Changes in Japanese Medical Students' Attitudes Toward Traditional Japanese Medicine over the Course of Medical School.

OBJECTIVE: No report of newly enrolled medical students discusses their attitudes toward traditional Japanese medicine (TJM), Kampo medicine, or acupuncture and moxibustion (AM), or their changes over the course of medical school. This study evaluates these changing attitudes. METHODS: At Tokai University School of Medicine, from 2006 through 2015, 852 students were analyzed 3 times, pre-1st-year introduction Kampo lecture, pre-4th-year 6-hour lectures, and post-3-hour experience-based learning (EBL) course. The 7-item questionnaire included: general impression about Kampo medicine, interest, learning motivation, future involvement, and image, interest in AM, and learning motivation. RESULTS: Their attitudes toward TJM became positive during the 3 years even without TJM education. The 4th-year TJM lectures and EBL course significantly changed their attitudes toward more positive. Females' attitudes were more positive regarding TJM from the 1st year than were the males which became more positive after the EBL course. Students with TJM learning or work experience had positive attitudes from their 1st year and throughout medical school. Students with less positive attitudes became more active in TJM and positive at graduation. CONCLUSION: Appropriate TJM education and standard medical education in preclinical years of medical school has helped make students' attitudes toward Kampo medicine and AM more positive.

Medical residents' interest in and current status of Japanese postgraduate education in acupuncture and moxibustion: a follow-up survey.

BACKGROUND: Japanese traditional medicine (Kampo medicine) is an important subject in Japanese medical schools. Acupuncture and moxibustion (AM), essential categories of Kampo medicine, are taught in a few medical schools today. However, the current state of postgraduate AM education is unknown. OBJECTIVE: To compare medical residents' awareness of AM before their AM education in the 4th year of medical school with that after completion of their 2-year postgraduate medical residency. METHODS: We conducted a postal questionnaire survey of medical residents at the end of their 2-year residency. We required a signature on this questionnaire so that we could examine for changes in their awareness of AM with those determined by similar, signed, former questionnaire surveys conducted before and at the end of their 4th-year AM lectures in medical school (reported previously). The completed questionnaires were returned by mail or facsimile. RESULTS: Among 93 residents, there were 72 (77.4%) effective responses. Only three residents (4%) had opportunities to learn AM during residency. Among the 68 residents who were not afforded the opportunity to do so, after completing their two-year residency, 32(47%) stated that they would like to study AM. Interest in AM was significantly less than that of the proportion of medical students (81%) who were initially interested in AM when surveyed just before their fourth year lectures on AM. CONCLUSIONS: Postgraduate AM education for medical residents appears to be relatively scarce in Japan. Moreover, medical residents' levels of interest in AM were lower than those demonstrated before their 4th-year AM lectures in medical school.

Educational Importance of Acupuncture and Moxibustion: A Survey at the Tokai University School of Medicine Japan.

OBJECTIVE: Acupuncture and moxibustion are categories of Japanese traditional medicine (Kampo). Precise teaching of Kampo is one of the important issues in medical education, and therefore acupuncture and moxibustion education has been applied to students in Tokai University School of Medicine. To investigate and compare the awareness the medical students have of acupuncture and moxibustion before and after the education, we conducted questionnaire surveys. METHODS: The questionnaires were distributed to 117 fourth-year students before and after the education. RESULTS: Of the 117 students issued surveys, 111 responded before, 115 after, and 109 both before and after the education program. Before the education, 79% of the respondents were interested in acupuncture and moxibustion, and 67%, 73%, and 80% thought they were effective, necessary, and worth learning. These results were increased to 92%, 95%, 94% and 97% after the education, respectively (p<0.001 in all four comparisons). Although 9% said they would perform acupuncture and moxibustion in their routines proactively before the education, after the education this increased to 24% (p<0.001), and 43% supposed that they would definitely introduce patients to acupuncturists. CONCLUSION: Medical students' awareness improved after the education, which demonstrated importance of the acupuncture and moxibustion education in medical school.

Evaluation of Kampo education with a focus on the selected core concepts.

OBJECTIVE: Japanese medical schools currently only offer students traditional Japanese Kampo medicine education for an extremely limited amount of time. The purpose of this study was to discover how to generate interest in and motivate learning Kampo medicine. METHODS: Kampo medical sessions, including a lecture series, written examinations, and small-group (12-14 students) EBL (experience-based learning) sessions, were provided for 4th-year medical students (N=117) at Tokai University School of Medicine. Students were taught about "qi, blood, and fluid" and the "deficiency-excess pattern," the two most important core concepts of Kampo medicine and connecting them to clinical application. We evaluated the teaching methods based on questionnaires and written examinations before and after the training course. The Wilcoxon signed-rank test was used to compare changes in awareness before and after the lectures and the Mann-Whitney U test to examine the relationship between the students' interest in Kampo medicine and their examination scores. RESULTS: This training method improved students' general understanding of Kampo medicine and increased their interest and motivation to study Kampo medicine. CONCLUSION: Considering the current status of Kampo education, this training method is effective to educate students in the basic concepts of Kampo medicine.

Evaluation of medical students using the "qi, blood, and fluid" system of Kampo medicine.

OBJECTIVE: Although "qi, blood, and fluid" (QBF) is the most important concept for patients in Kampo medicine, there are few studies about the conditions of the QBF system among healthy populations. We used QBF pattern scores to determine whether or not medical students, presumed to be healthy, had any potentially pathological conditions. METHODS: Six consecutive fourth-year classes totaling 652 medical students evaluated their own QBF conditions using Terasawa's QBF pattern scores. The six conditions: "qi deficiency" (QD), "qi stagnation" (QS), "qi counterflow" (QC), "blood deficiency" (BD), "blood stasis" (BS), and "fluid disturbance" (FD), were categorized according to Terasawa's criteria. The Mann-Whitney U test was used to compare the score differences between the genders, Chi-square test was used to examine gender differences in the QBF diagnoses, and the Spearman's rank-order correlation coefficient analysis was used to analyze the correlation between each category of QBF. RESULTS: In all, 44.6% of the students met at least one diagnostic criterion in the QBF system. QC, BD, BS, and FD were established more in females, and QD and QS were established without gender differences. CONCLUSIONS: Most students who were presumed to be healthy were revealed to have some potentially pathological conditions using the QBF system.

[Development and evaluation of fundamental education about Kampo medicine adopting an experimental program in clinical pharmacy using team-based format].

A model core curriculum was proposed by the government in 2001 that outlined the core structure for undergraduate medical education, in which a Kampo medicine educational program was established. The following year, it was introduced in pharmacy as well as medicine. For fourth-year students at Tokai Medical University, a lecture on Kampo herbal medicine, focusing on clinical pharmacy, was given using team- based learning. Students learned the fundamental mechanism of Kampo medicine through team discussions about their subjective assessment of herbal medicine "Keishito" using their sensory organs and comparing objective analysis data of the main ingredients of Cinnamomi Cortex. They found that knowledge about Kampo medicine can come not only from clinical trials but also from objective observation. