In Japan, awareness has increased in recent years of the importance of evaluating clinical educators. In Europe and North America, the Objective Structured Teaching Evaluation (OSTE), which employs standardized students, multiple stations, video recording, and scoring by multiple observers, is used to evaluate clinical educators. We report on the implementation of an OSTE in Japan. 1) Ten clinician-educator physicians participated in the OSTE, which comprised 5 stations and included standardized residents. The stations were video-recorded, and the educators were assessed by 7 different evaluators. 2) The educators were evaluated with a checklist and a 5-point scale. We assessed the reliability and validity of the checklist and analyzed the background characteristics of the clinician educators. 3) The factors most closely associated with high ratings on the checklist and the 5-point scale were: having a history of attendance at a seminar for clinician-educators, having greater than 5 years experience as an educator, and not being an internist. There was no interobserver variability among the evaluators. 4) The generalizability of the checklist was 0.81, and its reliability index was 0.83. The correlation coefficient between the total scale score and the checklist score was 0.8. 5) Although biases by participants were identified, our project suggests that the OSTE could be used in Japan to objectively evaluate the teaching skills of clinician-educators. Further research on the OSTE in Japan is warranted.
1) The historical development to date of the systems of medical education and medical licensure were reviewed, and the quantitative and qualitative evolution of medical schools was divided into 7 stages. 2) In the early Meiji era, persons who had already practiced medicine could apply to receive a medical license. Until the Taisho era, medical licenses were granted either to graduates of medical universities and relevant special schools or to those who passed the national examination. Thus, the criteria for medical license were not uniform during this period. 3) Before the end of World War II, medical schools aimed to improve the quality of medical education so that their graduates could receive medical licenses without taking the national examination and to raise their status to the level of universities. However, because the types of medical schools during this period varied and included imperial universities, colleges, and specialty schools, the quality of medical education also varied. 4) After World War II, the introduction of the state examination for the license to practice medicine and a new university system standardized medical education to guarantee its quality. 5) The quantitative expansion of the medical education occurred mainly in the 12 years after 1919, in the 7 years after 1939 and during the war, and in the 10 years after 1970, and, except for the years of violent change before 1887, the number of medical schools has otherwise remained stable.
In "osmotic learning" a student passively observes and presumably absorbs clinical knowledge. Unfortunately, clinical teaching based on this style tends to result in low student motivation to study, which leads to low faculty motivation to teach. Here we consider how to improve medical education in Japan based on a case study of a Japanese student's (H.I.) participatory experience with the adult learning model in the United States. 1) A Japanese medical student analyzed the weekly evolution of her responsibilities and contributions to patient care during a 1 month clinical rotation at the University of Michigan. 2) She participated through direct contact with 235 patients during the 1 month rotation. Starting with simple contributions to patient care, over time she became an active member of the treatment team. Due to the ever-increasing relationship of trust built during the rotation, the faculty member could give the student tasks requiring more responsibility. This led to a relative reduction in the faculty member's workload and, in turn, increased teaching efficiency. 3) From this case study, we conclude that clinical education based on the adult learning model can be applied in Japan, where "osmotic learning" has been prevalent, and that it can increase the motivation of medical students to learn and faculty to teach.
1) Yokohama City University Hospital has provided a 1-day nursing practice program during the orientation period for first-year interns since 2004. Here we report on the practice performed this year. 2) After taking part in the practice, interns described the communication and consultation among the medical team as well as the nurse-patient and nurse-physician relationships. In addition, they recognized the professionalism of nursing. 3) To assess the clinical outcome of this practice, we would use the attitude evaluation by head nurses of wards.
To investigate the effects of generational factors on the lives of medical students in the first and second years, we surveyed students about the frequency of problems and the seeking of advice. 1) A questionnaire was distributed to first- and second-year students in January 2009 asking about problems regarding academic work, mental health, financial concerns, career options, physical wellness, and interpersonal relationships. 2) About 70% of the students had sought advice regarding academic work and interpersonal relationships. Also, about 50% had sought advice regarding mental health. 3) Students chose potential advisors depending on the type of problem; however, they preferred to consult with their classmates and upperclassmen. In addition, their parents played a role. In contrast, students rarely consulted with teachers. 4) High percentages of first- and second-year medical students had various problems. Creating a support system to address these problems is important.
1) We performed a questionnaire survey on "vital signs check by pharmacists" for 120 hospital pharmacists who participated in a continuing education workshop about vital signs. 2) Fifty-two percent (58 of 111) of pharmacists felt that vital signs checks were necessary in the workplace, and 77% (85 of 110) of pharmacists wanted to check vital signs. 3) Eighty-six percent (95 of 110) of pharmacists thought that they should learn how to check vital signs, but only 10% (11 of 110) of pharmacists had been trained how to check vital signs. Therefore, pharmacists should be given many opportunities to learn how to check vital signs.