Communication Difficulties International Students Feel in Practical Training / 医学教育

Background and purpose: With the increase in the number of international medical students, there is an urgent need to develop programs to foster communication skills in Japanese, but the communication problems of international medical students are not clear. Methods: Semi-structured interviews and questionnaires were conducted with 10 international students to identify communication difficulties during clinical practice. Results: Regarding communication with patients, the frequently reported difficulties were difficulty in hearing elderly voices, difficulty with dialects, and difficulty with onomatopoeia. As for communication with health care professionals, the top concerns were not being able to understand jargon and difficulty in speaking concisely using technical terms. Discussion: Language input is a major problem. In educational institutions, they need to listen to a variety of speakers, learn frequent onomatopoeia, and practice oral case reports.

Medical Japanese Class for Second-year International Students: Collaboration between Medical Faculty and Japanese Instructors / 医学教育

The International University of Health and Welfare School of Medicine accepts 20 international students every year. In this paper, we report on the practice of “Medical Japanese Class” for these international students. The “Medical Japanese Class” is a class in which students learn medical terminology through listening, speaking, reading, and writing activities, and make presentations in Japanese based on the knowledge they have learned in English. This is a combination of the Language for Specific Purposes model and the Sheltered model, of Content-Based Language Instruction. We designed and implemented a lesson in which Japanese instructors used medical materials to introduce medical terminology and expressions. Medical faculty checked the application and correctness of medical content.

Does the hospitalization immersion experience improve medical students’ understanding of patients’ perspectives? A qualitative study / 한국의학교육

Purpose@#Although many studies have assessed the impact of interventions to increase medical students’ empathy by improving their understanding of patients’ perspectives and feelings, the impact of hospitalization experiences remains unclear. @*Methods@#Fifth-year medical students at Kyushu University from 2009–2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. @*Results@#Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients’ anxiety about illness and empathy as one of the requirements of health care providers from the patients’ perspective. @*Conclusion@#This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students’ empathy by improving their understanding of patients’ perspectives and feelings.

Does the hospitalization immersion experience improve medical students’ understanding of patients’ perspectives? A qualitative study / 한국의학교육

Purpose@#Although many studies have assessed the impact of interventions to increase medical students’ empathy by improving their understanding of patients’ perspectives and feelings, the impact of hospitalization experiences remains unclear. @*Methods@#Fifth-year medical students at Kyushu University from 2009–2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. @*Results@#Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients’ anxiety about illness and empathy as one of the requirements of health care providers from the patients’ perspective. @*Conclusion@#This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students’ empathy by improving their understanding of patients’ perspectives and feelings.

A joint survey of medical students' self-assessment of competency after clinical clerkship and learning strategies among 9 universities in Japan / 医学教育

<p>Abstract:</p><p></p><p> This study examined the ability of medical students to self-assess basic clinical competence and learning strategies including simulation-based medical education for sixth-year medical students (n=903) at nine universities in Japan. About 40% of 27 procedures to achieve clinical skills in a model curriculum were taught using simulators with or without clinical training in hospitals. We noted that significant numbers of procedures were not practiced through any learning strategies. Higher self-assessment scores were observed among students in 4 schools who had more frequent learning opportunities through simulation-based education than among those with less frequent opportunities in 5 schools.</p>

Medical Students' Simlympic Games 2014: / 医学教育

<p>　To encourage the broad use of simulation-based medical education and establish partnerships to promote objective structured clinical examinations after clinical clerkship among medical teachers, we hosted the first team-based clinical skills competition event for medical students in Japan, named ‘Medical Students' Simlympic Games 2014'. Thirty-six (12 teams of three) open-recruited 5th or 6th grade medical students participated in this event. Student teams performed clinical tasks at 6 stations, which actively utilized the strengths of simulators or simulated patients. Contents, composition, difficulty level, and validity were tested by trainee doctors and examined by committee members in advance. In this report, we describe our concept, executive committee formation, a variety of arrangements, the outline on the day of the event, and the results of a questionnaire targeting participants. (126 words)</p>

4. Implementation and challenges of Objective Structure Clinical Examination after clinical clerkship / 医学教育

<p>　The author is involved in the management of Objective Structure Clinical Examination (OSCE) for Common Achievement Tests to be implemented prior to a clinical clerkship. In this study, we discuss how to develop questions for students who will receive OSCE after a clinical clerkship, as well as potential challenges in the introduction and management of its examination system. Finally, we consider the short-term future of clinical education, given the actual situation where a specialty-specific accreditation system has been introduced according to global standards, and medical education focused on medical professionalism is being offered.</p>

Mixed-Method Outcome Evaluation of a Community-Based Education Program for Medical Students / General Medicine

<b>Background: </b>Although community-based training is included in medical undergraduate education in Japan, little assessment of the outcomes of community-based education programs has been performed. The aim of this study was to investigate the outcomes of a community-based education program using a mixed method.<br><b>Methods: </b>The study design utilized both qualitative and quantitative methods (mixed method). The subjects (n = 278) were fifth-grade medical students who were involved in the program from 2008 to 2010 inclusive. We collected two types of data: a six-item pre-and-post questionnaire (quantitative) and an open-ended questionnaire (qualitative) to evaluate the impressions this experience left on the students.<br><b>Results: </b>Pre-and-post questionnaires were completed by 263 (95%) of 278 subjects; on all items, the scores of the post- data were significantly higher than that of pre- data (P < 0.001). From the responses given by 139 respondents (total 181, 77%) in the open-ended questionnaire survey, 10 themes were extracted: 1. Inter-professional cooperation; 2. Role and cooperation among university hospitals, community hospitals, clinics, and welfare facilities; 3. Patient-centered medicine; 4. Trust-based relationships; 5. Competency in general medicine; 6. Professionalism; 7. Medical management; 8. Communication; 9. Common diseases; and 10. Long-term care.<br><b>Conclusions: </b>We found that medical students gained four major perspectives from their experiences: Inter-professional cooperation, trust based relationships, roles of community hospitals and clinics, and patient-centered medicine, respectively. Our findings suggest this program contributed significantly to their understanding of community medicine.

