ABSTRACT
To develop problem-solving skills and to motivate learning, The Jikei University School of Medicine started a tutorial educational program for fourth-year preclinical students in April 1999. Student doctors' patient-care models focused on discovery learning and acquiring strategies for general medicine through problem-solving skills. After information was first provided by prepractice handouts, one or two tutorial sessions were performed each week. Minimum requirements for each step were established, and instructors provided printed materials, display materials, and detailed oral information to facilitate discovery learning. This program is based on problem-finding and problem-solving through selfdirected learning and feedback systems for tutorial sessions. Examinations used multiple stations to reconfirm program aims and to reinforce problem-solving skills. On a questionnaire survey, 85% of fifth-year students taking part in practical clinical education thought that the tutorial education was needed to acquire problem-solving skills necessary for fifth-year clinical training.