Problems in the Evaluation of Medical Interviewing Skills with Objective Structured Clinical Examinations: How Can Reasonable Objectivity Be Ensured? / 医学教育

Students' interviewing skills are now commonly evaluated with standardized patient-based assessment methods. Four pairs of instructors at Nihon University School of Medicine used objective structured clinical examinations to evaluate the medical interviewing skills of 122 fifth-year medical students. The results were then analyzed to improve the accuracy of rating with objective structured clinical examinations. Interrater variability was significant among the two pairs of instructors. Variability was greatest when instructors evaluated a student's performance but was minimal when they judged whether a student had carried out a task. The number of standardized patients was 8, with the average score of each standardized patient ranging from 52.5 to 73.3 (full score, 100). These results suggest that the rating process for each item should be further refined and that the standard for evaluation should be clarified.

An Evaluation Standard for Medical School Teachers / 医学教育

We, members of the working group for evaluation of a medical faculty in education ability and carrier, have herein proposed a standard for accomplishing such purpose, which was intended to be a fundamental standard applied possibly to all medical schools in Japan with some modifications based on educational goal of each school. The working group members would be very happy if this standard would be useful and valuable for developing better medical education.

Introduction of symposium-style learning in the undergraduate medical education program. An attempt to encourage the medical students intending to have motivation and interest in the research fields of medical sciences / 医学教育

In 1996, our medical school introduced symposium-style learning that is focused on recent advances in medical science as a regular undergraduate program for 6th-year students. The goals of this program are as follows: 1) to teach that good scientific research is essential to support high-quality medical education and medical care, 2) to have students enjoy research in a way they cannot in the ordinary curriculum, and 3) to stimulate interest in research in medical students who may become researchers in the future. Although a long-term survey is needed to evaluate the effects of this kind of learning strategy, an analysis of questionnaires showed that it was effective for the intended purposes. Today, the content of medical education has become diversified, and the social demands on medicine have changed greatly. Thus, we believe it is necessary to develop an education program separately from traditional ones that are primarily oriented to transmission of knowledge.

A Report of a Questionnaire Concerning the Present Programs of the Postgraduate Clinical Course in Japan / 医学教育

The aim of this study is to report and analyze the results of a questionnaire concerning the present programs for the junior residents in the postgraduate clinical course in Japan.<BR>A questionnaire was sent to the administrators or the persons in charge of the programs of 347 institutions including 80 university hospitals and 267 clinical training hospitalsas designated by the Ministry of Health and Welfare.<BR>Answers to a questionnaire were returned by 271 institutions (78.1%). The results were analyzed and summarized as follows.<BR>(1) About 95% of both university and clinical training hospitals have their own programs at present.<BR>(2) In the substantial formula of programs, university hospitals have had straight or rotation form while the clinical hospitals have selected rotation or super rotate (comprehensive) form.<BR>(3) The programs of university hospitals have started in majority before 1992 while those of clinical hospitals have began after 1993.<BR>(4) The programs of university hospitals have contained the clinical training at the other departments or institutions in a significantly higher ratio compared to those of clinical hospitals.<BR>(5) The check system for the evaluation of the programs has well functioned in half of both hospitals.<BR>(6) For the assessment of the programs used, about half of the staffs of both university and clinical hospitals feel unsatisfactorily in their active programs.<BR>(7) Concerning the intention to renewal or modification of their programs used, there were rather passive agreements in both university and clinical hospitals.

A Committee Report on Compulsory Postgraduate Clinical Training / 医学教育

The aim of this study is to report the results of the workshop which was designed to define several indispensable conditions for the implementation of the compulsory clinical training. These conditions discussed include the guarantee of position and improvement of labor conditions for trainees, standard for the authorization of institutions receiving trainees, training curricula and teaching staff of institutions, and the certificate of qualification for the trainees after the compulsory training. The products of the workshop showed plans and guidelines to these conditions as seen in this paper.

Initial Two-Year Clinical Training Program in Postgraduate Medical Education / 医学教育

In 1991, the committee on postgraduate clinical training proposed revised behavioral objectives for basic clinical training in the initial two years. We present here a model for a clinical training program that should enable most residents to attain these objectives within two years.<BR>The program begins with orientation for 1-2 weeks, including a workshop on team care, and nursing practice.<BR>Basic clinical skills for primary care and emergency managements should be learned by experience during rotations through various clinical specialities. All staff members, even senior residents, should participate in teaching beginning residents in hospitals.