Clinical educators unable to accept the clinical medical training system and residents with no sense of belonging: / 医学教育

Through our experiences in faculty development workshops, we realized that we had not sufficiently understood the problems clinical educators had been facing on site. Thus, we planned to perform qualitative research as part of a needs assessment in faculty development workshops.<br>1)We aimed to analyze and structuralize previously unclarified underlying problems by exploring what clinical educators were worried about regarding the initial residency program.<br>2)We performed a questionnaire survey of 214 physicians participating in faculty development workshops and qualitatively analyzed their responses in the form of free comments.<br>3)Once declaring that they would "start with accepting the program," clinical educators are unaware of their ignorance and unacceptably criticize the residency system, such that their "ignorance disguised as criticism" is highlighted.<br>4)With the introduction of the new residency system, a framework for building relationships as a system, which requires residents to be trained in a particular organization, no longer works, causing significant confusion on site.

A survey of hospital managers' interest in conducting clinical research and clinical research education / 医学教育

Background: In Japan, although clinicians have been extremely interested in conducting clinical research, the shortage of clinical researchers is a serious problem. Therefore, it is important to explore barriers to conducting clinical research.1) We mailed a cross-sectional survey to hospital managers asking about their interest in and barriers to conducting clinical research and training clinical researchers at their hospitals.2) Of 810 eligible hospital managers, 301 completed questionnaires (response rate: 37.2%).3) The managers of university hospitals and national medical centers were more interested in conducting clinical research than were managers of other hospitals.4) Furthermore, 60.6% of managers of university hospital and 18.8% of managers of other hospitals reported the need to employ physicians who specialized in clinical research. However, given public research grants, about 50% of hospital managers were willing to employ research residents.5) Our results suggest there are still barriers to conducting clinical research, such as a lack of time set aside for clinicians and specialists to teach clinical research. A substantial strategy is needed to address the shortage of clinical researchers in Japan.

Experience with 10 Seminars and Workshops for Medical Education / 医学教育

We have organized the Seminar and Workshop for Medical Education (SWME) 10 times from 2000 through 2003. More than 1, 200 persons have participated, including teachers, physicians, students, and simulated patients. The themes of the SWME have included a problem-based learning tutorial system, medical interview skills, objective structured clinical examinations, medical ethics, advanced cardiac life support/basic life support, evidence-based medicine, coaching technology, medical English education, and crisis management education. Invited lecturers from throughout the country organized most of these workshops. Advantages of the SWME are two-fold:(1) improving the medical teaching skills of each participant and (2) scouting for good young lecturers. Workshop reports are published in our annual monographs and other materials. The present paper is a historical review of the SWME and also describes the nationwide scope of faculty development.

Postgraduate Education Through Evidence-Based Medicine: Short-Term Effects on Knowledge and Behavior / 医学教育

Objective: To investigate whether postgraduate education through evidence-based medicine can affect the knowledge and behavior of residents.<BR>Design: Self-controlled and externally controlled trial.<BR>Setting: University hospital.<BR>Participants: Fifteen residents specializing in family medicine.<BR>Intervention: Four 2-hour seminars and weekly evidence-based medicine-style journal club meetings.<BR>Main outcome measures: Scores from a test of knowledge of evidence-based medicine and the number of MEDLINE searches conducted each month.<BR>Results: All residents improved their knowledge of evidence-based medicine and conducted more MEDLINE searches each month than did other medical residents or residents of our department last year.<BR>Conclusion: Postgraduate education through evidence-based medicine is effective in improving residents' knowledge and behavior.

Use of Models in Teaching Palpation and Percussion in a Basic Diagnosis Training Course / 医学教育

In 1994, a basic diagnosis training course was introduced for 2nd-year medical students at Jichi Medical School (JMS) to teach basic interview and physical examination skills with an emphasis on diagnostic processes and principles. In planning and preparing the course, instructors at JMS frequently held discussions to determine learning objectives and activities. We used a comprehensive manual for small-group teaching to standardize lectures as much as possible. In all sessions of the basic physical examination, students were taught in small groups. We also constructed original models to teach palpation and percussion. These models allowed students to participate actively and helped them understand the principles, skills, and findings of palpation and percussion. Instructors at JMS concluded that the models were useful training tools.