5. Programmatic Assessment : A New Paradigm of Assessment for Learning / 医学教育

Compared to design methods of learning, learner assessment is not as systematic. The concept of learner assessment in health professions education has continued to evolve and has been significantly transformed since the early 2000s when Van der Vleuten proposed Programmatic assessment. Programmatic assessment is based on the philosophy that assessment is not an activity to cut out a part of learners’ competencies and judge learning outcomes at a scattered time (assessment of learning), but an activity to systematically assess learner’s competencies and link the results to learning (assessment for learning). This paper outlines the basic principles of programmatic assessment, introduces an example of programmatic assessment implementation, and discusses issues to be addressed when programmatic assessment is introduced into Japanese medical education.

2. Assessing Learners Without a Magic Bullet : Validity and Utility of Assessment / 医学教育

This paper describes the concepts of assessment theory which are necessary to implement the most desirable assessments, with a particular focus on validity and utility. Validity, classically defined as a trinity of content, criterion-related, and construct, is now encompassed by construct validity. By distinguishing between validity and validation, the process of reinforcing validity through argument-based validation is proposed. Furthermore, we refer to the concept of utility, which takes into account practicality (acceptability and cost) and educational impact, in order to make the assessment practice sustainable. Finally, we will address how learner assessment relates to program evaluation.

1. Paradigm Shifts in Learner Assessment and Prospects for Japan / 医学教育

As outcome-based education has taken hold worldwide, many new findings on learner assessment have emerged. In addition, with the COVID-19 pandemic and the rapid spread of generative artificial intelligence, the situation surrounding learner assessment is entering a new phase. Now is the time to review the historical transition of modern learner assessment in the world and in Japan, to clarify our inherent value criteria for learner assessment, and to discuss the future prospects for learner assessment. This paper will explain the key issues related to learner assessment in the context of past and present trends.

18 An Educational Strategy Using Professional Identity Essay at Jichi Medical University / 医学教育

In conjunction with Kegan's Constructive Developmental Theory, Kalet et al. defined the developmental stages of a physician's Professional Identity Formation (PIF). Kalet et al. also developed the Professional Identity Essay (PIE) as a tool to assess the developmental stages of PIF. This paper introduces an educational strategy to enhance the effectiveness of learning with the faculty by using the PIE in community-based clinical clerkship at Jichi Medical University. Students create self-images of the present and future in relation to the professionalism inherent in their mind. The goal is to motivate medical students to reflect sincerely on themselves based on their PIE descriptions and to focus closely on the learning behaviors of the faculty that has something in common with their future images. The reflection, learning behavior, and motivation are the basic elements of self-regulated learning (SRL) proposed by Zimmerman. This educational strategy is a practical application of the PIF-SRL theory proposed by the author.

An Overview of Early Clinical Exposure for Undergraduate Medical Education in Japan / 医学教育

Introduction: Early clinical exposure (ECE) is an educational methodology where medical students are exposed to the clinical settings in the undergraduate curriculum. This study aimed to examine the implementation status of ECE at medical schools in Japan. Methods: Based on published syllabi, we investigated the existence, location, and subjects (medical/non-medical staffs) of the training programs in medical schools. Results: Of 78 universities, 74 (95%) offered a total of 173 ECE practical training courses, and 51 (69%) combined on-campus and off-campus ECE training. Regarding the location and subjects, 81% of the on-campus ECE training was for medical personnel, 47% of the off-campus was for non-medical personnel, and 61% of the on- and off-campus was for both medical and non-medical personnel. Conclusions: More medical universities combined ECEs on-campus and off-campus and did not offer exposure only to medical staffs. The national trend can serve as a reference to discuss the circumstance of ECE and to plan ECE courses in the near future.

10. The 2022 Revision of the Model Core Curriculum for Medical Education in Japan for Healthcare Professionals and Global Trends in Health Professions Education / 医学教育

Globally, there are currently three major competency models for healthcare professions education: CanMEDS 2015 in Canada, Accreditation Council for Graduate Medical Education Six-Competency model in the United States, and Tomorrow's Doctors in the United Kingdom. An investigation by the Revision Committee for the Japanese National Model Core Curriculum revealed that these competency models had been utilized in seven countries. In each country investigated for revision, medical schools were allowed to implement these major competency models flexibly. Although each university has a high degree of freedom in curriculum design and educational delivery, each country is regulated by a quality assurance system that requires accreditation by the World Federation for Medical Education (WFME) and other organizations. The 2022 Revision of the Japanese National Model Core Curriculum has also been translated into English and released to the global audience in the field.

8. Learning Assessment and Good Practice (2) / 医学教育

In the 2022 Model Core Curriculum for Medical Education in Japan, "Chapter 3, Educational strategies and assessment" section II. "Learner Assessment," consists of three parts : II-1. Approaches to learner assessment, II-2. Assessment methods, and II-3. Questions about learner assessment. Based on the idea that "the way assessment is done varies from institution to institution," the answer to the "Question" is deliberately not included. We hope that readers will refer to this chapter when planning learning assessments in curriculum development while considering the curriculum's background and context.

