現行の医学教育モデル・コア・カリキュラム（平成28年度改訂版）では，チーム医療に関するコンピテンシーのレベルは，その項目名「チーム医療の実践」に示されている通り“理解”レベルではなく，より高い“実践”レベルが求められていることから，卒業時のゴールとして「他職種学生との協働学習成果あるいは臨床現場における他職種との診療実践」を達成できるカリキュラムが求められていると解釈できる。学習目標達成のためにはIPEを必修の正規カリキュラムとして実施することが必要であり本稿では実行可能性が高いと思われる2つの方法，1）既存のカリキュラムに埋め込んで実施する方法，2）IPE科目を新設する方法について，千葉大学の例を参考として，他大学に導入する時のヒントと共に紹介する。教員はIPEの実施の成功や学生の多職種連携実践を行う能力の獲得のみに目を奪われがちであるが，IPEの真の目的は「患者中心の」「ケアの質の改善」であることを常に心にとめて教育実践を行うことが重要である。

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This paper is based on my presentation to the JAIPE Annual Conference in Sapporo in August 2010 when I argued that the combined impact of demographic, economic, educational, professional and social pressures demanded a strategic response to promote closer collaboration in health and social care through interprofessional education (IPE), exemplified by developments in six countries and reviewed globally in two reports from the World Health Organization (WHO 1988 & 2010). Progress was being made in establishing channels for exchange and support between countries although much remained to be done.

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Plato’s problem that Chomsky applies to speakers’ knowledge of word meaning concerns the disparity between impoverished evidence given and perfect knowledge attained. This study explored whether the attained knowledge of word meaning is stable, articulated and known to adult speakers of Japanese. 118 university students judged twice the degree in which they knew the meanings of words (knowledge score) and the degree in which they could use the words in sentences (usage score), with two different intervening tasks being given between the two judgments. Some speakers engaged in a task of defining the meaning of the words and using them in sentences, while others did not. Findings showed that knowledge scores were comparable in the first judgments, while knowledge score decreased in the second judgments only for the speakers given a task of definition. No change was found in usage score regardless of the intervening tasks. Analyses of descriptions provided in the task of definition and use showed that the meanings of words were neither articulated nor known in detail to the speakers. These findings are not compatible with Plato's problem.

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To structure nutrition improvement approaches for care-dependent older people and related challenges, this study examined 12 medical and welfare professionals engaged in community-based integrated care services using the semi-structured interview method. [Devising measures for nutrition improvement and related collaboration] and [organizing nutrition improvement approaches] represented the approaches actually provided by these professionals to improve the nutritional status of care-dependent older people in community-based integrated care, and this indicates that all of these professionals engaged in community-based integrated care services were aware of the [correlation between the nutritional status and environmental factors] and [correlation between the nutritional status and mental/physical functions] in these people. On the other hand, they faced various challenges such as [difficulty in collaborating with other professionals/institutions for nutrition improvement], [a lack of nutrition education and its necessity], and [non-implementation of nutritional assessment and its necessity]. The results clarified a structure, where [difficulty in collaborating with other professionals/institutions for nutrition improvement] is the major challenge in [devising measures for nutrition improvement and related collaboration] and [organizing nutrition improvement approaches], suggesting the necessity of opportunities for interprofessional education (IPE) and interprofessional work (IPW) beyond occupations and institutions to improve the nutritional status of care-dependent older people in community-based integrated care.

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Objectives: The current study sought to understand the learning outcomes experienced by students and to explain their learning process in detail using interpretive data analysis.

Methods: A qualitative study examined students who participated in a multidisciplinary course in a ward. This study investigated latent meanings rather than factual information, using an interpretive paradigm. Data were collected via focus groups and analyzed using Steps for Coding and Theorization (SCAT).

Results: Students in the Assembly IV trial (interprofessional education in actual medical settings) experienced a process of transition from a competing (exclusive) mode to a mutual-understanding mode when communicating with people in other professions, and they acquired the perspective of an interactive (dialectic) link between involved communication (communication that attempts to connect directly with patients) and uninvolved communication (communication with patients indirectly through data and other methods) for patient communication. This enabled students to move beyond superficial communication while deepening their connections with people in other professions, complementing each other’s strengths, and learning about the possibilities inherent in the provision of collaborative medical practice.

