5. Programmatic Assessment : A New Paradigm of Assessment for Learning / 医学教育

Compared to design methods of learning, learner assessment is not as systematic. The concept of learner assessment in health professions education has continued to evolve and has been significantly transformed since the early 2000s when Van der Vleuten proposed Programmatic assessment. Programmatic assessment is based on the philosophy that assessment is not an activity to cut out a part of learners’ competencies and judge learning outcomes at a scattered time (assessment of learning), but an activity to systematically assess learner’s competencies and link the results to learning (assessment for learning). This paper outlines the basic principles of programmatic assessment, introduces an example of programmatic assessment implementation, and discusses issues to be addressed when programmatic assessment is introduced into Japanese medical education.

2. Assessing Learners Without a Magic Bullet : Validity and Utility of Assessment / 医学教育

This paper describes the concepts of assessment theory which are necessary to implement the most desirable assessments, with a particular focus on validity and utility. Validity, classically defined as a trinity of content, criterion-related, and construct, is now encompassed by construct validity. By distinguishing between validity and validation, the process of reinforcing validity through argument-based validation is proposed. Furthermore, we refer to the concept of utility, which takes into account practicality (acceptability and cost) and educational impact, in order to make the assessment practice sustainable. Finally, we will address how learner assessment relates to program evaluation.

Practical Application of Art-Based Research to First-Year Medical School Students' Community-Based Medical Education / 医学教育

Undergraduate medical education requires learning in both science and art. We have developed a learning model for use in first-year medical education that applies art-based research, which has been developed in sociology.　This is a method in which medical students themselves conduct research while creating works of art to solve local medical, health, and welfare problems, deepening their learning. They also share their artworks with other students.　The methodology consists of four steps: [I] groundwork, [II] collection of materials, [III] fieldwork and artwork, and [IV] appreciation of interactive artwork.　In the class, students take the initiative by creating works that are full of individuality and assertiveness. This learning model is a relatively new model for medical education through which students can deepen their understanding of the art of medicine.

3. A Newly Established Quality and Competency "Making Use of Information, Science and Technology" / 医学教育

Due to the importance of developing physicians' competencies to utilize information, science, and technology, the 2022 revision of the Model Core Curriculum for Medical Education newly established guidelines for qualities and competencies, which it refers to as "Competencies to utilize information, science, and technology." The Model Core Curriculum outlines these qualities as "understanding the ever-developing information society and practicing medical research and treatment while utilizing information, science and technology such as artificial intelligence." The guidelines are organized by the three perspectives of "ethical viewpoints and rules for dealing with information, science and technology," "principles of information, science and technology necessary for medicine and its surrounding society," and "utilization of information, science and technology in the medical field." The objectives of the course were set from the three perspectives of "ethics and rules for dealing with information, science and technology," "principles of information, science and technology necessary for medicine and the society surrounding it," and "utilization of information, science and technology in medical practice." We looked back on the process of formulating these qualities and competencies, which will become increasingly important, and discussed their future prospects.

How to Give Effective Feedback that Encourages Reflection Using Elements of Coaching: Introduction and Japanese Translation of the R2C2 Model / 医学教育

To improve resident performance in clinical practice, the R2C2 model was developed for supervisors who need to guide their residents’ reflection. It consists of four stages: Relationship building, exploring Reactions, exploring Content, and Coaching. It has been shown to effectively engage residents in reflective, goal-oriented discussions and in developing a Learning Change Plan with their supervisors. This paper introduces the Japanese translated version of the model and the evidence of its use.

5. Why Are You Not Good at Practical Skills Even Though You Can Study? / 医学教育

In the healthcare professional training course, we educators occasionally encounter a few learners who “can get grades in the classroom, but are not good at practical skills.” It is possible to explain why this occurs by using “Multiple Intelligence Theory”. According to the theory, we input information while utilizing the three intelligences of visual-spatial intelligence, musical intelligence, and bodily-kinesthetic intelligence in a complex manner. By having a perspective on what kind of cognitive individuality the learners have, we can prepare the scaffolding and appropriate learning opportunities.

4. Understanding and Support of Newly Medical Professionals Who Cannot Do Their Jobs Well / 医学教育

In this paper, in order to understand “newly medical professionals who cannot do their jobs well in clinical practice”, we gave concrete fictitious cases, examined the reasons from three viewpoints, and showed supporting examples for each. The first is the possibility of “discrepancies between the learner’s personality and the environment” and “difficulties in the learner’s own environment” from the perspective of environmental factors. Also included is the importance of how to match the learner and the environment. The second is the possibility of “bipolar disorder” from the perspective of clinical psychology, which requires consultation with a specialist and specialized therapeutic intervention according to the diagnosis. The third possibility is attention deficit/hyperactivity disorder from the perspective of neurodevelopmental disorders. In addition, it is important to improve the work environment, including the surrounding staff.

3. Learner Support for Medical Students Who Can't Communicate Well in Clinical Clerkship / 医学教育

In this paper, as support for “student who is not good at communication”, a fictional case of a pharmaceutical student will be examined from the followingthree perspectives. The first, from a developmental and social psychological perspective, is the possibility of “unlearning or mislearning of communication” and “discrepancy between the actual self, the ideal self, and the ought self.” In support, learning assertion skills can be effective. The second is from a clinical psychological perspective, in terms of “social anxiety disorder” and “narcissism”. In support, pharmacotherapy and cognitive behavioral therapy will be discussed. Third, from the perspective of neurodevelopmental syndrome, the possibility of “autism spectrum disorder” is considered. In this case, involvement that enhances self-understanding and self-affirmation will be important. Educators and supporters are required to make an accurate assessment of the cause of the difficulty.

2. Learner Support for Medical Students Who Are Delay in Learning / 医学教育

In this paper, as support for “students who are showing signs of academic underachievement”, a fictional case of a medical student will be examined from the following three perspectives. The first is a cognitive/neuropsychological perspective on the possibility of “incongruence between cognitive characteristics and learning strategies” and “higher brain dysfunction” . In support, it is important to identify the the student’s traits and adopt appropriate learning strategies. The second, from a clinical psychological perspective, discusses the possibility of “depression” due to tasks in “identity development”. Self-understanding and environmental coordination are required for support. Third, from the perspective of neurodevelopmental syndrome, the possibility of “specific learning disorder” is considered. In this case, too, it is necessary to devise learning strategies that match the student’s traits and provide continuous motivation. For individualized understanding as already mentioned, interdepartment collaboration is also expected.

1. Rethinking the Angle of Approaching Learners in Difficulties / 医学教育

Supporting learners in difficulties is difficult. It is the responsibility of hospitals, universities and other medical education institutions to respond effectively. Traditionally, there has been a bias against focusing on the learner and a tendency to be persuaded by teachers’ beliefs. However, the factors that can lead to learners having difficulties in education include not only the learners but also the educators and the environment. There are also pedagogical, psychological, and cultural approaches to analyzing each factor. In the future, we would like to suggest that a single supporter have more than one perspective. However, because of the context in which supporters are placed, there is a limit to the number of perspectives that can be taken. Therefore, it is hoped that medical education institutions will be able to provide a support system in which multiple supporters, from multiple positions and with multiple perspectives, can ensure a broad perspective.

"MEDC's Learning Space" - A Step-by-step Learning Program at Gifu University to Help Leaders Grow / 医学教育

Over the past 20 years, the Center for Medical Education Development Center, Gifu University has been working on training medical educators across the country. The Center offers a wide variety of programs to meet participants’ various needs and levels, targeting medical educators and administrative staff in various fields such as dentistry, pharmacy, nursing, physical therapy, and occupational therapy. This paper introduces the “Medical Education Starter Kit,” “Fellowship Program,” and “Master’s Course of Health Professions Education” among the programs. The objectives, target participants, and features of each program are outlined, including future prospects.

Rats (Residents-as-Teachers) Fellowship / 医学教育

Residents have teaching roles in clinical practice, and the importance of these roles has been pointed out. This is due to their proximity to learners as Near-Peers. There are two aspects to consider: cognitive proximity, which allows them to share what learners don’t know, and spatial proximity, which allows us to share time and space for an extended period. Residents-as-teachers programs, which aim to improve teaching skills for residents, are being developed all over the world, but are still rare in Japan. We are conducting research to determine what teaching competencies residents should have. We are running a one-year fellowship based on the results of that research. The scale of the program has gradually increased, and in 2020, due to COVID-19, the fellowship went online. We restructured the fellowship in terms of Study/Workload, Enhancing Engagement, and Technical Issues. We received high satisfaction ratings for the online implementation.

Designing a Program for Learning Health Professions Education / 医学教育

This paper outlines the essentials that each organizer of Faculty and Staff Development (FSD) programs in Health Professions Education should focus on when designing a program. The essentials are as follows: the reasons for studying at FDS, the place of practice, content, participants, peers, location, methods, timing, and evidence of learning. These will also help FSD participants think about their perspectives when they choose to participate in the program. It is hoped that more people will get involved in Health Professions Education to increase their knowledge and spice up their daily teaching practice. It is also hoped that those who complete the course will become Faculty Developers in their own areas and professions, revitalizing health professions education and cooperatively increasing the presence of Japanese Health Professions Education.

Basic Understanding of Support for Students Who Have Developmental Disorders at Medical Training Institutions / 医学教育

The Act for Eliminating Discrimination against Persons with Disabilities stipulates that medical training institutions need to offer the provision of Reasonable Accommodation to students with developmental disorders and/or related characteristics.　Reasonable Accommodation is the consideration to guarantee the rights of students with developmental disorders; thus, educational institutions have an obligation to provide this Reasonable Accommodation.　In this paper, we outlined specific support for students with developmental disabilities and related characteristics in medical training institutions from the aspects of “enrollment,” “university education,” and “employment.”　Essential ways to support students with developmental disorders and related characteristics include the presentation of clear criteria, mutual cooperation, and collaboration between faculty members and administrative staff, as well as understanding the basics of how to interact with such students.

