What Are Core Clinical Competencies for Medical Residents?: A Qualitative Study / 医学教育

To clarify the core competencies developed through postgraduate clinical training, we analyzed the conditions of our residency program with qualitative research methods. Seven residents (6 first-year residents and 1 second-year resident) answered a questionnaire and underwent semistructured interviews about postgraduate training. We also worked with the residents as “participant observers” of the treatment team. We found that residents often had trouble formulating diagnostic/treatment plans and tended to rely excessively on laboratory data to make decisions. We attribute these problems to a lack of practice in questioning expectations. We hypothesized that <I>mitate-ryoku</I>, the ability to describe the course of a patient's illness, is an extremely important clinical competency. According to the hypothesis, we tried to listen to the residents' description and to discuss it logically as colleagues. The residents described the patients expected condition over the next few days, considering both data and information they obtained from interviews and physical examinations. They adapted their ideas through logical discussion and were thus able to make acceptable decisions by themselves.

Examining reproducibility of force-exertion pattern and reliability of force-time parameters in the development phase during static explosive grip exertion / 体力科学

The evaluation of muscular power function has been mainly limited to dynamic contraction, but force-time parameters in static explosive contraction may be useful. The purpose of this study was to examine the trial-to-trial differences of exertion pattern and the reliability of the force-time parameters in the development phase of static maximal explosive grip (SEG) using seventy healthy young male subjects (age 18.8±2.3yr) . In SEG measurement, subjects were instructed to exert maximal isometric force with a dominant hand as fast and forcefully as possible. Data was collected from two trials with 3 minutes rest between trials. Eleven variables (time to fixed level, average force, integrated area, maximal rate of force development, and equivalent for mechanical power parameter) were selected as force-time parameters.<BR>The reliability of maximal grip strength (MAX) was very high (ICC=0.944, p<0.05) . In the above-stated instruction condition, the trial-to-trial difference expanded from 0.1- 0.4 sec, then re-duced in the vicinity of MAX during SEG exertion. Significant differences, however, were not found at any exertion time and reproducibility of SEG exertion pattern was very high between the two trials. The trial-to-trial reliability in all force-time parameters was significant (ICC=0.346-0.878, p<0.05) .<BR>Reliability of the parameters measuring the earlier phase (about 0.1-0.5 sec) was low or moderate (ICC<0.7), while reliability of the parameters measuring the MAX vicinity tended to be high. The MAX relationship to force-time parameters in the MAX vicinity is high, but is low or moderate for the other parameters. It was suggested that the force-time parameters in the vicinity of MAX in SEG exertion might be useful for evaluating static power function in a clinical setting.

Physical fitness of chinese and japanese junior track runners-can skeletal age and stature be useful for talent detection? / 体力科学

The present study was primarily designated as “Chino-Japanese cooperative study on physical fitness of junior track and field athletes” (1989) . The participants were male and female track runners of both countries ranging in age from 13 to 17 years.<BR>Skeletal age and stature for each sex and athletic event for the present series were compared between the two countries. The data of the present series were then compared with the earlier series, that is, the reference data derived from “Chino-Japanese cooperative study on physical fitness of children and youth” (1986) .<BR>Regarding the mean skeletal age of reference data (13 to 17 yrs.), the Japanese are more advanced (0.6 years in boys; 0.5 years in girls) than the Chinese, respectively. On the other hand, for the mean stature, the Chinese are taller (1.92cm in boys; 2.16cm in girls) .<BR>In the present series, the mean differences for skeletal age between the two countries show a tendency to be smaller than those in the reference data (0.38 years for boys and 0.39 years for girls in 100m runners; 0.15 years for boys in 1500m runners and girls in 800m runners), respectively.<BR>Although the mean differences of skeletal age between the two countries are becoming smaller, the stature of the Chinese boys and girls are getting taller than the Japanese (6.9cm in boys and 5.60cm in girls in 100m runners) . The mean differences are not so great as in 100m runners, however, it is 2.50cm in boys of 1500m runners and 4.05cm in girls of 800m runners.<BR>Comparison of the athletic records between the two countries was made and in general little difference was found. The Chinese records are more complete than the Japanese and show statistically significant difference particularly in 17 years old.<BR>In conclusion, the Chinese junior track runners seem to mature later skeletally or biologically than the Japanese, even though they are already taller than the Japanese. As a natural result, more gain in stature and more improvement in the athletic records will be expected for them. Otherwise some differences between the two countries in the process of sampling of the present study could be questioned.

Physical characteristics on well-trained young swimmers / 体力科学

Well-trained young swimmers seem to have different physical characteristics as compared with non-athletes of the same age group. The purpose of this study was to determine physical characteristics of well-trained young competitive swimmers from a standpoint of differences in training, sex, and growth and development. A total of 47 boy and girl swimmers and 124 untrained boys and girls were selected as subjects.<BR>All swimmers began to swim regularly in an elementary school age and continued hard swimming training for at least 2 years. A battery of 53 parameters representing each physical domain such as physique, muscular strength, flexibility, neuromuscular function, cardio-respiratory function, were selected to examine subject's physical characteristics. The following results were found : boy swimmers have less body fat, superior physique, mascular strength, flexibility, agility, and also superior cardio-respiratory function as compared with untrained boys. Also girl swimmers have almost the same physical characteristics except for physique and general static strength. Boy swimmers possess larger stature and bone width, and superior muscular strength and cardio-respiratory function as compared with girl swimmers. A similar sex difference is found in non-athletes. High school swimmers have more solid body mass, and superior dynamic and static strength, relating to an achievement of swimming speed, than junior high school swimmers.

PHYSICAL CHARACTERISTICS IN WELL-TRAINED YOUNG SWIMMERS / 体力科学

Well-trained young swimmers seem to have different physical characteristics as compared with non-athletes of the same age group. The purpose of this study was to determine physical characteristics of well-trained young competitive swimmers from a standpoint of differences in training, sex, and growth and development. A total of 47 boy and girl swimmers and 124 untrained boys and girls were selected as subjects.<BR>All swimmers began to swim regularly in an elementary school age and continued hard swimming training for at least 2 years. A battery of 53 parameters representing each physical domain such as physique, muscular strength, flexibility, neuromuscular function, cardio-respiratory function, were selected to examine subject's physical characteristics. The following results were found : boy swimmers have less body fat, superior physique, mascular strength, flexibility, agility, and also superior cardio-respiratory function as compared with untrained boys. Also girl swimmers have almost the same physical characteristics except for physique and general static strength. Boy swimmers possess larger stature and bone width, and superior muscular strength and cardio-respiratory function as compared with girl swimmers. A similar sex difference is found in non-athletes. High school swimmers have more solid body mass, and superior dynamic and static strength, relating to an achievement of swimming speed, than junior high school swimmers.