Survey on female physicians' life events and career support / 医学教育

<p>Introduction: In Japan, the number of female physicians is increasing rapidly. The importance of education focused on career development and the work-life balance is increasingly being recognized.</p><p>Methods: In February 2008, we sent a questionnaire regarding the working status and life events to 1,374 female physicians who graduated from Okayama University Medical School or who were working at university-affiliated hospitals and facilities at the time of the investigation.</p><p>Results: Of the 376 respondents (26.8% response rate), we analyzed 360 respondents whose specialty is clinical medicine. Among them, 75.9% (n=269) of female physicians have partners, 70.2% (n=233) have children, and most of the female physicians experience these life events from age of 25-29 years. Although 82.1% (n=216) regarded the timing of their marriage as appropriate, 65.2% (n=144) regarded it as appropriate about having first child. Of the 174 respondents who returned to clinical work, 32.2% (n=56) returned to the same position as a full-time worker, and 27.6% (n=48) changed their position from full-time to part-time. Important factors to return to work easily, 〈understanding from their supervisors〉, 〈support from their family〉, and an appropriate amount of work were the top three reasons.</p><p></p><p>Discussion: It is important to educate medical students about career development based on the life stage and work-life balance for gender equality in medicine.</p>

Medical Students’ Opinion of a Web-based Module to Teach Clinical Reasoning and Knowledge / General Medicine

<b>Background: </b>Japanese medical student education lacks emphasis on teaching clinical reasoning skills. To partially remedy this situation, we developed a prototypic web-based module for tutors to teach clinical reasoning. We report the medical students’ opinions of this module.<br><b>Methods: </b>Twenty-four students from two Japanese medical universities were randomly assigned to the two tutored virtual classrooms, each classroom with six students, or to the self-study group, 12 students, after taking the Internet-based Sequential Question and Answer pretest. After four weeks, each of the 24 students took the Sequential Question and Answer posttest. The entire 24 students answered a questionnaire about the Sequential Question and Answer tests; all 12 tutored students answered a questionnaire about the web-based tutored module.<br><b>Results: </b>Although both tutored and self-study Sequential Question and Answer posttest scores increased, the increases of the tutored group’s posttest compared to the self-study posttest group were not statistically significant (p = 0.066). Ninety-two percent of the students rated the Sequential Question and Answer tests as an improved way to learn case presentation and clinical reasoning. Moreover, 79% of students felt that the Sequential Question and Answer tests were an effective way to learn clinical information. The tutored students rated the web-based tutored seminars as an ‘excellent to fair’ method to learn clinical reasoning using a five-point ‘excellent to poor’ scale.<br><b>Conclusions: </b>We developed a prototypic web-based module for tutors to teach clinical reasoning to medical students. The students’ opinion supported the modular components of the web-based seminar format, Sequential Question and Answer test, and the tutoring syllabus as an effective way to improve learning clinical reasoning, case presentation, and medical information. Students also suggested refinements of the prototypic module.

Clinical Reasoning Web-based Prototypic Module for Tutors Teaching 5^th Grade Medical Students : A Pilot Randomized Study / General Medicine

<b>Background: </b>At present clinical reasoning skills are not systematically taught in Japanese medical universities. We developed a prototypic preliminary module for clinical tutors to introduce clinical reasoning to Japanese medical students. We hypothesized that tutored medical students would outperform self-study students.<br><b>Method: </b>Using the web-based Sequential Question and Answer test that rewarded history and differential diagnosis as proxies for clinical reasoning, we compared the pre and posttest scores of 12 randomized fifth grade tutored students at two universities during four tutor-led 1.5-hour web-based seminars using a structured syllabus to 12 randomized self-study students.<br><b>Results: </b>The tutored and self-study groups’ pretest scores were statistically similar at about 40 out of 100 weighted correct points. The tutored students’ posttest scores were 62 points, significantly greater (p = 0.007) than the pretest mean 42 points, compared to the self-study students’ posttest scores of 52 points, significantly greater (p = 0.012) than pretest mean 40 points. The difference between the two posttest groups was of borderline statistical significance (p = 0.08).<br><b>Conclusions: </b>We successfully assessed a prototypic module for tutors to introduce clinical reasoning to Japanese medical students. The tutored students achieved higher scores than the self-study students. Further research is needed to exploit the potential of our modular clinical reasoning system.

Survey of female physicians about leaving a full-time joband returning to work / 医学教育

Introduction: In Japan, the number of female physicians is increasing rapidly. Therefore, surveying female physicians about their current working status, especially about their continuing to work, is important.<br>Methods: In September 2009, we sent a questionnaire regarding working status to 1403 female physicians who had graduated from Okayama University Medical School or who were working at university-affiliated hospitals or facilities at the time of investigation.<br>Results: Of the 420 female physicians who responded （response rate, 29.9％）, 46.6％ （n＝191） had left their jobs at some time, and 92.4％ （n＝171） of them had done so within 10 years after medical school graduation. The most common reason for leaving their jobs was childbirth／childcare, and the second most common was their husband’s job transfer. Of those who had ever left their job, 82％ （n＝151） wished to return to work at the time of their leaving. Only 27.2％ （n＝74） took childcare leave.<br>Discussion: Female physicians have trouble continuing their clinical work and developing their careers while caring for children. A system should be developed to support physicians who wish to continue their clinical work during life events, such as childcare. In particular, career support during the first 10 years after graduation from medical school is extremely important.

Development Process of Medical Education Assets Library （MEAL） / 医学教育

  Committee for Information Infrastructure in the 16th term of JSME Board Members was newly created to edit Medical Education White Book issued every four years and to provide sooner and more comprehensive information infrastructure provision. MEAL was opened as a website for medical education information since August 2011. MEAL consists of glossary, articles, books and more resources using a system like Wiki or Blog on the Web. By such technological progress, not only one–way information provision from JSME but also bidirectional communication between JSME members and committees／board members became available. Internationally, similar websites are known, such as MedEdPORTAL by AAMC （Association of American Medical Colleges）, and expected to be new scholarly information added to journals.

Laboratory practice in transfusion medicine for medical students and physicians at Okayama University Hospital / 医学教育

1) All students but 1 correctly typed the ABO blood groups, but only 33.2% of students and 63.9% of physicians properly performed cross-matching.<br>2) Most failures in cross-matching were due to the inability to detect allogeneic antibodies, but 5.2% of students and 2.9% of physicians failed to detect ABO mismatching.<br>3) Although laboratory practice is suggested to help students to solidify knowledge and comprehend principles, achieving an official goal of residency - gaining competence in performing and interpreting cross-matching independently - appeared difficult.