Conclusions: Students participating in interprofessional education within medical settings learned about the potential to achieve a circular realization of collaborative medical practice. A circular realization of collaborative medical practice involves incorporating diverse approaches into one’s own professional work via exposure to the viewpoints of other occupations and avoiding decision-making based on assumptions that are only valid within one’s own profession. This process enables the discovery of better methods and perspectives and the achievement of effective medical practice by moving beyond superficial communication.

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医師と看護師の協働推進のための教育やその評価には，医師と看護師双方の視点からの現状把握が必要である．本研究では，Jefferson Scale of Attitudes toward Physician-Nurse Collaboration（JSAPNC）の日本語版を作成し，医師と看護師の協働に対する態度について調査を実施した．
1）4 府県 4 病院の医師 520 名，看護師 2,139 名を対象として自記式質問紙調査を実施した．本論文では，JSAPNC 全項目に回答した医師 265 名，看護師 1,629 名を解析対象とした．
2）因子分析の結果，JSAPNC 日本語版は原版と異なる因子構造であったが，Cronbach のα信頼性係数は医師，看護師ともに総合得点で 0.79，下位尺度で 0.5 ～ 0.7 台であった．
3）JSAPNC 得点は医師より看護師の方が有意に高かった．医師では尺度得点と個人属性の関連は認められず，看護師では年齢，経験年数，免許・資格の種類，職位，所属施設が関連していた．
4）JSAPNC 日本語版は総合得点による諸外国との比較に利用可能であると判断された．本研究の尺度得点は海外の先行研究に比べ低く，専門職連携教育の普及やその評価の必要性が示唆された．
5）医師の協働に対する態度に関連する要因は今後より詳細な調査が必要であり，看護師については，組織的要因の影響を合わせて検討していく必要がある．

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　本研究では，口腔医学教育（歯学部における医学教育）拡充の意識を明らかにし，対応を検討することを目的とした．全国の歯学部28校の教育責任者に口腔医学教育の拡充について郵送法で質問紙調査を行い，KJ法およびSWOT分析法を用いて回答内容の解析を行ったところ20校から回答を得た．教育拡充への肯定的な意見は55～95%であったが，課題対応への肯定的な意見は35～60%だった．教育拡充に関わる促進・抑制因子の回答内容は，KJ法によって，「社会」10件，「医療」19件，「教育」37件に分類された．SWOT分析の結果，「強み」区分に0件，「弱み」に26 件，「機会」に35件，「脅威」に5件が分類された．抑制要因の「弱み」区分は「教育」項目のみで，促進要因の「機会」区分は「医療」「社会」「教育」の項目が含まれた．クロス分析ではクロス集計表の「弱み×機会」のマトリックスに大部分（63件）の回答が集中した．以上のことから，教育責任者は，口腔医学教育拡充を外部環境の機会として多面的に促進する方向で肯定的にとらえている一方で，大学内部の教育面からの弱みとして消極的にとらえており，教育の弱みを克服して変化への対応の機会を掴むことが口腔医学教育拡充の戦略の枠組みであることが示唆された．