An opinion poll regarding the national licensure examination for clinical instructors and trainees within 2 years of passing the examination / 医学教育

We sent questionnaires to clinical instructors and trainees within 2 years of the latter passing the national licensure examination for medical practitioners to investigate their opinions about the examination and to improve its style. Most instructors wanted to change the examination into an ideal style; however, the trainees had positive comments about the present examination. Several problems came to light, including whether the present examination is asking the minimum requirements for initial training and what the necessary actions are for assessing clinical skills. We must take measures to improve the examination.

Issues to conduct randomized controlled trials in medical education area / 医学教育

1) We conducted a randomized controlled trial in medical education area and explored practical issues through reflection on the processes.<br>2) In February 2007, 39 fourth-year medical students in Nippon Medical School listened to the lecture about how to ask key questions for the diagnosis. Shortly after they had medical interview with a standardized patient for measurement purpose. They were randomly allocated to study and control groups. The lecture content for the intervention group corresponded to the interview but the one for the control group did not correspond to the interview.<br>3) We identified the issues related with ethical review for research, how to mask the information of randomization out of assessors, and equity of educational intervention and assessment offered to both groups.

Questionnaire survey on the development of education system for medical educationist in Japan / 医学教育

1) The committee for the graduate education of medical educationists, Japan Society for Medical Education, investigated needs for the education system of medical educationists.2) A questionnaire was sent to 1831 leaders in healthcare education and the society members, and 644 replied (recovery rate 35.2%). Fifty % of the respondents agreed the necessity of medical educationists. Certificate level was most popular, however, master and PhD degrees were also considered to be necessary. 3) These results support the establishment of educational system for medical educationists in Japan.

Development of education system for medical educationist in Japan: an introduction / 医学教育

1) Japan Society for Medical Education launched a committee for the graduate education of medical educationists in Japan. The committee proposed a direction toward establishing the system, by way of discussion among the members, needs assessment, information gathering of overseas master courses, and discussion at the open meeting.2) To promote medical education in Japan, we should establish 2 systems concurrently: (1) a graduate education for medical educationists who have a broad base of theories and can lead future medical education, and (2) a broader certificate system for medical teachers who have good practical teaching skills.

Opinions of Physicians Graduating from Kyushu University Medical School about an End-of-life Care Course Taken 10 Years Earlier / 医学教育

Opinions of young physicians about a course on end-of-life care which they took at the Kyushu University Medical School 10 years earlier were analyzed. Fifty-seven (23%) of 247 graduates responded to a questionnaire. All clinicians had been involved in end-of-life care to some extent. All respondents agreed that a course about end-of-life care should be included in the medical school curriculum. In general, they thought highly of the course on end-of-life care that they took in medical school. They thought that such a course should last 10 to 20 hours and should be given after the end of clinical lectures and before the start of clinical training. The respondents suggested a good basic policy would be to attach importance to contemplating the end of life rather than to simply memorizing information about end-of-life care.

Statistical Analysis with the Item-Response Theory of the First Trial of the Computer-Based Nationwide Common Achievement Test in Medicine / 医学教育

Data from the first trial of the computer-based nationwide common achievement test in medicine, carried out from February through July in 2002, were analyzed to evaluate the applicability of the item-response theory. The trial test was designed to cover 6 areas of the core curriculum and included a total of 2791 items. For each area, 3 to 40 items were chosen randomly and administered to 5693 students in the fourth to sixth years; the responses of 5676 of these students were analyzed with specifically designed computer systems. Each student was presented with 100 items. The itemresponse patterns were analyzed with a 3-parameter logistic model (item discrimination, item difficulty, and guessing parameter). The main findings were: 1) Item difficulty and the percentage of correct answers were strongly correlated (r=-0.969to-0.982). 2) Item discrimination and the point-biserial correlation were moderately strongly correlated (r=0.304 to 0.511). 3) The estimated abilities and the percentage of correct answers were strongly correlated (r=0.810 to 0.945). 4) The mean ability increased with school year. 5) The correlation coefficients among the 6 curriculum area ability scores were less than 0.6. Because the nationwide common achievement test was designed to randomly present items to each student, the item-response theory can be used to adjust the differences among test sets. The first trial test was designed without considering the item-response theory, but the second trial test was administered with a design better suited for comparison. Results of an analysis of the second trial will be reported soon.

Factors Considered Important for a Terminal Care Curriculum / 医学教育

A 21-hour education program for fifth-year medical students in terminal care was started at Kyushu University in 1991 with the participation of more than 20 lecturers from different specialties. Problems encountered as this curriculum was introduced are discussed. We believe that establishing a professorship in terminal care is essential for improving this curriculum.