and guide students to learn useful communication styles in the medical setting.
The participation of primary care physicians is essential for the success of ambulatory-care teaching. The “PEP2 Workbook” was developed by the Preceptor Education Project of the Society of Teachers of Family Medicine and provides clinicians with a variety of efficient and effective strategies for ambulatory-care teaching. Strategies include preparation for office visits by students, activities on the first day, one-minute preceptor teaching skills, observation of the student, providing feedback, and dealing with problems. Primary care physicians can apply these strategies readily in clinical practice to improve office-based teaching.
A cross-sectional study was performed in the general medicine clinic of Saga Medical School Hospital to evaluate the humanistic quality of the clinical curriculum by assessing Patient satisfaction. The Patient Satisfaction Questionnaire (PSQ) developed by the American Board of Internal Medicine, was translated into Japanese, and 6 of 10 items were selected to evaluate the humanistic qualities of 123 fourth-year medical students who performed medical interviews of 442 patients. The patients rated each PSQ item with a 5-point scale from poor to excellent. The mean PSQ score was 3.38±0.66 (good to very good). The scores for “answering questions” and “giving clear explanations” were significantly lower than were scores for attitudinal aspects. The results suggest that the undergraduate curriculum at Saga Medical School for patient education skills requires further improvement.
In Japan, a clinical clerkship system has not been established for surgery as has been established for internal medicine. This report describes the present state of surgical clinical clerkships for third-year medical students in the United States. In the United States medical care has shifted from inpatient hospitalization to the outpatient clinic. Even when surgery is performed, preoperative examinations are done at the outpatient clinic and postoperative hospitalization is extremely short. For third-year students, surgical clinical clerkships last only 2 to 3 months. Because rotating through all surgical departments is extremely difficult, every student rotates through only 2 or 3 departments. Lectures for 2 hours every day play an important role in teaching fundamental surgical knowledge.
At this university, an overseas component has been included in the elective clinical clerkship program for sixth-year students since 1998. Since that time, 28 students have done short-term clinical clerkships in various foreign countries. This report presents results of a questionnaire survey of students who have done overseas clerkships. The questionnaire comprised 8 items, including the reason for selecting the clerkship location and the contents of the training program. Questionnaires were returned by 68% of students. Most of the 28 students did clerkships in English-speaking countries. The average duration of study was 2.3 months (range, 1 to 3 months). All students were satisfied with their training experience; however, many felt their language skills were insufficient for participating in overseas training programs. In addition, more comprehensive arrangements, including establishing close contact with the receiving institutions and insurance provisions, are needed to maintain and further develop overseas clinical clerkships.
The first trial of common achievement test-computer-based testing was held from January through August 2002. The number of examinees was 5, 693, of whom 5, 676 were analyzed. Single-best-answer, five-choice questions were used. The highest score was 92 points, the lowest score was 19 points, and the average score was 55.9±10.2 points (standard deviation). Scores were distributed normally. The test sets did not differ significantly in difficulty, although test-set items differed for each student. The percentage of correct answers, the ∅-coefficient, and the point-biserial correlation coefficient were calculated for each category of the model core curriculum. The percentage of correct answers was highest in category A of the model core curriculum, and percentages of correct answers were similar in categories B, C, D, E, and F. The ∅-coefficient and the correlation coefficient were low in categories A and F and were highest in category C. Although the percentage of correct answers in this trial was lower than expected, many test items had discriminatory power. The Test Items Evaluation Subcommittee is now evaluating test items, determining pool items, and revising new test items for the second trial and expect to compile a useful item bank.
A program for early-exposure of first-year medical students to nursing and patient care was started at Osaka City University in 1994. Eighty students completed the program in the 2002 academic year. To improve methods of teaching and evaluation, we analyzed the responses of students and nursing instructors to questionnaires about satisfaction with the program after each practice session. Students were randomized to four settings (university hospital, general hospital, general emergency hospital, and general geriatric hospital). Responses of students and instructors did not differ between settings suggest that early exposure was uniform. Medical students gave higher scores for interest in and significance of early exposure, although nursing instructors did not. The success of the program of early exposure of medical students to nursing care will be used to further improve the curriculum.