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Teamwork in health care settings is assumed to be beneficial for the client since it allows for a more holistic, comprehensive, co-ordinated approach. It is essential, therefore, for team members to have an adequate knowledge of, and respect for one another's professions. Traditionally, the different health care professions know little about each others specific skill-set and their roles as health care practitioners, whereas in interprofessional education (IPE), clinicians and/or students become familiar with the knowledge, skills and attitudes of each other to be effective team members. Changes in the current health care environment require well-versed, flexible, collaborative clinicians who work for the client's best interests. Traditional professional silos are no longer viable. IPE both at the undergraduate/pre-employment level and postgraduate/post-employment level is seen as one means to foster effective cross-professional communication, collaboration and client-centred care. IPE assists students to increase their knowledge of the roles and functions of other related professionals and enable an integrated approach to both in the workplace and in collaborative practice. Given that IPE is resource intensive, a question that can be posed is "how effective is IPE?" Many evaluation studies examining the effectiveness of IPE in health care contexts (mainly with physicians and nurses) have been completed. Only a few investigations have included other health professions such as occupational therapy, pharmacy, social work or physiotherapy. All of the IPE effectiveness studies report some form of positive benefit or outcome, but none of the studies are definitive or have been replicated. Many of the published health science IPE evaluation studies lack adequate rigor in terms of poor or unclear research design used, small sample size, non-randomisation of participants, lack of comparison control group, lack of acknowledgement of bias, non-standardised instruments used and/or statistical analyses completed. Several systematic reviews have been completed dealing with the published health science IPE evaluation literature, but the results have been largely inconclusive. Ongoing evaluation of the effectiveness of IPE in the health sciences is required.

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科学技術に関する仕事について,創造性の議論が最近しばしば行われる.創造性は,どんな要因と関連して発揮されるものか,実際の研究生活や,世界の研究仲間達のエピソードをもとに見直してみる.そのことから,歴史や,社会の文化的な背景,そして,人間の持っ根源的な,知る喜びなどがからみ合ったドラマの中に創造性の本当の姿が見られることを示そうとしたのが本論文である.

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This article deals with the semantics of so-called mismatched two-past counterfactual conditionals exemplified by “If his son had been born tomorrow_F (instead of yesterday), John would have been ecstatic.” The antecedent of this conditional is a past perfect, but posits a fictitious situation in the future of the utterance time. I argue that a focused future temporal adverbial (e.g. tomorrow) in the antecedent is associated with covert instead and that this yields the desired interpretation. The future adverbial is contrasted with a covert past adverbial (e.g. yesterday), which justifies the use of the past perfect in the antecedent. A formal proposal presented here is based on Kratzer (1981) and Rooth (1985, 1996).

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With increasing competition in the global steel market, strip casting technology potentially offers an efficient, economical and environmentally-friendly approach to the production of hot-rolled, coiled steel. This review provides a summary of the basic theory and history in the developments of strip casting operations of steels, along with technical discussions regarding various strip casting initiatives that have been carried out in the past, as well as present. Two strip casting processes are discussed in detail; Twin-Roll Casting (TRC) and Horizontal Single-Belt Casting (HSBC). With its inevitable logic, the emergence of strip casting technology could have an enormous impact on the world's steel industry. This present paper reviews the progress of strip casting technology for steel from a historical perspective, and this will be followed by a sequel, reviewing recent technical developments in the field.

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　医療専門職の多職種連携に関する理論は多くの学問分野から成り立っており，実践への援用が難しい要因になっている．そこでこれらの理論を整理し，まず基盤となる社会構成主義・社会関係資本理論を説明し，その他の理論についてミクロ／メゾ／マクロの視点で記述する．
　まず社会構成主義では社会的相互作用と個人間の相互作用の必要性を，また社会関係資本では共通の規範や価値観，理解を伴ったネットワークの重要性を，多職種連携の文脈で説明する．さらに社会福祉の理論を援用し，社会集団をミクロ・メゾ・マクロに分類して，多職種連携に関する理論を概説する．ミクロ（個人の学び）の視点からは，医学／医療者教育全般にとって基盤となる成人教育理論を提示し，さらに偏見を軽減するための条件を示した接触仮説，内集団と外集団をどのように区別しながらアイデンティティを確立していくかを示した社会的アイデンティティ理論を紹介する．メゾ（チームでの学び・実践）の視点からは，チームで学習すること・協働することをチーム学習・協働論で示し，チームが道具を使って，分業・協業しながら対象を拡大していく状況を活動理論で，チームプロセスをタックマンモデルで示す．またマクロ（組織での学び・実践）の視点として，複雑系と社会化についての理論を紹介する．
　最後に，多職種連携をメタ視点でとらえた文献を紹介する．これらの理論と実践の往復に基づく経時的・多面的な省察により，多職種連携が促進することを期待する．

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