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.

16. Using Humanities and Art to Teach Medical Professionalism / 医学教育

It is said that “medicine is an art based on science,” but education in the art is not well practiced in medical education in Japan compared to education in the science. In a survey of medical students in the U.S., medical students who were exposed to literature, music, theater, visual arts, and other humanities had better empathy, emotional evaluation, and self-efficacy1). Medical humanities education, which is practiced mainly in Europe and the United States, is value education with humanities subjects to overcome dehumanizing medical practices, medical students and medical professionals, and to cultivate professionalism in physicians, such as humanity and altruism. This article focuses on “philosophical dialogue” and “improv” as practical examples of arts education in medicine in Japan that use the humanities and the arts to teach professionalism.

Survey on female physicians' life events and career support / 医学教育

<p>Introduction: In Japan, the number of female physicians is increasing rapidly. The importance of education focused on career development and the work-life balance is increasingly being recognized.</p><p>Methods: In February 2008, we sent a questionnaire regarding the working status and life events to 1,374 female physicians who graduated from Okayama University Medical School or who were working at university-affiliated hospitals and facilities at the time of the investigation.</p><p>Results: Of the 376 respondents (26.8% response rate), we analyzed 360 respondents whose specialty is clinical medicine. Among them, 75.9% (n=269) of female physicians have partners, 70.2% (n=233) have children, and most of the female physicians experience these life events from age of 25-29 years. Although 82.1% (n=216) regarded the timing of their marriage as appropriate, 65.2% (n=144) regarded it as appropriate about having first child. Of the 174 respondents who returned to clinical work, 32.2% (n=56) returned to the same position as a full-time worker, and 27.6% (n=48) changed their position from full-time to part-time. Important factors to return to work easily, 〈understanding from their supervisors〉, 〈support from their family〉, and an appropriate amount of work were the top three reasons.</p><p></p><p>Discussion: It is important to educate medical students about career development based on the life stage and work-life balance for gender equality in medicine.</p>

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.