To establish a framework for clinical education as a continuum from undergraduate clinical clerkships to postgraduate residency programs is an enormous challenge for Japanese medical education. The purpose of this article is to compare learning objectives achieved by clinical clerkship students to those achieved by postgraduate residents. 1) Eighty-seven clerkship students and 67 residents at our hospital were assessed with the Web-based Evaluation System of Postgraduate Clinical Training with 253 learning objectives established by the Ministry of Health, Labour and Welfare. 2) Clerkship students achieved most attitudinal objectives and performed well on the medical interview, basic physical examinations, and physician's order sheet. 3) Clerkship students could observe major symptoms and diseases. 4) These findings indicate the need to establish a common template for learning objectives used in both clerkships and residency programs.
Medical professionalism, which is of great interest in most countries, underpins the relationship between patients and doctors. The concepts of medical professionalism should be understandable not only by physicians but also by patients. However, there are few studies that evaluate the concept of medical professionalism from patients' perspective. a) We conducted two focus group interviews with 12 people who were not health care professionals. One interview was done with people who were living in Tokyo and one with people living in Osaka. Each interview was one hour long. During the interviews, we explored themes related to medical professionalism from patients' perspectives. b) We qualitatively analyzed response data from audio records of the interview and inductively extracted categories pertaining to medical professionalism. We compared our findings with the domains of the American Board of Internal Medicine's Charter on Professionalism (CP). c) We found 5 themes; 1) Primacy of patient welfare 2) Fairness 3) Social responsibility 4) Maintaining appropriate relations with industry 5) Maintaining appropriate relations with patients. d) Although our themes are almost equivalent to the principles cited in CP, there are some differences, such as the importance of maintaining appropriate relations with patients. e) Given the current findings, medical educators and trainers should continue to develop the Japanese concepts of medical professionalism in a manner that takes into consideration patients' perspectives.
The use of simulators for skills training has become widespread. However, no quantitative analysis has been performed to determine whether simulation-based medical education is useful for improving the acquisition of clinical skills. The educational effect must be evaluated to further develop stimulation-based education. A seminar for cardiac auscultation was held, with the skills laboratory taking the initiative; the effectiveness was verified, and various problems were identified. 1)The skills laboratory held a series of training seminars to examine the effectiveness of simulation-based education. 2) Sixteen medical students participated in the seminars. One seminar lasted 120 minutes, including 60 minutes of lectures and 60 minutes of skills training. All students attended the three seminars. A questionnaire survey, a written examination, and a skills test were administered to all students three times (before, immediately after, and 5 months after the seminars). 3) The students were extremely satisfied with the seminars. The students believed their cardiac auscultation skills had improved and that this improvement was still present 5 months later. After the seminars, the heart sound simulators were used more frequently than before the seminar. 4) The results of skills testing after the seminars were better than those before the seminars and remained better 5 months later. However, results of a written examination 5 months after the seminars were similar to those before the seminars. 5) The seminars in the skills laboratory were effective for improving students' auscultation skills and increased the effective use of mannequins in the skills laboratory.
1) The Foundation Programme, consisting of 2-year rotations for residents, was introduced as a new postgraduate training scheme in 2005. 2)In the Foundation Programme, medical students are requested to apply for Foundation Schools in each district. 3) Foundation physicians are assessed with a Foundation Learning Portfolio, which is characterized by high validity and is based on medical education theory. 4) The Foundation Programme is strongly influenced by the National Health Service, which is a social democratic health-care system. Therefore, we may describe British medical education as "social democratic medical education." 5) In Japan, physicians and professional medical educators are requested to seek a new model of postgraduate training system balancing liberalism and social democracy.
1) We conducted a workshop to discuss the definition of the term "physician scientist", what thought processes and competencies are expected, and how to better help physician scientists develop through medical schools. 2) The definition of a physician-scientist is a physician who both provides patient care and approaches unsolved questions in understanding the mechanisms of diseases and developing new treatments. 3) Essential conditions for a medical school to cultivate physician scientists include providing good role models for physician scientists, making efforts to stimulate students' motivation, and supporting collaboration among physicians and scientists on the faculty.
Pharmacists must have a holistic understanding of patients and should make efforts to communicate with patients to support their medical therapy. In this study, we analyzed the effects of communication education by role-playing on first-year students who did not possess pharmaceutical knowledge or an image of pharmacists. All 248 first-year pharmacy students were educated about communication through the following four steps: 1) understanding the basics of communication, 2) the importance of role-playing by pharmacists and patients, 3) observation of role-playing by senior students and patients, and 4) observation of role-playing by classmates and simulated patients. After each step, students were given time to reflect and to write their impressions. These written comments were classified into the following four categories: 1) communication with patients, 2) respect for patients, 3) the role of pharmacists, and 4) the student's own attitudes and skills. As a result of our education program, more than 90% of the first-year students were able to understand the role of a pharmacist and why a pharmacist requires communication skills. The communication education made the students more aware of the patient in health-care. These results suggest that education increasing first-year students' understanding of and respect for patients is an essential component of professional education.
1) We have performed ambulatory clinic practice for first-year residents 3 times. Residents evaluated the practice program and their own examination skills using questionnaires after the practice. 2) Most residents felt that this program was necessary and effective for clinical training. Self-evaluation scores for the last practice were slightly higher than those for the first practice in the cognitive, affective, and psychomotor domains. 3) Residents recognized the importance of ambulatory clinic practice. This program was suggested to be effective for postgraduate clinical education.
1)Tokyo Medical University is making an effort to apply the Balanced Scorecard as a new management system. 2) Although expectations have been high for management reforms in medical practice, the education that is needed to achieve the reforms constitutes a burden for medical staff. 3) For staff to acquire the management abilities that are required in today's medical practice, both more efficient management education and an education program that is uniformly designed among the various work categories are required.
1) A total of 60 medical and nursing student volunteers operated summer camps for 37 childhood cancer survivors treated at Mie University Hospital and for 51 members of their families in August, 2007 and 2008. 2) A questionnaire survey (response rate, 81%; N=47) revealed that the students were seeking to make valuable contributions and to gain benefits for their future careers. 3)The students were able to deepen their understanding of childhood cancer survivors and their families.