[Fostering Pharmacists to Succeed in a Drastically Changing Society].

In 2006, Japan's pharmaceutical science education was revised to a 6-year enrollment course, placing greater emphasis on cultivating practical clinical ability. Quality Assurance (QA) measures have been implemented including offering education based on a model core curriculum and third-party assessments. In August 2021, Ministry of Education, Culture, Sports, Science and Technology (MEXT) launched an investigative commission to review the above. For QA, the commission summarized a comprehensive report in August 2022 for items including: modality of selecting entrants; revising enrollment limits; securing education management; information disclosure; corresponding to pharmaceutical education assessments. For revising the model core curriculum, the commission is reviewing correspondence to: demographic changes due to decreasing birthrates, an ageing population, changes in the structure of diseases; rising and emerging infectious diseases; utilizing Big Data and artificial intelligence (AI). As Japan's ageing population is forecast to peak in 2040s, pharmacists must be fostered to provide safe and quality medicine towards a drastically changing future. Medical care is provided through the collaboration of various professions. In such changing demographics, team medicine is crucial to provide quality medical care. Moreover, towards all medical professions sharing the same vision, revisions to the model core curricula for medical and dental education are also being reviewed. The commission is now reviewing detailed curricula to foster pharmacists with competencies to: comprehensively assess patients and ordinary citizens; utilize information science and technology; professionalism. Towards securing quality pharmaceutical education, pharmaceutical departments at universities must also organize and implement an educational curriculum based on the Model Core Curriculum for Pharmaceutical Education. This paper will introduce the investigative commission's review.

Clinical Clerkships in General Medicine Enable Students to Acquire Basic Medical Competencies and Experience in Community-Based Integrated Care: A Descriptive Questionnaire-Based Study.

Background No previous research has targeted educators regarding educational practice and the achievements of students in terms of the learning objectives of clinical clerkships in university general medicine departments of Japan. We aimed to clarify the characteristics of clinical clerkships in Japanese general medicine departments using a questionnaire administered to chairpersons of university general medicine departments. Methods This was a descriptive questionnaire-based study using Google Forms (Google, Inc., Mountain View, CA, USA). We asked the chairpersons of general medicine departments in Japanese universities the following questions, with responses given on a 5-point Likert scale: Question 1: How well are primary symptoms in the national model core curriculum for undergraduate medical education taught in clinical clerkships in university general medicine departments? Question 2: How successfully can students achieve the learning objectives of the national model core curriculum for undergraduate medical education through clinical clerkships in general medicine departments of university hospitals? Question 3: How successfully can students achieve the learning objectives of the national model core curriculum for undergraduate medical education through clinical clerkships in other community clinics or hospitals? The results of the questionnaire responses are described as mean±standard deviation. Results Of the 71 Japanese universities with general medicine departments, 43 were included in the analysis. For Question 1, the symptoms and pathophysiologies with a mean score of 4 points or higher were fever, general malaise, anorexia, weight loss or gain, edema, abdominal pain, lymphadenopathy, and headache. All those symptoms require basic medical competencies. For Questions 2 and 3, the intramural clinical clerkship of general medicine departments had a higher mean score than the extramural clinical clerkship for diagnostic reasoning that emphasizes medical history and physical examination and a comprehensive approach to patients with multiple health problems. In contrast, the extramural clinical clerkship, in which medical students can build experience with community-integrated care, had a mean score of 3 points or higher for all items. Conclusions The clinical clerkship in general medicine departments of Japanese universities provides students with chances to acquire clinical competencies regarding primary symptoms and pathophysiologies. Additionally, the extramural clinical clerkship provides experience in community-based integrated care, including home medical care, collaboration, health and welfare, and long-term care.

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.

9. Digital Transformation of the 2022 Revision of the Model Core Curriculum for Medical Education in Japan / 医学教育

The Model Core Curriculum (Core Curriculum) is a "model" that systematically organizes the "core" parts of a university "curriculum," which all universities should work on in common. This section describes the part of the Core Curriculum revision that is related to digital transformation (DX). In order to disseminate the Core Curriculum, prepare for future changes, and support the collaborative work of many experts, the DX of the Core Curriculum included the introduction of data and the digitalization of the Core Curriculum work process. The digitization of the core curricula has made it possible to search for and browse through them on a website, distribute them in multiple formats such as Excel files and csv files, and link them to various software such as electronic syllabi and data analysis software. The digitalization of the work process has enabled multiple members to revise the core curricula in parallel. In the future, more personnel will need to support the introduction of such digital technology and a wider range of data.

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.

