Igaku Kyoiku / Medical Education (Japan)
Online ISSN : 2185-0453
Print ISSN : 0386-9644
ISSN-L : 0386-9644
Volume 46 , Issue 5
Showing 1-14 articles out of 14 articles from the selected issue
practice articles
  • Jin Irie, Yoichi Kato, Byongmun An, Yoshihiro Yamahata, Bon Ohta, Masa ...
    2015 Volume 46 Issue 5 Pages 401-408
    Published: October 25, 2015
    Released: March 03, 2017

    Introduction: In Japanese emergency departments, many physicians have to decide immediately whether they should limit life-sustaining treatments for critically ill elderly patients who may be at their end-of-life (EOL) or in cardiopulmonary arrest. To propose effective medical training, we investigated the ability of junior residents to recognize this challenging problem.

    Method: We conducted a semi-structured interview of 38 junior residents who had completed the junior residency program of University Hospital, Kyoto Prefectural University of Medicine. We then qualitatively analyzed the transcripts of the interviews.

    Results: Through observation of the attending physician's interview, which is a discussion about decision-making with the patients and their families, junior residents recognized the problem of EOL and made their decision. Finally, they preferred "doctor-led discussion" or "neutral discussion."

    Discussion: We recommend that attending physicians should give junior residents many opportunities to observe their interview about decision-making.

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  • Yoko Akamine, Benjamin W. Berg, Mari Nowicki, Gen Ouchi, Yukie Abe
    2015 Volume 46 Issue 5 Pages 409-418
    Published: October 25, 2015
    Released: March 03, 2017

    Introduction: Fundamental Simulation Instructional Methods (FunSim) is an international simulation faculty development course for Japanese healthcare educators, with English and Japanese language versions. The objectives of this study were to assess post-course outcomes of international "FunSim" , and identify barriers to the implementation of simulation-based education (SBE) for Japanese simulation educators.

    Methods: Using a 73-item web-based questionnaire, FunSim course outcomes were assessed at Kirkpatrick model level one (Reaction) ; two (Learning) ; and three (Behavior) . A Likert-type rating scale (1-7) was used for course evaluation (level one) , and for confidence and competency (level two) ; four different types of Yes-No question were used for level three. A Likert-type rating scale (1-5) was used to rate twelve pre-defined potential barriers to the implementation of SBE methods.

    Results: A total of 178 (63%) of 283 participants responded; FunSim language was 47.8% English (E) and 57.3% Japanese (J) , with no differences between (E) and (J) "language barrier" responses. Eighty-eight percent of ratings for the 7-course evaluation items were > 4. Confidence and competency scores decreased "at the time of the survey" compared to "at the end of the course" (P<0.05) . Pre/Post-course participants who were active simulation faculty members increased from 68 to 112 (P<0.001) . Human factors such as "Simulation specialist availability" , " Time for teaching and faculty development" , " Number of trained faculty" , "Faculty development availability" , and "Faculty skill" were predominant barriers compared to other issues.

    Conclusion: FunSim participants reported positive course feedback and no critical language barriers. Barriers to the implementation of SBE are primarily human factors. Work release, hiring simulation specialists, and faculty development must be addressed to establish effective SBE systems.

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short reports
  • Asumi Oguchi, Yu Kitamura, Masaru Nagase, Keigo Mizuno, Koji Tsunekawa ...
    2015 Volume 46 Issue 5 Pages 419-424
    Published: October 25, 2015
    Released: March 03, 2017

     Few studies have examined medical students' perceptions of community medicine and specialty choice through comparison between students of quotas related to community medicine and regular admission. We conducted a questionnaire survey on students' desire for future work places, types of health facility/hospital, medical specialization, and community medicine involving year 1 to year 5 students in Gifu University School of Medicine (n=335, selective admission: regular admission=81:254) . This study demonstrated that the selected students for community medicine (years 1 to 5) preferred to work at a core/small-sized hospital in a rural area and tended to choose the specialties that were characterized by primary care, such as pediatrics. Moreover, they had positive perceptions of community medicine. Further follow-up study needs to be undertaken in order to explore how students are actually engaging in community medicine after graduation.

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  • Yoshimi Harada, Yoji Hirayama, Kana Wakuda, Junji Otaki
    2015 Volume 46 Issue 5 Pages 425-428
    Published: October 25, 2015
    Released: March 03, 2017

     It is necessary to perform out-patient training in order to acquire the basic medical skills of primary care. However, the actual situation of out-patient training has not been clarified in Japan. Therefore, we performed a survey of out-patient training by junior residents at university hospitals throughout Japan.

     A questionnaire survey was performed on out-patient training for junior residents at 80 university hospitals (main hospitals) nationwide. We received responses from 39 hospitals. The hospitals where out-patient training by junior residents was performed numbered 34, and there were 26 hospitals in which the training in out-patient reception hours is being performed. Hospitals which received training on related hospitals were also noted. There were many hospitals receiving a few patients with common symptoms. It is important to conduct training in university hospitals in cooperation with local hospitals.

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