Review of Medication Administration Support for Community-dwelling Older People in Japan / 日本プライマリ・ケア連合学会誌

<p><b>Introduction: </b>To understand the current status of and problems with drug administration support (DAS) for elderly people living in communities, we reviewed the original DAS articles for all healthcare professions.</p><p><b>Methods: </b>We extracted and reviewed original articles published for 15 years from January 2000 in CiNii articles and "Igaku Chuo Zasshi". Key words were as follows: "elderly," "housebound," and "compliance management OR compliance guidance", based on the thesaurus in each database. The extracted articles were reviewed for content.</p><p><b>Result: </b>In all, 34 articles were extracted. The individuals involved in DAS were family members, neighbors, home helpers, nurses, physicians, pharmacists, and devices for compliance support. Care managers were not included as support. The current status of DAS extracted by content analysis was "compliance assistance", "compliance management", and "coordination arrangement". Problems with DAS were "information sharing and inter-professional collaboration", "appropriate prescription plans for abilities and lifestyles of the elderly", and "establishing support for taking medicine".</p><p><b>Conclusion: </b>We found that sharing information and inter-professional collaboration are needed to support drug administration for community-living elderly people in Japan.</p>

The White Coat Ceremony at Mie University / 医学教育

1) By participating in the white coat ceremony, 60% percent of students felt that they had been accepted as fledgling medical professionals and become members of the medical community, and 86% began to think that they must take care of patients sincerely in the near future.2) The white coat ceremony made students aware that they would become physicians and gave them an opportunity to renew their enthusiasm for starting clinical clerkships. The distance between students and teachers was reduced.3) We will continue to hold the white coat ceremony, because it is an effective way of teaching professionalism to students.

Educational effectiveness of early clinical exposure with reflection / 医学教育

Early clinical exposure has been implemented worldwide as an effective method of medical education. The duration of early clinical exposure is 1 year in some universities in Western countries. In Japan, however, early clinical exposure occurs most often through health and welfare services, and its duration varies. One-year early clinical exposure and reflection upon it were implemented for first-year students at Mie University School of Medicine in 2006 to motivate them and to teach them about professionalism. The effectiveness of this program was evaluated with a questionnaire, a daily log, and a portfolio.1) The questionnaire survey revealed that students considered the program extremely valuable. They had learned much about communication skills, the relationship between medicine and society, patients' families, and professionalism.2) An analysis of the daily logs clearly showed that students were unsure and hesitant at the start of the program. However, they gradually became accustomed to participating in this program and began to learn earnestly.3) Qualitative analysis of the portfolios revealed that students considered 10 items important in the practice of medicine, including communication skills, responsibility, the value of being a physician, professionalism, and the motivation to study medicine.4) In their final reports, the students described the expected behaviors of physicians they should seek to perform, by learning medical ethics or through professionalism.5) In conclusion, 1-year early clinical exposure is a more effective method than short-term or intermittent exposure for medical students because of its uniqueness and the maintenance of motivation.

Effective Medical-Interview Behaviors in Japan / 医学教育

1) Medical-interview behaviors that are effective in Western countries do not always work effectively in Japan.<BR>2) Facilitation, the open-to-closed cone, and summarization effectively elicit physical information from patients.<BR>3) Open-ended questions may effectively elicit emotional information from patients.<BR>4) Reflection and legitimization increase patient satisfaction.<BR>5) Patients' subjective assessment of the duration of a medical interview is based more on patient satisfaction than on the actual duration.<BR>6) It is unclear whether nonverbal communication in Japan is more closely linked to patient satisfaction than it is in Western countries.