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.

Experiencing Patient-Centered Medicine through the Practice of Inter-Professional Education (IPE) in Undergraduate Medical Education / 医学教育

This study examined whether medical students were able to consider themselves to have practiced patient-centered team medicine through the practice of small group IPE. Undergraduate medical, pharmacy, and nursing students during Clinical Clerkship were asked to complete case-based clinical reasoning and treatment/nursing planning in small groups, and a questionnaire was administered to the IPE. The medical students felt that they were able to practice clinical reasoning and treatment planning, the pharmacy students felt that they were able to propose countermeasures against side effects of treatment, and the nursing students felt that they were able to provide necessary information to the medical team and practice patient-centered medicine with the medical team.　Each department had different objectives they considered when practicing team-based medicine. It is important to incorporate each of these elements in IPE.

5. How Should They Respond to the Suffering of Patients with Illnesses That They Themselves Have Not Experienced? / 医学教育

Physicians are expected to listen and respond to their suffering patients. But how should they respond to the suffering of patients with illnesses that they themselves have not experienced?　The scope of palliative care has expanded to emphasize the provision of palliative care to patients with "SERIOUS ILLNESS," regardless of whether or not they are cured. In addition to cancer, physicians have had to deal with the suffering of patients with heart failure, respiratory failure, cerebrovascular disease, etc., but their treating physicians are still clueless about how to face their suffering and how to respond to their suffering. Whole Person Care is a systematic educational program to enable people to face their suffering patients by helping them to adjust to their own condition. This paper provides an overview of "Responding to Patient Suffering".

4. Cultivating Mindful Awareness and Clinical Congruence / 医学教育

Whole Person Care is educated for medical students as the core curriculum at McGill University. The core of Mindful Medical Practice Course aims to provide students with the experience of moving from "not knowing" to "knowing" and "realizing" to cultivate excellent clinicians who "actualize it." We outline mindful awareness and clinical congruence as the core concepts of the course. Students learn it through a variety of exercises and works. They will deepen their awareness of physical sensations, thoughts and emotions in daily life and practice Whole Person Care with congruence stance.

3. Educational Objectives and Methods of Whole Person Care / 医学教育

Whole Person Care education at McGill University aims to develop competent and compassionate physicians who can relate as a whole person to facilitate healing and provide better medical care to their patients. A step-by-step approach is adopted for the education throughout the four-year curriculum. It includes classes, experiential learning in small groups (20 students), simulation education, and panel discussions. It promotes interactive and unique experiential learning through a variety of exercises and works, and aims at transformational learning. It is essential to develop an attitude of being as a whole person, learning to be mindful and aware of the present moment (self, other and context).

2. How can We Establish Mindfulness Education for Future Healthcare Professions? / 医学教育

Mindfulness can be defined as awareness of physical and psychological processes in a nonjudgmental way. The purpose of adapting the ideas of mindfulness in health professions education is twofold. First, mindfulness education can develop stress management skills and self-care ability. Consequently, it can promote personal and professional identity formation. Second, mindfulness education can urge future healthcare professionals to improve the quality of patient care. Thus, this article will present practical reports from three medical schools that introduced mindfulness education for developing stress management skills and improving patient care and then discuss how universities can establish mindfulness education for future healthcare professions.

1. History of Curriculum Development at McGill University Faculty of Medicine and Training Medical Professionals for the Role of "Healer" / 医学教育

The Faculty of Medicine and Health Sciences at McGill University in Canada there has always been an exploration of effective curriculum development that adapts to new eras and aims to encourage medical students to understand how to enhance patients' well-being. In particular, the current MDCM curriculum, which launched in 2013, offers impressive programs at a conceptual level and at a curricular level. These programs explicate to students two roles for physicians who wish to place their patient's wellbeing at the center of their work: professional and healing. This article introduces the history of curriculum development in the Faculty of Medicine and Health Sciences at McGill University and explores how universities in Japan can develop healing curricula in each context.

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.

Resident Mentoring System - How It Is Working and Its Evaluation by Mentees / 医学教育

Introduction: several clinical training hospitals have their own resident mentor systems in Japan. However, the details and effects of the system still remain unclear.　Objective: The aim of this study is to introduce Okayama University Hospital’s resident mentor system and to investigate its effectiveness based on mentees’ evaluations.　Method: A questionnaire survey was conducted on residents using the system.　Results: 32 (78.0%) of 41 residents used the system. 28 (87.5%) of them completed the survey, indicating most residents were satisfied with the currently-used system.　Discussion: We will conduct a more detailed questionnaire survey for mentors and mentees to further improve the resident mentor system.

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.

The Necessity of Simulation Specialist / 医学教育

　Simulation specialist who masters simulators is important for a management of simulation center. Okayama university medical school started to train simulation specialists. Now simulation training are familiar in our university through the simulation specialists helps course directors.

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.