ABSTRACT
The effects of psychosocial education on undergraduate medical students were evaluated in an open trial. Undergraduate medical students were exposed to psychosomatic medicine and, in particular, holistic medicine as part of their undergraduate medical education. Almost all students (94.9%) reported addressing “extramedical” clinical problems with a holistic approach (n=98). Psychological, social, and economic problems were mentioned in 64.3%, 50.0%, and 5.1% of reports, respectively. Problems in relationships between members of the medical staff and patients were included in 37.8% of reports. Self-evaluation with the Egogram Check Lists by students who had undergone clinical practice revealed scores of “Critical Parent, ” “Nurturing Parent, ” “Adult, ” “Free Child, ” and “Adapted Child” of 2.59 1.57, 4.59±1.89, 4.79±1.54, 4.85±1.64, and 4.65±1.64, respectively (n=82). “Adult” scores were higher after clinical practice than before (n = 32, p<0.02, Student's paired t-test). Clinical practice seemed to help students mature and become better able to cope with problems objectively. Education in psychosomatic medicine is an important component of undergraduate medical education.
ABSTRACT
At the Niigata University School of Medicine, objective structured clinical examinations (OSCEs) were performed for the first time in 2001 for 92 fourth-year medical students. The average evaluation scores students received from instructors were summarized, and the differences between scores given by different instructors were examined. We found that practice methods for the medical interview and physical examination before OSCE and the question topics and evaluation methods of OSCE were appropriate, but scores on some items were extremely low. The standardization and objectivity of the evaluation were satisfactory, perhaps because one explanatory conference and two training conferences were held for instructors before OSCE. However, some questions tended to produce differences between instructors, as did some topics, especially in the medical interview. The scores with standardized patients and those by teachers were strongly correlated, but those with the former were lower than those by the latter.
ABSTRACT
Objective: Bakumondo-to (Mai men dong tang, B), a traditional Chinese blended medicine, has notable antitussive activity in bronchitic guinea-pigs. In this study, we examined whether or not B was effective in treating postinfectious cough.<br>Methodology: Consenting, non-smoking patients who met the following diagnostic criteria were selected as subjects: (1) those who had been coughing continuously for more than two weeks postinfectiously; (2) who did not use angiotensin-converting enzyme (ACE) inhibitors orally; (3) who had no history of nasal and/or paranasal disease, chronic pulmonary disease, atopy or gastroesophageal reflux disease; and (4) who had normal chest X-rays, respiratory function, peripheral eosinophil counts, levels of C-reactive protein, and serum IgE concentrations. Subjects were randomized into two groups: those given a daily dose of 9g of B extract granules orally for one week, and those given a daily dose of 60mg dextromethorphan hydrobromide (D) orally for one week. Using a cough diary (in which cough was scored from 0 to 9 points), we compared and studied the antitussive effects between the two groups.<br>Results: Group B was comprised of thirteen patients, and Group D, twelve. There were no significant differences between the two groups with respect to age, sex, cough scores at the time of hospital visits, duration of continuous coughing, and test results. Significant antitussive effects were seen in both groups. However, cough scores decreased significantly from the second day for the B group, and on the third, sixth and seventh day for the D group. Compared with the D group subjects, those in the B group showed higher antitussive effects on the second days (P<0.05). No serious side effects were observed for either group.<br>Conclusion: In this randomized open trial, we concluded that Bakumondo-to is an effective treatment in non-smoking patients with postinfectious cough, and it appears to demonstrate an antitussive action immediately after administration.