Assessing Medical Students' Clinical Reasoning Competency Through the Simulated Case Conference / 医学教育

An oral examination using a simulated case conference format was conducted for fourth year medical students who took a practical course on clinical reasoning prior to their clinical clerkship. Although there were many disadvantages such as fewer cases and shorter testing time to use such examinations for summative purposes, we found that we could assess students' knowledge and presentation skills based on their logical reasoning. We could also comprehensively evaluate students' readiness for clerkship by applying the RIME assessment framework. We discovered the practical value of using the examination as a means of supporting learners who are facing difficulty in learning after we successfully used it to detect such learners and address their concerns. We hope that some elements of this simulated case conference can be used not only as a job preview but also as an assessment tool for pre-clinical clerkship education in other medical schools.

Applying Skits in Teacher Training:A Method to Present Tomorrow's Teachers / 医学教育

In a workshop for health care education teachers, participants are expected to understand new teaching approaches, acquire them, and prepare themselves for tomorrow’s education. While role play is a well-known method for learning in the clinical classroom, this paper reported on an innovative learning strategy that utilizes skits. Firstly, participants generated ideas and set goals to demonstrate how they would change their teaching from tomorrow. Secondly, they arranged the setting for skits, made scenarios based on their own goals, decided the cast from among the group members, and performed the skits in front of the other participants. Thirdly, they did a peer review and debriefing of their skits. This innovative approach may accelerate participants’ ability to set practical goals that should change their future teaching behaviors.

Academic administrative staff feel difficulty when dealing with health-care professional students / 医学教育

<p>　This study examined the cases of the difficult encounters with problematic students that academic administrative staffs in the health professions education institutons faces. 185 cases were obtained from the 143 administrative staffs who participated in the training program for academic administrative staffs training from 2013 to 2015. Although there are 136 cases (73.5%) related to the problem students, some cases existed which problems were from the system or faculty members. In order to dealing with difficult encounters appropriately in the health care professional training institutions, the cooperation between teachers and academic administrative staffs is indispensable.</p>

Medical students' marriage/family and career perceptions: A pilot questionnaire survey / 医学教育

<p></p><p> The increase of female physicians and its undeveloped supporting system can be one of the causes of physicians' shortage. Although physicians' marriage/family perceptions and their influences on career choices have been extensively studied, those of medical students are not fully understood. An anonymous questionnaire survey was conducted involving male/female medical students in years 2 and 5 at Gifu University School of Medicine. The results showed that many male/female students hoped to get married, have children, and continue to work in the future, but different perceptions were demonstrated between the sexes with regards to the partners' occupation, working style, and influences of family/marriage perceptions on students' specialty choice. The results suggest the presence of sex-related differences in perceptions among medical students. The survey indicates the necessity of early undergraduate education for a better mutual understanding of gender issues.</p>

How Do Male and Female Medical Students Perceive Their Own Career? Implications from a Student Viewpoint / 日本プライマリ・ケア連合学会誌

<b>Introduction</b>: The aim of this study is to explore career perceptions of male and female medical students.<br><b>Methods</b>: Semi-structured interviews to 16 medical students (9males, 7 females) were undertaken.<br><b>Results</b>: Qualitative data analysis showed that development of their career perceptions were affected by “gender view”, “interests in medicine” as well as their “perceptions of family”. Specifically, female students in the lower grades felt difficulty in making decisions on career choices due to the conflict between carrying out family responsibilities (e.g., housework and childcare) and interests in medicine. After clinical clerkships, their perceptions of a career were formed in one of two ways: giving priority to family responsibilities or interest in medicine. On the other hand, male students in lower and higher grades consistently gave priority to their interests in medicine for their career choices.<br><b>Conclusion</b>: Differing career perceptions between male and female medical students emerged from this study, and supports the need for undergraduate education on gender-equality in society.

Medical students' perceptions of community medicine: A comparative study between students of quotas related to community medicine and regular admission / 医学教育

<p>　Few studies have examined medical students' perceptions of community medicine and specialty choice through comparison between students of quotas related to community medicine and regular admission. We conducted a questionnaire survey on students' desire for future work places, types of health facility/hospital, medical specialization, and community medicine involving year 1 to year 5 students in Gifu University School of Medicine (n=335, selective admission: regular admission=81:254) . This study demonstrated that the selected students for community medicine (years 1 to 5) preferred to work at a core/small-sized hospital in a rural area and tended to choose the specialties that were characterized by primary care, such as pediatrics. Moreover, they had positive perceptions of community medicine. Further follow-up study needs to be undertaken in order to explore how students are actually engaging in community medicine after graduation.</p>