The Current Status and Issues of Clinical Training Workshops for Attending Physicians at Kyorin University Affiliated Hospital / 医学教育

Objective: To analyze participants’ opinions regarding the content of clinical training workshops for attending physicians.　Method: A total of 225 people participants in the workshops (approximately 17 hours in 2 days) that were held between 2013 and 2016. We provided the following training sessions: (1) Kawakita Jiro Method (KJ), (2) Process of clinical training, (3) Training program planning procedure, (4) Training objectives, (5) Classification of objectives, (6) Professionalism (PF), (7) 6 Microskills (6MS), (8) Significant event analysis (SEA), (9) Training strategies, (10) Coaching, (11) Educational evaluation, (12) Clinical training systems (CTS), and (13) Roles of attending physicians (RAP). We only used the results of questionnaires obtained from participants who consented to the investigation, and reviewed them for (1) training proficiency, (2) session interest, and (3) course evaluation.　Results: Training sessions showing high proficiency were KJ, RAP, and CTS, and those indicating low proficiency were educational objectives, SEA, and PF. Training sessions that were of great interest were 6MS, Coaching, and KJ.　Conclusion: In the evaluation of the entire course, overall value scored the highest, followed by significance of future participation and applicability of content. Overall, the participants felt that the time for the training course was a little long and that the difficulty level was somewhat high.

5-Aminosalicylic acid aggravates colitis mimicking exacerbation of ulcerative colitis

Ulcerative colitis (UC) is one of the major clinical phenotypes of inflammatory bowel diseases. Although 5-aminosalicylic acid (5-ASA) is widely used for UC and its efficacy and safety have been demonstrated, a few patients paradoxically develop a severe exacerbation of colitis by 5-ASA administration. It is crucial to know clinical features including endoscopic findings in this condition for making a correct diagnosis and a prompt decision to withdraw the medication. Here, we report case series with UC exacerbated by 5-ASA. Medical records of 8 UC patients experiencing an exacerbation of colitis after induction of 5-ASA that was improved by the withdrawal of 5-ASA but also re-aggravated by dose increase or re-administration of 5-ASA were reviewed. The patients were newly diagnosed with UC, started 5-ASA and developed an exacerbation in approximately 2 to 3 weeks. They did not appear to have systemic allergic reactions. Seven of the 8 patients had a high fever. Three of 5 patients who undertook total colonoscopy showed right-side-dominant colitis. These findings suggest clinical characteristics in this condition. Further assessment of clinical and endoscopic features in more cases is necessary for establishing diagnostic criteria and understanding underlying mechanisms in those cases where 5-ASA aggravates the colitis.