7. Educational Strategies and Good Practice (1) / 医学教育

In the 2022 revision of the Model Core Curriculum, a new "Educational Strategies and Assessment" section was added as a further development in outcome-based education. By adding a chapter on strategies and evaluation, which is an important element of the curriculum, and linking it to qualities and abilities, we have devised a way for learners and instructors to make use of the Core Curriculum more easily. In addition, 11 example of strategy and assessment cases are included as Good Practice to encourage practical application. However, since these are only examples, we hope this chapter will be further developed as universities create strategies and evaluations that make the most of their unique characteristics.

5. The 2022 Revision of the Model Core Curriculum for Medical Education in Japan and the Common Achievement Test Being Made an Official Requirement / Participatory Clinical Clerkship / 医学教育

Following the revision of the structure and content of the Model Core Curriculum for Medical Education to be more outcome-based and the legal status of the medical practice performed by medical students in the clinical clerkship, we have revised the Guideline for Participatory Clinical Clerkship. The following items were revised or newly described : significance of enhancing the participatory clinical clerkship, scope of medical practice, confidentiality, patient consent, patient consultation and support service, objectives of the clinical clerkship, simulation education, departments where the clinical clerkship is conducted, assessment in the clinical practice setting, CC-EPOC, and entrustable professional activities. A foundation has been established to promote seamless undergraduate and postgraduate medical education. However, future work is needed to examine the specific level of performance expected at the end of the clinical clerkship and department-specific clinical practice goals and educational strategies.

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.

3. A Newly Established Quality and Competency "Making Use of Information, Science and Technology" / 医学教育

Due to the importance of developing physicians' competencies to utilize information, science, and technology, the 2022 revision of the Model Core Curriculum for Medical Education newly established guidelines for qualities and competencies, which it refers to as "Competencies to utilize information, science, and technology." The Model Core Curriculum outlines these qualities as "understanding the ever-developing information society and practicing medical research and treatment while utilizing information, science and technology such as artificial intelligence." The guidelines are organized by the three perspectives of "ethical viewpoints and rules for dealing with information, science and technology," "principles of information, science and technology necessary for medicine and its surrounding society," and "utilization of information, science and technology in the medical field." The objectives of the course were set from the three perspectives of "ethics and rules for dealing with information, science and technology," "principles of information, science and technology necessary for medicine and the society surrounding it," and "utilization of information, science and technology in medical practice." We looked back on the process of formulating these qualities and competencies, which will become increasingly important, and discussed their future prospects.

1. Outline of the 2022 Revision of the Model Core Curriculum for Medical Education in Japan / 医学教育

The basic policies of the 2022 revision of the Model Core Curriculum for Medical Education are : (1) revision of the basic qualities and abilities required of physicians in society in 2040 and beyond, (2) further development of outcome-based education (reorganization of learning objectives and the addition of a chapter on strategy and assessment), (3) consistency with legal and institutional changes in physician training, (4) streamlining and digitization of the document, (5) improvements to future researcher training and development, (6) evidence-based Model Core Curriculum content, and (7) Partial standardization with the core curricula of dentistry and pharmacy.　Major points of revision include the addition of "Generalism" and "Information Technology " to the list of qualities and abilities, reorganization of diseases are to be consistent with the national examination, description of infectious diseases are to based on actual clinical practice, and "basic departments/specialties for participatory clinical clerkship" following discussion with JACME.

[Reviewing the Model Core Curriculum for Pharmacy Education and Fundamental Capacities to Become a Pharmacist with a 20-year Perspective on Human Resources Development].

The model core curriculum for pharmacy education (core curriculum) specifies the basics of 6-year pharmacy education. Pharmacy education is currently being provided based on the revised version of the core curriculum created in 2013 (revised core curriculum), with the aim of training pharmacists with the ability to fulfill social needs. The revised core curriculum also defines the "fundamental capacities to become a pharmacist" that should be acquired by the time of graduation. As education based on the revised core curriculum has been progressing, various challenges of this version, which may also be related to the basis of 6-year pharmacy education, have been identified. Measures to address these challenges, including: clearly indicating the number of goals in each area and the relationship between basic and clinical pharmacy; demonstrating the basic ideas of 2 areas differing from those for knowledge acquisition, 〈basic items〉 and 〈pharmacological research〉; and defining 〈clinical pharmacy〉 and the 〈fundamental capacities to become a pharmacist〉 in the context of pharmacy education, should be discussed in the future. Students educated based on a new version of the core curriculum, which will be created during the next term, are supposed to be active in society as pharmacists 20 or 30 years later. With this taken into account, this paper discusses the revised core curriculum currently in use, and proposes improvement plans for the new version, such as specifying parameters to evaluate learning achievements and the hierarchical relationships among areas.

[Promotion of Child Health and Development Care in Pharmacy Education].

