Introduction of novel clinical educational systems in Jichi Medical Universit / 医学教育

  Clinical educational systems in Jichi Medical University are unique in several aspects.<br>1）A clinical clerkship is a compulsory 72–week subject.<br>2）Community–based learning has been adopted for more than ten years.<br>3）To improve clinical reasoning for medical students, we developed a teaching program using morning conference in Internal Medicine.<br>4）We introduced a free course–student doctor system.

Self-Directed Learning and Community-Based Clinical Clerkships / 医学教育

Medical education programs in North America are often based on the adult education theory of self-directed learning (SDL). Many kinds of SDL have been introduced into preclerkship education, clerkships, residency training, and continuing medical education. The first goal of this paper was to review SDL in North American medical education. The second goal was to describe an example of community-based clerkship in which SDL was applied in the department of family and community medicine of the University of Toronto. A third goal was to give three recommendations for Japanese clinical clerkships. The first recommendation is the effect of the learning contract. The second is that the preceptor should give quick and frequent feedback to students and that a useful Japanese feedback device should be developed with information technology. The third recommendation is that a new curriculum combining community-based education for students with continuing medical education for doctors is necessary to improve Japanese medical education.

Opinions of Japanese Medical Students on the Necessity of Experience in Community-based Learning Programs / 医学教育

We conducted a questionnaire survey of all sixth-year students at 10 Japanese medical schools asking their opinions on the necessity of experience in community-based learning (CBL) programs. We developed a detailed questionnaire to examine students' experiences in CBL and their opinions of its necessity using the students' reports from CBL by Delphi process. After excluding data from 1 medical school because of a low response rate, we analyzed data from 659 students (response rate, 75%). The necessity of each item in the required programs, except “seeing labor in medical facilities, ” was more likely to be recognized by students who had experienced the item than by students who had not experienced it. The differences between experiencing and nonexperiencing students in recognizing necessity were greatest for “conversation with patients in their homes, ” “seeing physicians' consultation or referral to other medical institutions, ” “observing nurses work in the outpatient clinic, ” and “participation in conferences with various professional staff.” These results suggest that medical students can recognize the significance and meaning of CBL through experience.