There are some methods of evaluating teaching: student-, self-, peer- and third person-evaluation etc. Validity, reliability and feasibility are required for assessing the quality of teaching. Therefore, we examined the reliability of teaching evaluation by medical students in Nippon Medical School in comparison with peer evaluation. 1) Twenty-four clinical lectures during the same school year were arbitrarily chosen as objectives. Correlations between student- and peer-evaluations in both generalized ratings and global assessment were analyzed by Pearson's correlation coefficient and Spearman's correlation coefficient by rank. 2) In generalized ratings, a significant correlation between the evaluations was demonstrated (r=0.532, p=0.0056), while a marginal correlation between the evaluations was observed in global assessment (p=0.0492). 3) The results probably provide evidence of the reliability of teaching evaluation by medical students. 4) The criteria for evaluation and the validity of questionnaires should be defined for a more reliable teaching evaluation by medical students.
In Europe and America, it is reported that residents develops burnout syndrome or depression by their stress, and these are connected with dropouts from their training program and undesirable outcomes of the patients such as unethical practice. Recently, though resident's poor working conditions and death from overwork, etc. become problems also in Japan.But, Japanese resident's stressor is uncertain. 1) Focus group interview was executed for 25 junior residents in 10 facilities, and their stressor were explored. 2) As a result, three cateogories ; physiological stressor as one human being, stressor as a new member of society, and stressor as a trainee doctor and beginner novice doctor was extracted. 3) Three stressors were named the life gap, the society gap, and the profession gap respectively. The stressor of junior resident was described as the product what was born by the gap of medical student and becoming a doctor. 4) Japanese residents have various stressors. Stressor as a trainee doctor was a stressor peculiar to Japanese junior residents. 5) Stress management should be done considering such a stressor in the light of safety and effective clinical training.
Positive self-esteem helps students build and maintain self-efficacies to affect later clinical practice. We examined the outcome of problem-based-learning (PBL) curriculum by evaluating self-efficacy in terms of sustained learning and clinical competencies among medical school graduates. 1) We compared practicing doctors who either had PBL tutorial experience or who had not by a questionnaire survey. 2) The subjects self-evaluated whether they had achieved expected abilities (1) at the end of undergraduate years, (2) during 2-year internship, and (3) at present. 3) Among 1, 502 doctors surveyed (response rate=36.0%), doctors with PBL tutorial experience had higher selfefficacy (odds ratio>2.1) in their clinical abilities than doctors without it, especially during the school years. 4) In the later 2 periods, doctors with PBL experience had higher self-efficacy in communication skills. 5) PBL tutorial foster self-efficacy in clinical abilities, especially in communication skills, during earlier clinical career.
Studying the correlation between the results of the Common Achievement Test (basic objective structured clinical examination [OSCE] and computer-based testing [CBT]) and the results of advanced OSCE in the same examinees is necessary to improve clinical clerkships and to establish the role of each examination. 1) Ninety-seven students took the Common Achievement Test CBT and the basic OSCE in their fourth year and took the advanced OSCE in their sixth year. The Common Achievement Test basic OSCE were composed of interview, chest, abdomen, neurology, and head and neck stations, and the CBT included blocks 1-4 and 5-6. The advanced OSCE had 3 scenarios in the chest station, 2 in the abdomen station, and 4 in the neurology station. Each scenario had 3 items. We also examined the pass analysis on the basis of these 3 items in the advanced OSCE. 2) The results of the Common Achievement Test basic OSCE interview did not correlate significantly with the results of the interview station of the advanced OSCE. The results of physical examinations in the Common Achievement Test basic OSCE, excluding the chest, did not correlate significantly with the results of the physical examination stations of the advanced OSCE. 3) In the advanced OSCE, an adequate medical interview is necessary for the physical examination. An adequate physical examination is also necessary for answering the written tests (e.g., differential diagnosis). 4) Students should have sufficient basic knowledge and motivation for successfully performing clinical clerkships, because the correlations among the results of the advanced OSCE interview, the OSCE total score, the Common Achievement Test basic OSCE and CBT score were extremely strong. 5) The advanced OSCE, the Common Achievement Test basic OSCE, and CBT have distinct characteristics and roles.
1) We have implemented a portfolio as a learning and assessment tool into clinical clerkship rotation focusing on primary care medicine. 2) We received favorable responses both from students and teachers. 3) It is further required to promote the understanding of portfolio among teachers and students to enhance its utilization.
In 2006 26 first-year residents at St.Luke's International Hospital underwent training with a highly sophisticated simulator to learn how to treat patients with cardiopulmonary arrest or anaphylactic shock.We evaluated the effects of simulation training for first-year residents. 1) After training, we analyzed the residents' performance in the 2 scenarios and the residents' satisfaction with simulation training. 2) According to the resident's performance dataduring simulation training, first-year residents have sufficient skill to treat patients in cardiopulmonary arrest but not patients with anaphylactic shock. 3) Twenty-five of the 26 residents (96.2%) were highly satisfied with simulation training.
1) Surveillance on the attitude to the postgraduate degree was performed by a questionnaire in the graduates of Jichi Medical University, who were engaged in community medicine soon after graduating and had not so many opportunities to conduct medical research. 2) More than a half of the respondents had obtained the postgraduate degree after the 9-year mandatory period of engagement as clinical physicians in the local communities.Among the respondents not having the postgraduate degree, 50-60% of them felt the need for the degree. 3) The remarks of the degree holders indicated that objective assessment ability and the scientific point of view acquired in the degree process had favorable effects on their performance as clinicians thereafter. The result suggested that the substantialization of research in the field of clinical medicine was demanded in the graduate school.
1)In order to improve the PBL tutorial, better writing of scenario and timing to intervene were discussed based on experience of the participants. 2) The application of PBL tutorial to laboratory practice as well as clinical situation was demonstrated.Further, progressive style of PBL tutorial was introduced. 3)The participants complained various points of PBL tutorial and the resolving method or approach was discussed.