Consensus Statement; Behavioral and Social Sciences in Medical Education / 医学教育

<p>The Consensus of this Committee is:</p><p>1) To change the name of the present committee from "Premedical Education Committee" to "Committee on Behavioral and Social Science" ; accordingly to discuss theoretical foundations, clinical application, learning objectives and outcomes of behavioral and social science in Japanese medical schools.</p><p>2) To collect actual case studies of teaching behavioral and social sciences in Japanese medical schools and create a database for such practices.</p><p>3) To develop behavioral and social science curriculum content in Japanese medical schools.</p><p>4) To organize training courses for teaching methods for behavioral and social science curricula and develop standardized teaching methods and materials.</p>

5. Enhancing Behavioral and Social Sciences in Medical School Curricula / 医学教育

<p>　As psychological, behavioral, and social factors have a significant impact on health and illness, approaches to these factors are important in medical practice. From the perspectives of global standards of medical education, medical curricula with emphasis on behavioral and social sciences are necessary. The behavioral and social science contents of medical education in the U.S. include six domains: mind-body interactions in health and disease, patients' behavior, physicians' role and behavior, physician-patient interactions, social and cultural issues in health care, and health policy and economics. We need to develop educational outcomes, strategies, assessment, and faculty development to incorporate behavioral and social sciences into medical curricula in Japan.</p>

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.

Learning from the Curriculum of the University of Glasgow / 医学教育

1)In medical education in the United Kingdom, departments of general practice organize the basic training in clinical skills and specialty training in primary care.<br>2)A clinical clerkship in primary care is a compulsory 5–week subject, as are clerkships in internal medicine, surgery, pediatrics, obstetrics/gynecology, and psychiatry.<br>3)As a tutorial training system has been established, general practitioners are contributing to medical education as clinical instructors.

Knowing the Patient Better : How Facilitated Sharing of Diabetes Patients' Life Stories Enhances Patient-Physician Relationships but not Metabolic Control / General Medicine

<b>BACKGROUND</b>: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.<br><b>METHOD</b>: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.<br><b>RESULTS</b>: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.<br><b>CONCLUSIONS</b>: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.

Knowing the Patient Better: How Facilitated Sharing of Diabetes Patients' Life Stories Enhances Patient-Physician Relationships but not Metabolic Control / General Medicine

<b>BACKGROUND</b>: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.<br><b>METHOD</b>: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.<br><b>RESULTS</b>: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.<br><b>CONCLUSIONS</b>: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.

Three essential conditions to cultivate physician scientists / 医学教育

1) We conducted a workshop to discuss the definition of the term "physician scientist", what thought processes and competencies are expected, and how to better help physician scientists develop through medical schools.2) The definition of a physician-scientist is a physician who both provides patient care and approaches unsolved questions in understanding the mechanisms of diseases and developing new treatments.3) Essential conditions for a medical school to cultivate physician scientists include providing good role models for physician scientists, making efforts to stimulate students' motivation, and supporting collaboration among physicians and scientists on the faculty.

Reflection on the Past 30 Medical Education Seminars and Workshops Held by the Medical Education Development Center / 医学教育

The Medical Education Development Center has organized seminars and workshops for medical education 30 times from 2000 through 2008 throughout Japan. The participants have numbered more than 3200 and have included educators, physicians, students, and simulated patients. The topics of seminars and workshops have included problem-based learning tutorial systems, medical interview skills, objective structured clinical examinations, evidence-based medicine, coaching technology, simulations, and community medicine in response to educational needs. A questionnaire survey of 1793 participants of the 11th to 30th seminars and workshops (response rate, 85.6%) showed a high degree of satisfaction (4.33±0.13 of 5 points). Invited lecturers and directors from throughout the country often organized these workshops. The results of workshops are reported in our annual monograph, "Trends in Medical Education."