Cross-sectional Study of the Educational Roles of Residents in the New Medical Specialty Program / 医学教育

Background: Although there is a growing momentum in Japan to expect residents to play an educational role, the guidelines are still unclear. Objective: The purpose of this study is to examine the characteristics and contents of teaching roles for residents in the new curriculum of each specialty program and uncover current issues. Methods: Two researchers independently searched for and determined the wording related to teaching in the program for all 19 specialties. The research team extracted the relevant issues. Results: Seventeen of the 19 programs included a statement on educational roles for their residents, but almost all of the programs did not include educational competencies and any specific strategy to achieve it. Discussion: The definition of educational competencies and the development of methods to acquire the competencies are issues for the future. It is necessary to develop and expand programs for the Residents-as-Teachers program in Japan.

Does the hospitalization immersion experience improve medical students’ understanding of patients’ perspectives? A qualitative study / 한국의학교육

Purpose@#Although many studies have assessed the impact of interventions to increase medical students’ empathy by improving their understanding of patients’ perspectives and feelings, the impact of hospitalization experiences remains unclear. @*Methods@#Fifth-year medical students at Kyushu University from 2009–2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. @*Results@#Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients’ anxiety about illness and empathy as one of the requirements of health care providers from the patients’ perspective. @*Conclusion@#This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students’ empathy by improving their understanding of patients’ perspectives and feelings.

Does the hospitalization immersion experience improve medical students’ understanding of patients’ perspectives? A qualitative study / 한국의학교육

Purpose@#Although many studies have assessed the impact of interventions to increase medical students’ empathy by improving their understanding of patients’ perspectives and feelings, the impact of hospitalization experiences remains unclear. @*Methods@#Fifth-year medical students at Kyushu University from 2009–2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. @*Results@#Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients’ anxiety about illness and empathy as one of the requirements of health care providers from the patients’ perspective. @*Conclusion@#This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students’ empathy by improving their understanding of patients’ perspectives and feelings.

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.

1. My experience of publishing my studies in medical education / 医学教育

　I assume that it is difficult for many people who are involved in medical education to maintain motivation to conduct medical education research and publish their studies because of many difficulties in Japan. However I experienced a sense of fulfilment after overcoming them and publishing my research articles. I expect that this description of my experience of publishing my studies in medical education with three TIPs to overcome several difficulties helps those who want to start medical education research and publish their studies.

Mixed-Method Outcome Evaluation of a Community-Based Education Program for Medical Students / General Medicine

<b>Background: </b>Although community-based training is included in medical undergraduate education in Japan, little assessment of the outcomes of community-based education programs has been performed. The aim of this study was to investigate the outcomes of a community-based education program using a mixed method.<br><b>Methods: </b>The study design utilized both qualitative and quantitative methods (mixed method). The subjects (n = 278) were fifth-grade medical students who were involved in the program from 2008 to 2010 inclusive. We collected two types of data: a six-item pre-and-post questionnaire (quantitative) and an open-ended questionnaire (qualitative) to evaluate the impressions this experience left on the students.<br><b>Results: </b>Pre-and-post questionnaires were completed by 263 (95%) of 278 subjects; on all items, the scores of the post- data were significantly higher than that of pre- data (P < 0.001). From the responses given by 139 respondents (total 181, 77%) in the open-ended questionnaire survey, 10 themes were extracted: 1. Inter-professional cooperation; 2. Role and cooperation among university hospitals, community hospitals, clinics, and welfare facilities; 3. Patient-centered medicine; 4. Trust-based relationships; 5. Competency in general medicine; 6. Professionalism; 7. Medical management; 8. Communication; 9. Common diseases; and 10. Long-term care.<br><b>Conclusions: </b>We found that medical students gained four major perspectives from their experiences: Inter-professional cooperation, trust based relationships, roles of community hospitals and clinics, and patient-centered medicine, respectively. Our findings suggest this program contributed significantly to their understanding of community medicine.

Methods for Effective Teaching and Meaningful Learning in Medical EducationII / 医学教育

  We describe popular learning methods in current medical education along with their bases in educational theory. Lectures have the advantage that teachers can provide students with a large amount of organized information. Problem-based learning is an active learning method using small-group discussions to motivate learning. Early clinical exposure is based on the theory of experiential learning. Simulation education has become more important from the point of view of patient safety. Participatory undergraduate clinical training and postgraduate clinical training should be understood as being based on the theories of cognitive apprenticeship and peripheral participation. Considering life-long learning, the reflective practitioner is a useful concept.

Methods for Effective Teaching and Meaningful Learning in Medical Education / 医学教育

  We present an overview of effective teaching and meaningful learning. When selecting teaching methods or learning methods, medical educators must understand the integrity of such methodology with an educational taxonomy or idealized images of future physicians as learners. Adult learning theory, self-directed learning, metacognition, reflective practitioners, and collaborative learning are the key concept for understanding outcomes to achieve when physicians are learners. Cultural differences as well as flexiblity in learning beliefs must be taken into account when applying educational theories from Western countries. Whereas there is no single optimal learning strategy, an elaborate combination of lectures, small-group discussions, and one-to-one instruction enables medical educators to teach learners effectively. Adult learners generally prefer to use various learning methods and to learn in an appropriate safe learning environment.

A Pilot Study of Medical Students' Medical Interview and Physical Examination Practice with Simulated Patients / 医学教育

Objectives: To investigate future directions of medical interview and physical examination practice (MIPEP) with simulated patients and to clarify its educational meaning for medical students. Design: Qualitative design using 8 focus groups before and after MIPEP with simulated patients (4 pre-MIPEP and 4 post-MIPEP). Methods: Nine simulated patients and 10 medical students participated. Four physicians served as facilitators. Each student practiced consultation, including two medical interviews and physical examinations (of one male and one female simulated patient), for 15 minutes. After every consultation, students had a 15-minute feedback session with a simulated patient and a facilitator. All simulated patients and students participated in both the pre-MIPEP and post-MIPEP focus groups. Results: Through pre-MIPEP and post-MIPEP focus groups, medical students realized that an appropriate disposition and talking with patients during physical examination are helpful. MIPEP with simulated patients helps students to gain confidence before clinical practice. Simulated patients found that the value of MIPEP with simulated patients for medical students was increased by thorough course preparation and by the simulated patient's training and motivation, which was affected by the students' attitudes to MIPEP with simulated patients. Conclusion: MIPEP with simulated patients is valuable for teaching the appropriate disposition towards patients, including making physical contact and talking with patients as fellow human beings. When the students' attitudes satisfy the simulated patients, MIPEP with simulated patients can become a powerful educational method.