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.

6. Extrinsic Factors for Learning: from a Perspective of Patient Safety Education / 医学教育

The “problems” of the “problem” learner are not only those intrinsic to the learner, but also those extrinsic to the educator and the system. This paper focuses on patient safety education as an example of where these extrinsic problems are manifested. Patient safety management in the last two decades has been mainly a means to improve the system by analyzing failed incidents in a no-blame manner, but there is also an emphasis on balancing the accountability of the person involved, thus the importance of education is increasing. However, there are barriers to motivating individuals to learn from their failures. The “problem” in patient safety education may be overcome by assuring psychological safety, giving consideration to motivation based on self-determination theory, and using the Safety-II paradigm to change the viewpoint of failure.

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.

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.

Residency Program Coordinators' Perceptions of Their Roles and Attributes / 医学教育

Purpose: To clarify the awareness of residency program coordinators on their roles and attributes.　Methods: We asked residency program coordinator’s to describe their perception of “roles” and “attributes” that they consider important, We then, qualitatively and semi-quantitatively analyzed the data.　Results: Administrative work, public relations activities, coordination, pastoral and educational roles such as mental support, life support, and social education for trainees were extracted as the roles they identified. Regarding the attributes, humanity, the improvement of the quality of work, and various attributes for human resource development were extracted such as counselors, communication, harmonious human relationship, trainee-centeredness and educational mindset.　Discussion: The residency program coordinators perceived the importance of their “roles” and “attributes” for the development of trainees. Our results may be able to contribute to the development of current and future coordinators.

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>

What are "problem learners" ? A systematic literature review on problem learners / 医学教育

<p>Introduction: The problems of problem learners hare not been systematically demonstrated. The purpose of this study was to summarize the English expression and definition of problem learners and classify factors associated with problems.</p><p>Method: A systematic literature review was conducted.</p><p>Results: The expressions extracted were disability, learning disorders, at-risk, difficult, problem, struggle, underperform, unprofessional, unsafe, gifted, and outstanding. Factors associated with the problems were classified into learners' characteristics, cognition, attitude, and skill.</p><p>Discussion: These findings will help teachers understand and detect the problems of problem learners appropriately.</p>

Across institutions and professional borders: Three-year journey for extracurricular course development for interprofessional education with multi-institutions / 医学教育

<p>　This paper reports how Gifu University has been developing an extracurricular course for interprofessional education (IPE) in collaboration with multi-institutions for three years. Since the planning and implementation of such an IPE course have not been described exhaustively, we summarize our experience and the outcomes based on the analysis of a questionnaire survey involving the participants, including students and faculty members.</p>

Staff and faculty development in the coming decades: / 医学教育

　Modern medical education stresses the importance of staff／faculty development and its evaluation. The Medical Education Development Center of Gifu University has been accredited by the Ministry of Education, Culture, Sports, Science and Technology as a National Collaboration Center and has held Seminar and Workshop on medical education 50 times over 14 years towards achieving the mission of staff／faculty development in Japan. Through the analysis of the characteristics of participants and the topics of the workshops and seminars held by the Medical Education Development Center, the history and future of staff／faculty development were examined. The key points suggested to predict the direction of staff／faculty development in the education of health professionals were: acquisition of comprehensive teaching competence, various learning strategies, the importance of work place and practicality, collaborative learning beyond boundaries, scholarly discussion to integrate international and domestic evidence, continuing professional development, and evaluation based on learning stage.

Validity and reliability of the Japanese versions of the Trait Emotional Intelligence Questionnaire-Short Form and the Jefferson Scale of Physician Empathy / 医学教育

  Emotional intelligence and empathy are crucial in patient–physician relationships and clinical outcomes. It has been reported that both emotional intelligence and empathy decrease as students advance through medical school. This study aimed to validate Japanese versions of the Trait Emotional Intelligence Questionnaire–Short Form （TEIQue–SF）, developed by Petrides and Furnham （2001）, and the Jefferson Scale of Physician Empathy （JSPE）, developed by Hojat et al. （2001）.<br>1）The TEIQue–SF and JSPE were translated and administered to 370 medical students. Valid responses were obtained from 321 students（88%）.<br>2）Cronbach’s alpha for internal reliability was high for both the TEIQue–SF （0.87） and the JSPE （0.89）. All item total score correlations were positive for both the TEIQue–SF （range, 0.29 to 0.64） and the JSPE （range, 0.27 to 0.72）.<br>3）Cronbach’s alpha was smaller if an item was deleted than if all items were included for both the TEIQue–SF （0.84–0.85） and the JSPE （0.81–0.86）.<br>4）Factor analysis of both the TEIQue–SF and the JSPE revealed that the Japanese versions had some structural differences from the original versions. However, criterion–related analysis showed that the TEIQue–SF and the JSPE were highly correlated with the NEO–Five Factor Inventory, a measure of the Big Five personality traits.<br>5）These findings provide support for the construct validity and reliability of the Japanese versions of the TEIQue–SF and the JSPE when used for medical students. Further investigation is needed.

A proposed "feedback worksheet" for simulated patients / 医学教育

1) Medical interview practice with simulated patients is an effective method for facilitating the learning of intervie w skills by health professionals.In particular, feedback from simulated patients is an extremely useful means for healti professionals to learn what patients are thinking.<BR>2) However, because simulated patients must have significant amounts of training and experience to provide effective feedback, many find the task challenging, difficult, and stressful.<BR>3) Therefore, we created a feedback worksheet so that simulated patient know what to keep in mind during interviews and how to share their feelings in a precise and simple manner.