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Volume 42, Issue 2
Displaying 1-8 of 8 articles from this issue
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pilot research
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Hiroyuki Komatsu, Yasuji Arimura, Takuroh Imamura, Kazuo Kitamura, Aki ...2011 Volume 42 Issue 2 Pages 55-63
Published: April 25, 2011
Released on J-STAGE: March 25, 2013
JOURNAL FREE ACCESSCardiac patient simulators are commonly used in Japanese educational institutions; however, most institutions have not established concrete learning objectives or strategies for mastering physical examination of the circulatory system, including cardiac auscultation. In this study, we propose clear learning objectives and strategies for simulator practice for fifth-year medical students who have passed the objective structured clinical examination, and explored their educational effectiveness.
1)The subjects were fifth-year medical students (n=94) at the University of Miyazaki. Learning objectives were the mastery of the sequential physical examination and the ability to distinguish 6 cardiac findings, including normal status. The subjects were evaluated with a checklist before and after lectures and simulator practice.
2)The mean score (maximum score=14) significantly increased from before simulator practice (2.2±0.9) to after simulator practice (11.4±1.5; p<0.001). There was no difference in scores after practice among the cardiac diseases.
3)Before practice more than 50% of subjects could use a stethoscope on only right positions and could indicate only the maximum point of a cardiac murmur; in contrast, after practice more than 90% of the subjects could sequentially describe physical findings and accurately predict cardiac diseases.
4)In a questionnaire administered after practice, 83% of the subjects answered that all physicians should acquire proficiency in cardiac auscultation regardless of their specialty.
Simulator practice with clear learning objectives may help improve clinical examination skills when both time and human resources are limited. The reevaluation of the program's continuing educational effectiveness and the establishment of an iterative learning program will be needed.View full abstractDownload PDF (893K) -
Results of needs assessment involving clinical educators in faculty development workshopsMotoharu Fukushi, Naoki Nago2011 Volume 42 Issue 2 Pages 65-73
Published: April 25, 2011
Released on J-STAGE: March 25, 2013
JOURNAL FREE ACCESSThrough our experiences in faculty development workshops, we realized that we had not sufficiently understood the problems clinical educators had been facing on site. Thus, we planned to perform qualitative research as part of a needs assessment in faculty development workshops.
1)We aimed to analyze and structuralize previously unclarified underlying problems by exploring what clinical educators were worried about regarding the initial residency program.
2)We performed a questionnaire survey of 214 physicians participating in faculty development workshops and qualitatively analyzed their responses in the form of free comments.
3)Once declaring that they would "start with accepting the program," clinical educators are unaware of their ignorance and unacceptably criticize the residency system, such that their "ignorance disguised as criticism" is highlighted.
4)With the introduction of the new residency system, a framework for building relationships as a system, which requires residents to be trained in a particular organization, no longer works, causing significant confusion on site.View full abstractDownload PDF (964K) -
with mentoring in medical education for clinical researchHiroki Mishina, Yoko Yokoyama, Mitchell D Feldman, Naoki Kakudate, Sh ...2011 Volume 42 Issue 2 Pages 75-80
Published: April 25, 2011
Released on J-STAGE: March 25, 2013
JOURNAL FREE ACCESSMentorship in academic medicine in the United States and Europe has been recognized as an effective system for increasing a mentee's research productivity, career success, and ability to obtain research grants. Therefore, to promote mentoring programs in Japanese academic medicine, it is important to investigate factors that facilitate or interfere with mentoring.
1)We interviewed 12 physicians who have performed clinical research under existing mentoring programs in Japan and asked them about factors that, in their experience, had facilitated or interfered with mentoring.
2)We qualitatively analyzed transcripts of interviews to identify these factors.
3)Factors identified as facilitating mentoring were: appropriate evaluation of a mentee's research skill, knowledge of a mentee's career goals, mutual communication between mentor and mentee, and the presence of senior researchers close to a mentee.
4)Factors identified as interfering with mentoring were: the busyness of a mentor, a mentee's concerns about giving offense by consulting the mentor about trivial matters, and the hierarchically organized social relationship in which the mentor is superior and the mentee is inferior.
5)Assessment of the mentoring process and education programs for mentors were expected to be necessary measures to promote mentoring programs.View full abstractDownload PDF (750K)
review
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: An Introduction to the American System of Night FloatAlan R. Teo, Jay Starkey2011 Volume 42 Issue 2 Pages 81-87
Published: April 25, 2011
Released on J-STAGE: March 25, 2013
JOURNAL FREE ACCESS1)In the aftermath of a well-known case of medical malpractice in the U.S., excessive resident work hours became a major national issue. In order to help reduce resident work hours, the system of night float was developed.
