Medical Student Selection on the Standpoint from Applicants and Social Needs. Activities of the Committee on Student Selection, 1994-1996 / 医学教育

This is a report of the activities of the committee on medical student selection 1994-1996, particularly focused on the 15th Conference on Medical-Student Admission held 1996/8/31 with the subjects of social needs and influences upon high school education for the purpose of improving student selection system in Japan. We must consider how largely admission tests have being influenced high school students at the time of decision making, what medical schools they submit their applications to, and what ability the society or community requires physicians, for creating better system of evaluation for admission in Japan.

Evaluation of Undergraduate Clinical Training Based on Clinical Clerkships in Medical School / 医学教育

We evaluated our undergraduate clinical clerkship system in 1992, using the multiplication method advocated by the Working Group on “Evaluation of clinical skills of medical students ” of the Japan Society for Medical Education. We divided the clinical training period into three terms: the first term was held from May through June, the second from September through October, and the third from December through January. We determined scores using checklists and rating scales in ten categories, totalled the scores for each period, and compared them between periods. The total scores for the third period were the highest, followed by those for the second period. Scores for basic knowledge, data gathering, and basic technical procedures increased with increase in the number of training hours. However, scores for manner, attitude, and interviewing skills were already high in the first period. We conclude that the multiplication method is useful for objectively evaluating students' clinical skills.

On Attitude Education of Students. Evaluation of Doctors' Attitudes toward Patients by Medical Students / 医学教育

Learning of humanistic attitudes in undergraduate medical education is increasingly expected to provide holistic care and comprehensive medical service. However, there has been no report that deals with doctors' attitudes toward patients in relation to the educational subject. Medical students, who had been implemented a clinical clerkship for two months, evaluated doctors' attitudes by questionnairs after clerkship. They scored by checklists and rating scales. In this article, we report the views of medical students on doctors' attitudes, and discuss important points for the success of the learning attitudes during undergraduate educational prosses.

Clinical Clerkship in Undergraduate Clinical Training with a Special Reference to Learning Humanistic Attitudes / 医学教育

To determine the effectivenss of “clinical clerkship (CC)” in undergraduate clinical training, a questionaire was sent to 105 students who had received the classical bed side teaching (BST) in 1990 and to 103 who have received CC from 1992 through 1994. The effectiveness of clinical training was pointed out by 53, 7% of group BST and 61.8% of group CC. The numbers of effectively learned items were larger in the order of psychomotor, affective and cognitive domains in the group BST, while there were in the order of affective, psychomotor and cognitive domains the group CC, indicating that CC is more effective in learning in the affective domain than BST (p<0.01). In the affective domain, students learned by observing physicians' attitudes to patients in BST, while they learned through their own personal interactions with their assigned patients in CC. CC is therefore believed to be quite effective for students to learn humanistic attitudes.

Initial Two-Year Clinical Training Program in Postgraduate Medical Education / 医学教育

In 1991, the committee on postgraduate clinical training proposed revised behavioral objectives for basic clinical training in the initial two years. We present here a model for a clinical training program that should enable most residents to attain these objectives within two years.<BR>The program begins with orientation for 1-2 weeks, including a workshop on team care, and nursing practice.<BR>Basic clinical skills for primary care and emergency managements should be learned by experience during rotations through various clinical specialities. All staff members, even senior residents, should participate in teaching beginning residents in hospitals.

An ex post facto evaluation of the 82nd and 83rd national examination for Physicians' license / 医学教育

The 82 nd and 83 rd National Examination for Physicians' License, which were held in 1988 and 1989 respectively, were evaluated from question to question as well as in all the questions as a whole to set minimum pass scores and analysis “relevance” and “difficulty” in a matrix utilizing a modified Ebel's method.<BR>The evaluators were teachers in different disciplines in nationwide medical schools and teaching hospitals and clinical trainees who had taken and passed the immediate past examinations.<BR>Following data processing, the questionable and difficult questions were on the decrease compared with the preceding year, and it was tentatively concluded that the National Examinations have gradually improved year by year.

Objectives of post-graduate clinical training / 医学教育

Japanese medical graduates are recommended to receive clinical training for more than two years after graduation, because undergraduate clinical training is insuffiicient.<BR>In 1976 the committee of postgraduate clinical training proposed the objectives of basic clinical training after graduation of medical schoool and in 1981 the committee proposed the objectives for the first postgraduate year of training and the methods of clinical skill assessment.<BR>We here present the revised objectives of basic clinical training after graduation of medical school.<BR>It is emphasized that clinical trainees should have basic clinical skills of primary and emergency care during the two year training.<BR>These clinical skills include interviewing techniques, skills in physical examination and interpretation of physical findings, laboratory skills, skills relating to diagnosis and managements, communication skills to other doctors and to other medical co-workers and terminal care.