4. Alignment of the 2022 Revision of the Model Core Curriculum for Medical Education in Japan with the‘Standards of the National Medical Practitioners Qualifying Examination' / 医学教育

In this revision, we have attempted to align the Model Core Curriculum for Medical Education competency, "problem-solving ability based on specialized knowledge," with the "Standards of National Examination for Medical Practitioners." The major diseases and syndromes in "Essential Fundamentals" correspond to the basic diseases in Table 1 of the Core Curriculum, symptoms, physical and laboratory examinations, and treatment in "General Medicine" correspond to the items in Table 2 of the Core Curriculum, and the diseases in "Medical Theory" correspond to the diseases in PS-02 of the Core Curriculum. The validity of the diseases in the Core Curriculum was verified using the evaluation results of the examination level classification of the "Research for Revision of National Examination Criteria." Approximately 690 diseases were conclusively selected. This revision mentions the number of diseases in the Core Curriculum for the first time. Hopefully, this will lead to a deeper examination of diseases that should be studied in medical schools in the future.

Current Status and Prospects of Community-based Medical Education: A Discussion Based on the Special Symposium "Evolution and Essence of the Community-based Medical Education through COVID-19 Pandemic" / 医学教育

Community-based clinical clerkship, which involves travel outside the university or prefecture, was restricted or reduced due to the outbreak of the new coronavirus infection. What kind of shortage of learning this caused and how the shortage was compensated for were discussed in a special symposium at the 53rd Annual Meeting of the Japanese Society for Medical Education. As a result, two “essences” of community-based medical education emerged: 1) to recognize one’s role and responsibility in the future in the context of interprofessional practice, and 2) to look beyond the framework of medical institutions and view the whole scope of medicine with the patient at the center. It was concluded that online supplementary education should be utilized to enhance the value of practical training experience even in the post-Corona era. It was also supposed that this would lead to the “evolution” of community-based medical education itself.

Medical Education Specialist Certified Coursework / 医学教育

The Medical Education Specialist Certified Coursework, which has been officially in operation since 2014, has produced 181 specialists to date. In response to the globalization of medical education, the program has established a system to foster specialists who can work to improve education in accordance with international standards at each educational institution. However, the outbreak of COVID-19 made it impossible to hold face-to-face lessons, forcing the organizers to reform the course. The course resumed in February 2021 as a full online course. Moodle was used as the learning platform, and lectures and group work were conducted via Zoom. There were no major connection problems, and the results of the post-course questionnaire showed a high level of satisfaction and usefulness of the learning. To make this course a good practice for a new era in education, the strengths of both face-to-face and online methods should be incorporated.

A Survey of Introduction Medical Education Journals and the Number of Articles Published from Japan / 医学教育

When submitting research papers to international academic journals, we consider the aims and scope of the journals, readership, acceptance rate, impact factors, etc. to select which journal is most suitable for our studies. In this paper, the editorial board of Medical Education Japan analyzed articles published in international journals between 2009 and 2018 by first authors belonging to institutions in Japan. Pertaining to the number of articles, BMC Medical Education ranked first with forty-one articles (all were original research papers) and Medical Teacher ranked second with 22 (16 original research papers). There were 8 and 7 articles published by first authors from Japan in Academic Medicine and Medical Education, respectively. There are few articles published from Japan in Advances in Health Science Education and Teaching and Learning in Medicine. Some journals, like Advances in Physiology Education and Journal of Surgical Education, focus on specific fields of medicine. We will show characteristics of these major journals (e.g. area of interest, unique article categories, key points for submission, etc.). We hope that readers utilize this information for article submission.

Use of Medical Simulators for Self-Learning among Undergraduates in Japan / 医学教育

While the number of medical schools with simulators is increasing, data pertaining to self-learning is scarce. We conducted a web survey, exploring the ownership and use of simulators at 82 medical schools in Japan; 29 medical schools responded. Twenty-eight of the medical schools owned one or more simulators. Twenty-four allowed undergraduates to engage in self-learning using simulators, and many imposed some restrictions on their use. The medical schools allowed the simulators to be used for a variety of reasons, including “examination preparation,” “improvement of clinical ability,” and “to meet strong demands from students.” Reasons for restriction on use were “equipment management” and “doubts regarding the outcome of self-learning without faculty.” The use of simulators in self-learning is widely supported at medical schools in Japan. In order to optimize self-learning with simulators, appropriate settings and optimal simulator choice should be explored.

What and How to Learn in Medical Schools:A Case Study of First-year Experience in Class / 医学教育

A first-year experience class for medical students was conducted to show a whole curriculum structure and to introduce some study skills through a few group work activities. Although the class was originally lecture-based, it was redesigned with active learning methods like group discussion, peer-review experience and peer-to-peer presentation using short articles. Students were asked to submit a learning record note and received feedback via Moodle. First-year students are expected to identify milestones toward the achievement of core competencies during the 6-year undergraduate curriculum and acquire basic skills leading to the development of various learning strategies. Learning outcomes of this attempt should be investigated for years and the class needs to be improved based on the evaluation.