In the second year of the new postgraduate clinical training program, “ Community Health and Medicine” is a required course. I highly recommend that clinics, which are medical facilities familiar and close to people in the community, be used for the study of comprehensive services, i. e., primary care. The current status of the primary care training of physicians overseas, the history of the Japanese Medical Society of Primary Care, and the “Report on Graduate Education for Domiciliary Medicine (Home Care)” of the Japanese Society of Medical Education all emphasize the advantages of clinics for training in community medicine. Aspects of the functions of clinics are explained in respect to outpatient and home care.
Clinical cases requiring bioethical thinking and decision-making have become more complex owing to advances in medical technology and changes in family relationships. In addition, members of medical staff are asked to acquire the ability to think in terms of bioethics. For training in such ability, the use of case studies is important and essential. For a medical ethics class we created 30 cases involving communication between patients and physicians, changes in family relationships, and advanced medical technology, such as genetic diagnosis and gene therapy. We asked all second-year medical students of the Osaka University Medical School to think about these 30 cases and answer questionnaires about bioethics. We believe the case-study method is effective for training students in the ability to think in terms of bioethics.
A follow-up study with multivariate analysis examined the relations of methods for selecting students, performance after admission, and scores on the national examinations for medical technologists and for nurse practitioners. The subjects were 247 students who had entered the division of laboratory medicine at the School of Allied Health Sciences, Yamaguchi University, from 1995 through 2000 and 484 students who had entered the division of nursing during the same period. Scores on examinations at the School of Allied Health Sciences and on national professional examinations did not differ between students who had been admitted on the basis of recommendations from high school principals (including an interview) and students who had been admitted on the basis of an open entrance examination (also including an interview). However, questions remained about the legitimacy of the high school records of students admitted on the basis of recommendations from high school principals but not of students admitted on the basis of an open entrance examination. Furthermore, the relevance of the interview during the open entrance examination for medical technologists and nurses was not recognized. In addition, for medical technology students who had been admitted on the basis of open entrance examinations, we found that scores on the national examination were correlated with the scores on the entrance examination and with their grades at the School of Allied Health Sciences.
We have organized the Seminar and Workshop for Medical Education (SWME) 10 times from 2000 through 2003. More than 1, 200 persons have participated, including teachers, physicians, students, and simulated patients. The themes of the SWME have included a problem-based learning tutorial system, medical interview skills, objective structured clinical examinations, medical ethics, advanced cardiac life support/basic life support, evidence-based medicine, coaching technology, medical English education, and crisis management education. Invited lecturers from throughout the country organized most of these workshops. Advantages of the SWME are two-fold:(1) improving the medical teaching skills of each participant and (2) scouting for good young lecturers. Workshop reports are published in our annual monographs and other materials. The present paper is a historical review of the SWME and also describes the nationwide scope of faculty development.
Integrated lecture programs for high school students involving university teaching staff have recently become popular. Here, we report on such a program involving lectures on tumor pathology attended by 110 high school students at the Yokohama City University School of Medicine. Two weeks before the lectures at our university, the students were given a 45-minute introductory lecture by a teacher at their school. The 1-day course at our university comprised an overview lecture by the author (40 minutes), light-microscopic observation of histologic specimens of normal and tumor tissues (50 minutes), and a summary with an introduction to diagnostic pathology (20 minutes). During light-microscopic observation, medical students served as teaching assistants. The high school students were given handouts of microscopic
Objectives: To investigate how simulated patients perceive physical examinations. Methods: Simulated patients, who were members of the Nagoya University Simulated Patient Society, were divided into two groups according to age, one group in their 40s and one in their 60s, and interviewed about their perceptions of physical examinations. A coding scheme was used to organize the data in thematic categories and extracted concepts. Results: Both groups believed that: 1) training in physical examination is essential for medical students and 2) communication between a patient and a physician during physical examination is important. The 60s group had positive “attitudes” and less “hesitation” in terms of physical examination, whereas the opposite was true for the 40s group. As for “acceptable body parts, ” there was a greater degree of acceptance among the 60s group, whereas the “students' sex” affected the 40s group but not the 60s group. Conclusion: The results suggest that simulated patients can participate in physical examination education, providing each simulated patient's preferences are considered.
We participated in the “Advanced Objective Structured Clinical Examination (OSCE) Osaka Trial, ” which was part of the 10th Medical Education Seminar and Workshop in Osaka. OSCEs have been used to assess students' clinical ability before the clinical clerkship program, where the medical interview and the medical examination are introduced as basic clinical skills. The Advanced OSCE is used to assess students' clinical ability after they have done clinical clerkships; it will soon be a part of the national board examination. In the present trial, the students and residents took the Advanced OSCE with 6 themes: pharyngeal pain, palpitations, dyspnea, abdominal pain, hypertension, and cardiac arrest. We examined questionnaires completed by students and residents just after they had taken the Advanced OSCE. We believe that the use of simulators is important for medical students and residents to improve their clinical skills and that appropriate feedback is also extremely important.