Background: The Objective Structured Clinical Examination （OSCE）–Reflection Method （OSCE-R）, a version of the OSCE for training physical therapists which incorporates group reflection through video, has been developed and implemented in our study. The purpose of this research was to introduce the OSCE-R to the second-year students and to examine its effects on learning.
Method: The subjects were 91 second-year students of the physical therapy department of our university. Before and after group reflection, OSCE score comparison, reflection sheet analysis, a questionnaire survey, and interview investigation were performed.
Results and Discussion: The OSCE scores increased significantly, and students learned the importance of reflection and empathy with patients. The combination of theory and clinical practice helped students to actively learn while crossing boundaries between school and hospital.

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Introduction: Our school adopted team-based learning （TBL） in symptomatology classes for fourth-year students in 2010.
Method: This study examined the effects and problems of using a questionnaire survey involving students.
Results: The final scores of the students were distributed widely between approximately 65 to 90 points, indicating that TBL increased the spread of scores. The results of the survey showed that many students considered TBL to be a more effective approach than class-based learning, but most students showed an unfavorable attitude toward peer assessment. However, the results of multiple linear regression analysis showed no correlation between the survey results and final scores. The students who did not work together had better scores than students who did （p＝0.048）.
Discussion: The findings suggest that students’ scores after TBL are correlated with those after class-based teaching and that TBL helps improve students’ scores, especially those for case-study questions.

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Introduction: Differences in residency programs between large and small hospitals have not been shown in Japan.
Method: We performed a qualitative analysis of focus-group interviews of residents in community hospitals to investigate characteristics and problems of their residency programs.
Results: We found that residents in community hospitals treated difficult patients with the help of the medical staff; this cooperation was one of the most important characteristics of residency programs. We also found that residents tended to have less experience in emergency medicine and several other specialties.
Discussion: We found that residents in community hospitals learned how to treat difficult patients with the help of medical staff by means of a biopsychosocial model.

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Background: Complementary medicine and alternative medicine have been included in the curricula of many medical schools and colleges; however, teaching methods have not been standardized. We gave lectures and practical instruction on acupuncture and moxibustion medicine to medical students during their clinical clerkship in anesthesiology. We used a questionnaire to evaluate the usefulness of small-group teaching.
Methods: The subjects were 93 fifth-year medical students doing clinical clerkships in anesthesiology. The clinical clerkship consists of small-group learning with 2 or 3 students per group. After a lecture and practical instruction on acupuncture and moxibustion were given, students were asked to fill out a questionnaire about their interest in and basic knowledge of acupuncture and moxibustion and whether they would like to master the technique.
Results: All 93 students answered the questionnaire （response rate, 100%）. After the small-group teaching, students became more interested in acupuncture and moxibustion and learned that the costs of treatment were covered by health insurance. Most students were interested mastering acupuncture and moxibustion in the future.
Discussion: Our results suggest that lectures and practical instruction during clinical clerkship are useful for getting medical students interested in acupuncture and moxibustion medicine.

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  In 1945, the Committee for Investigation of Japanese Medical Science, Supreme Commander for the Allied Powers ［SCAP］, proposed that future Japanese medical students receive a four-year liberal-arts pre-medical education, followed by four years of medical-technical training. The proposal was promoted by Colonel （later Brigadier-General） Crawford F. Sams, Chief, Public Health & Welfare Section, SCAP, and the Medical Education Council in the Ministry of Health and Welfare of the Japanese Government.
  However, Professor Yoshishige Abe, Chairman of the Education Reform Committee of the Ministry of Education, and a former Minister of Education, refused to accept the proposal in light of impoverished post-war Japanese resources.
  The proposal was abandoned when the Civil Information & Education Section, and the Chief of Staff, SCAP, were both unwilling to issue directives to the Japanese Government to implement the proposal. The six-year medical education program, comprised of two years of liberal-arts pre-medical study and four years of medical-technical training within the individual medical schools, thus became the norm in post-war Japan.
  Since 2009, Dr. Shigeaki Hinohara, M.D., Honorary Director of the St. Luke’s International Hospital in Tokyo, has been advocating for a “Graduate Medical School” attached to the St. Luke’s International Hospital. This graduate medical school model would accept students on completion of at least a bachelor’s degree. If actualized, it would be a noteworthy trial of an eight-year medical education program, almost seventy years after it was first proposed in Japan.

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  In this manuscript, several approaches and methods of assessment based on Miller’s pyramid of competence are demonstrated.
●Deliberate assessment and its planning regulate a learner’s approach to learning and drives learning.
●In the design and conduct of assessments, the educational effect and the effect on learning should be taken into account.
● While knowing does not necessarily guarantee competence, competence does not necessarily guarantee knowing.
●It is important to design and perform an informative, continuing, comprehensive programmed assessment to maximize the benefits of outcome-based education.
●The importance of assessment should be understood by the members of an institution, and the assessment must be feasible with regards to the available educational resources.

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  The admission quota for medical students has increased rapidly from 2007 to the present in Japan. Medical students of selective admission for medically underserved areas （Chiiki-Waku） account for most of the increase. Becoming a medical specialist had been reported to be one of the necessary conditions to obtain employment in a medically underserved area. For the last three years, early admissions have occurred in the medically underserved areas in Kagoshima. Consequently, the graduates will start senior doctor training next year. It is very important to provide these individuals with a career plan so that they can become medical specialists. We investigated the information on the medical specialist system and the work system for medical students of selective admission for medically underserved areas in Kagoshima. According to these findings, it is difficult for them to become medical specialists in the current systems. Because medical students of selective admission for medically underserved areas will account for about 20% of the graduates of medical schools a few years later, these problems apply to not only Kagoshima prefecture but also Japan. Because it is difficult to become a medical specialist, the current systems need to be improved. To do so, the cooperation of all interested parties is needed.

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