Japan is simultaneously facing both an aging society and low birth rates, causing a continuing population decline. To cope with the declining birthrate, it is urgent to make child health and development medicine a natural accompaniment to all life stages. As pharmacists and pharmacies have a major role to play in this, it is necessary to position child health and development medicine in training for student pharmacists. On the other hand, student pharmacists are young adults who may be directly involved in child health and development, and this is not only an issue for women, but also needs to be understood by men. This symposium provides an opportunity to build a consensus on the role of pharmacists in the increasingly diverse and sophisticated support for child development in terms of pharmaceutical education.

Report of the 71st Annual Meeting of the Japan Society for Oriental Medicine Special Program 1—“Pre-and Post-Graduate Kampo Medicine Education for the Next Generation”: Symposium on Model Core Curriculum in Medicine, Dentistry, Pharmacy and Nursing, and the Current Status of Kampo Education / 日本東洋医学雑誌

At the 71st Annual Meeting of the Japan Society for Oriental Medicine in August 2021, we conducted a special program focusing on education in Kampo medicine, “Pre-graduate and post-graduate Kampo medicine education for the next generation.” As part of this project, we directed a symposium on the model core curriculum (core curriculum) in medicine, dentistry, pharmacy and nursing. The core curriculum in these fields includes Kampo education. Each institution shall promote education in accordance with the core curriculum, considering the characteristics of the field and the circumstances of the educational institution. We introduced the core curriculum in each field, and summarized and reported the current status of Kampo education in the field, points to note and suggestions for multidisciplinary cooperation, issues related to clinical practice and lack of educators, and future prospects.

[Approach to Starting Clinical Pharmacy Practice Experience Based on the Model Core Curriculum for Pharmacy Education (2013 Version) in Hokkaido Prefecture].

The Model Core Curriculum for Pharmacy Education was revised in 2013 and has been applied to all pharmaceutical universities throughout Japan since 2015. Based on this revised core curriculum for pharmaceutical education, Pharmacy Practice Experiences began in February 2019. This Model Core Curriculum focuses on application of outcome-based education in order to achieve "professional competencies for pharmacists". The Model Core Curriculum for Pharmacy Practice Experiences addressed two main points: the eight common diseases that trainees should learn about, and collaboration between universities, pharmacies, and hospitals to conduct effective training for students. In Hokkaido, the Pharmacy Education Council Hokkaido District Coordination Agency, organized by the Hokkaido Pharmaceutical Association, the Hokkaido Society of Hospital Pharmacists, Hokkaido University, and Hokkaido University of Science, and Health Sciences University of Hokkaido has worked to improve practical pharmacy education since four-year pharmacy education programs. Additionally, the agency is central to coordinating and responding to various issues and working toward the implementation of practical pharmacy training. I contributed as chair of the working group to implement pharmacy practice experiences based on revisions of the core curriculum. In particular, we formulated evaluation standards based on sample evaluations presented at a liaison conference on the practical aspects of pharmacy. In addition, in order to convey the changes in pharmacy practice experiences based on this revised core curriculum for pharmacists, I contributed to the implementation of new pharmacy practices as an instructor at seminars in Hokkaido.

Comparison of Subjective/Objective Evaluation of Medical Students at Social Medicine Training between Different Grades in the Same Academic Year: Focus on Student Readiness / 医学教育

Background: The aims of the present study were to reveal the impact of the introduction of social medicine training one year earlier in a new university curriculum on subjective/objective evaluation of medical students, and to discuss the readiness of said students. Methods: In this natural experiment study, subjects comprised 73 third- (n = 31) and fourth-grade (n = 42) medical students who participated in social medicine training, namely “Family Health Practice Tutorial,” in 2017. The data consisted of student’s self-assessment and assessment from clients. The associations between these assessments and student grade were analyzed using the Mann-Whitney U test and ordinal logistic regression. Results: The score for “Language” in the assessment from the clients was significantly lower in the third-grade students than in the fourth-grade students after adjustment for gender (odds ratio = 0.147; 95% confidence interval = [0.027, 0.797]). Discussion: Insufficient readiness for language to residents in the community was found in third-grade medical students. Advanced communication training prior to practice for third-grade students may contribute to sustainable social medicine training in the community.

The Seamless Transition of Medical Education from Pre- to Post-graduate Training: Approach from Outcome-based Education / 医学教育

In the past, pre-graduate medical education and clinical training have not been sufficiently discussed and consistent training of physicians has not been carried out because the entities that implement the studies are different. In order to realize high quality pre-graduate education and post-graduate clinical training, and to promote seamless training of physicians, it is necessary to establish a system of medical education. It is also necessary to consider the outcomes of pre-graduate medical education and clinical training to maintain consistency in the review of clinical training system for physicians in 2020. This paper discusses the Model Core Curriculum for Medical Education and clinical training from the perspective of outcome-based education for consistent physician training.

