[Evaluation of experience-oriented hospital practical training by an examination].

Ehime University Hospital has been conducting a four-week practical hospital training course, consisting of 18 programs, for undergraduate students. The course includes experience-oriented programs, such as drug counseling training using case-based learning procedures (CBL practice), evidence based medicine (EBM practice) based on the provision of drug information, and training to avoid adverse drug reactions (pre-avoid practice). A previous study based on a questionnaire survey showed that experience-oriented programs enhanced students' understanding of the hospital practical training, while also increasing their satisfaction. In this trial, written examinations were given to 24 students to evaluate their clinical knowledge and problem-solving abilities at the start and the end of the practical hospital training course to evaluate the educational effects of this curriculum objectively. The problem-solving abilities were examined using a test of a case analysis, which required the students to answer multiple clinical problems or proposals. The examination scores on the clinical knowledge at the end of the practical hospital training course had significantly increased by 9.5% (p<0.01) in comparison to that at the start. In addition, the accuracy rate regarding their problem-solving abilities markedly increased by 28.8% (p<0.001). Moreover, the number of answers also significantly increased by about 1.5-fold (p<0.001). These results suggested that the experience-oriented programs for hospital practical training increased the clinical knowledge and the problem-solving abilities of these students.

Relationship between the risk of falling and drugs in an academic hospital.

The purpose of this study was to investigate the frequency of inpatient falls and to evaluate the risk factors of drugs in an academic hospital. The study population consisted of inpatients at Ehime University Hospital in Japan and the study was conducted from April 1st to October 31st, 2006. Children and teenagers (<18 years old) were excluded. Inpatient falls were registered regularly with incident reports submitted by nurses and other hospital employees discovering the fall. Logistic regression techniques were used to estimate the odds ratios (OR) of the association of falls and drug use. Of the 4084 adult patients, 65 (1.6%) fell. An OR (unadjusted) for risk of falling were observed for various drug classes; hypnotics (OR 2.12; 95% CI, 1.25 to 3.52), anxiolytic (OR 3.35; 95% CI, 1.83 to 5.82), anti-Parkinson's (OR 5.79; 95% CI, 1.71 to 14.80), narcotics (OR 3.08; 95% CI, 1.06 to 7.11), hypotensives, diuretics (OR 2.39; 95% CI, 1.42 to 3.95). A multivariate logistic regression analysis showed that inpatient falls were significantly associated with patients older than 70 years (OR, 2.25; 95% CI, 1.35 to 3.77), with patients taking anxiolytic drugs (OR 2.36; 95% CI, 1.24 to 4.25), and with patients taking anti-Parkinson's medication (OR 5.04; 95% CI, 1.44 to 13.43). In conclusion, this study provides information regarding the relationship between fall-related accidents and drugs. Therefore, pharmacists should provide appropriate drug information related to the risk of falling to both patients and medical staff members.