2)In the night float system, the resident on duty has no daytime clinical responsibilities and instead works solely on the night shift. Typically, residents have multiple night float rotations, lasting one to two weeks each, over the course of a year.
3)In medical centers where night float is utilized, residents who are not on night float are relieved of responsibility for providing overnight clinical coverage of their patients. Resident satisfaction with this system has been high, and the night float has been adopted by residency training programs throughout the U.S.
4)The night float system has benefits not only in terms of reducing resident work hours but also potentially improving certain clinical skills, promoting patient safety, and enhancing other areas. However, some studies have shown drawbacks of the system in the areas that other studies have hailed improvements.View full abstractDownload PDF (779K) -
Takuya Iwasaki, Yoshifumi Takeyama, Masayuki Iki, Hiroyuki Itoh, Haru ...2011 Volume 42 Issue 2 Pages 101-112
Published: April 25, 2011
Released on J-STAGE: March 25, 2013
JOURNAL FREE ACCESSThe collapse of community medicine has becomes a serious social problem in Japan, and a variety of measures have been implemented to counter it. In medical education, the model core curriculum has been revised, and many universities have started programs for community medical. We have had a community-based medical course at the Kinki University School of Medicine since 2005. This study examined the changes in students' consciousness about and affinity for community medicine during our program.
1)Questionnaires were completed by 494 students taking part in community-based medical training from April 2006 through July 2010. Results from before and after training were compared.
2)The questionnaire had 3 parts. The first part concerned medical activities with community residents. The second part concerned medical activities with housebound elderly persons. The third part concerned the students' future plans.
3)Many students gave themselves high scores for activities with community residents and housebound elderly persons. More students preferred hospitals in regional towns. A few students chose rural areas.
4)In an introduction to community medicine, it is important to first foster cordial relations with community residents. Cultivating problem-solving skills is the next challenge.
5)Community-based medical programs enhance medical students' understanding of and affinity for community medicine. Furthermore, some students will choose community-based medicine as a specialty.View full abstractDownload PDF (1044K)
report
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Daigo Kaneda, Satoru Kitada2011 Volume 42 Issue 2 Pages 113-117
Published: April 25, 2011
Released on J-STAGE: March 25, 2013
JOURNAL FREE ACCESSOur institution has introduced the objective structured clinical examination as a means of objectively assessing the learning status of students. An annual task is to increase the reliability of assessment tables at medical interview stations. To increase the reliability of assessment tables, it might be necessary to increase the concordance among assessors. Thus, we examined the reproducibility of the assessment items.
1)With the cooperation of 4 training institutes for acupuncture and moxa cautery, medical interview examinations by 89 students were videotaped after they had heard a lecture on medical interviews, had been provided with information about the examination, and had given consent.
2)We asked 6 institute members with experience in assessing medical interview examinations to assess the same recorded videotaped interviews individually and in pairs. We asked them to assess the same video again after a certain period of time.
3)High concordance was observed for every item by single assessors but not for many items among assessors.
4)Single–assessor concordance was not necessarily correlated with that among assessors.
5)When agreement was not expected in advance, the assessors performed assessments on the basis of their own educational criteria, which may result in decreased concordance among assessors.View full abstractDownload PDF (693K) -
Nobuaki Michihata, Hiroki Mishina, Hirokazu Sakai, John Ichiro Takayam ...2011 Volume 42 Issue 2 Pages 119-122
Published: April 25, 2011
Released on J-STAGE: March 25, 2013
JOURNAL FREE ACCESS1)The primary author completed a one–year program for clinicians, Training in Clinical Research(TICR), at the University of California San Francisco(UCSF).
2)In TICR, several educational systems including mentoring and feedback were used.
3)The clinicians at UCSF were provided protected time for clinical research and research education.View full abstractDownload PDF (686K)
Committee report
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16th ethics and professionalism committee, Japan society for medical educationYasushi Miyata, Hideki Nomura, Seiji Bito, Keiko Koumoto, Mayumi Asahi ...2011 Volume 42 Issue 2 Pages 123-126
Published: April 25, 2011
Released on J-STAGE: March 25, 2013
JOURNAL FREE ACCESS1)Professionalism should be explicitly introduced as a fundamental content into curricula/programs of undergraduate medical education, postgraduate clinical training, and of continuing medical education provided by professional societies and the Japan Medical Association.
2)We need to enhance our research activities on goals and objectives which should be accomplished through professionalism education, effective learning strategies, appropriate assessment methods, as well as the impact of informal and hidden curricula.
3)We propose that the medical profession should collaboratively develop various activities to win the trust of the general society in tandem with the introduction of professionalism education.View full abstractDownload PDF (679K)
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