[Analysis of Basic Life Support Training Provided to Pharmacy Students Using Feedback Device].

The quality of chest compression affects survival after sudden cardiac arrest, particularly when it occurs out of hospital. Pharmacy students should acquire basic life support skills as part of the model core curriculum of pharmacy education. Here, we trained first-year students at the Faculty of Pharmacy to deliver cardiopulmonary resuscitation and used a manikin with a real-time feedback device that quantified chest compression skills. Students were classified into shallow compressions (SC; <50 mm) and deep compressions (DC; ≥50 mm) groups based on the depth of chest compressions measured prior to training. After training, the mean compression depth (mm) was significantly shallower for the SC, than the DC group and many students in the SC group did not reach a depth of 50 mm. Similarly, students were classified into slow compression rate (SR; ≤120/min) and rapid compression rate (RR; >120/min) groups based on the results of training in the rate of chest compressions. Significant differences in mean compression rates were not found between the groups. However, correct compression rate (%), the percentage of maintaining 100-120 compression/min was significantly higher in the SR, than in the RR group. Chest compression rates correlated with compression depth, and chest compression tended to be too shallow in group that was too fast. The quality of chest compression might be improved by delivering chest compressions at a constant rate within the recommended range.

Current Status and Issues of Education on Radiation Health Risk Science / 医学教育

In accordance with the new model-core-curriculum for medical education, the current status of education about the science of radiation health was surveyed in all medical schools in Japan. Among the four learning points related to the “Biological effects of radiation and radiation hazards” , about half of the schools covered issues on “radiation and human body” and the “effect of medical radiation exposure” in one, or less than one, 60-minutes class, but did not touch on “radiation risk communication” and “radiological disaster medicine” . A significant deviation of human resources was also observed between schools. Learning tools such as presentation files and video content were preferred as education support materials. Therefore, development and distribution of the learning tools, especially in “radiation risk communication” and “radiological disaster medicine” , may be a first step to promoting high-quality education on the science of radiation health risk in each school’s curriculum.

A Questionnaire Survey on Economic Evaluation of Pharmaceutical Care in Schools of Pharmacy / 社会薬学

In Japan, the model core curriculum for pharmacy education was revised in 2013 and a topic related to pharmacoeconomics was added. A questionnaire survey was conducted to clarify the current situation of teaching this topic in schools of pharmacy. In an annual meeting of social pharmacy education in October 2017, a purpose this survey was explained and asked someone who had taught this topic in each school to answer questions. A total of 61 schools responded by mails or e-mails among 74 schools across Japan (82.4% response rate). About 68% of schools, the topic was taught as a part of required subjects. Main keywords related to analytical methods such as cost-effectiveness, ICER, and QALY were covered at 90% and over of all schools. However, utilization for healthcare decision making process was rarely discussed with case analysis (21.6%). Only limited schools answered that they included keywords of HTA and guideline. More than 90% of schools showed that preparation of syllabus and slides for the lecture was helpful. The survey indicated that contents taught in each school differed across schools and an appropriate educational tool would be required to standardize way of teaching under the core curriculum requirements.

[Contribution to the Development of Pharmaceutical Education in Six-year and Four-year Programs].

　I joined efforts to promote the pharmaceutical education system by participating in committees for developing a model core curriculum for pharmaceutical sciences (core curriculum), in pharmacist educator workshops, in the development of a pharmaceutical common achievement test, evaluation of pharmaceutical education programs, and the creation of a national examination for pharmacists. This review outlines the efforts to reform these pharmaceutical education systems. The core curriculum was prepared under the initiative of the Pharmaceutical Society of Japan. Pharmacist educator workshops were frequently held for the training of educators engaged in the six-year undergraduate course. The Subcommittee of Pharmaceutical Sciences of the Science Council of Japan also held workshops for the development of pharmaceutical education. Under these efforts, the education system consisted of the six- and four-year courses started in 2006. The Ministry of Health, Labour and Welfare revised the national examination for pharmacists. More than 10 years after formulating the core curriculum, the Ministry of Education, Culture, Sports, Science and Technology led the reform of the core curriculum in 2013. The basic idea of the revised core curriculum is outcome-based education. Minor revisions to the national examination for pharmacists were also made following this revision of the core curriculum. The Subcommittee of Pharmaceutical Sciences of the Science Council of Japan conducted reference standards for pharmaceutical sciences to promote education and research in the four-year course. Thus, we created education systems for developing pharmacists and researchers capable of contributing to medical care through the creation, production, and proper use of medicines.