Clinic-based educational strategies utilized for practical training of common medical devices focusing on medical and nursing care for the elderly prior to formal on-site clinic training / 日本プライマリ・ケア連合学会誌

<b><i>Abstract</i></b><br><b>Objective</b> : We investigated the usefulness of providing medical students with demonstrations and education for commonly used medical devices focusing on medical and nursing care for the elderly. Educational materials were also distributed, in addition to the input from the participation of paramedic assistants as various strategies for providing instruction, prior to formal on-site practical training at our clinic.<br><b>Methods</b> : Forty-two 5th year medical students undertook a questionnaire survey regarding the education provided prior to on-site practical training, and which was performed after training was completed at our clinic.<br><b>Results</b> : All students responded that demonstrations of medical devices were “easy to understand”, while 81% responded that the distribution of materials was “necessary” and 97.6% responded that explanations from paramedics were either “important” or “necessary”. In addition, 95.2% reported that the explanations given prior to training “enhanced” their understanding of nursing care insurance facilities. In respect of medical procedures such as percutaneous endoscopic gastrostomy (PEG) tube management, while 97.6% of students reported that “the explanations given prior to practical training were adequate”, nevertheless 50% reported that “they still did not feel comfortable in actual practice even though the explanations given prior to training were adequate” .<br><b>Conclusion</b> : The approaches used at our clinic for education given prior to on-site practical training, were considered beneficial for medical students. However, some of them did not feel comfortable performing medical procedures even though adequate explanations had been provided, indicating the need to create a program that promotes greater confidence in performing practical procedures among medical students in the future.

Basic knowledge required by medical students for clinic-based clinical clerkship focusing on medical care for elderly patients / 日本プライマリ・ケア連合学会誌

Introduction: Recently, we reported on the effectiveness of short-term educational programs in clinic-based clinical clerkships that focus on medical care for elderly patients. To evaluate the need for providing a preliminary explanation of the medical care system and the medical equipment related to our programs, we assess the basic knowledge indispensable for all medical students for clinic-based training. <br>Methods: Before the training, we distributed a questionnaire related to our programs to medical students of Oita University who had participated in clinical clerkships. <br>Results: The analysis of the questionnaire data revealed that only 11.4% of the students knew the difference between the numbers of beds in a clinic and a hospital. In addition, 24.3% and 35.7% of the students did not know that vaccinations and medical examinations, respectively, are not approved for health insurance coverage in Japan. Of the students, 31.4% could not see the inappropriateness of addressing elderly female patients as “Grandma”. Furthermore, 28.1% of them did not know the sizes of needles and catheters, and only 18.6% of them knew the difference between a normal syringe and a catheter-tip syringe. In regard to the long-term care insurance system, 62.9% of them did not know of the concept of daily-life group care for elderly dementia patients. <br>Conclusion: These results suggest that preliminary explanations of the medical care system and the medical equipment related to our programs must be provided at the beginning of the training.

Screening of chronic or smoldering type adult T-cell leukemia(ATL) in health examination using E-4000 15-parameter, fully-automated hematology analyzer / 日本農村医学会雑誌

In Oita prefecture, where ATL is relatively endemic, the authors carried out hematology analysis using an E-4000 hematology analyzer in a health examination. This analysis screened a group of 104 males and 181 females out of randomly collected 11, 568 persons in terms of a higher (exceeded 50%) W-SCR rate (i. e. lymphocyte rate in cell size distribution). The collected peripheral blood smears from this group were further subjected to the examination of lymphocyte morphology.<BR>Abnormal lymphocytes exhibiting dyscaryosis, such as indentation or lobulation, were observed in 11 cases, and further examination of anti-ATLA antibody and earlobe blood smears revealed eight suspected cases of ATL-related condition.<BR>Clinical symptoms characteristic of ATL were not observed in the above eight cases, though the anti-ATLA antibody titer measured by the ELISA method increased by more than 25. In one case, being diagnosed as chronic-type ATL, abnormal lymphocytes amounted to 70% and the leukocyte count was 28, 000/μl. In the other seven cases, abnormal lymphocytes amounted to only 1-11%, and the leukocyte counts ranged from 5, 300 to 11, 100/μl, which was almost within the normal limits.<BR>The method in reported as an useful means for screening cases of nonsymptomatic chronic or smoldering type ATL through a health examination.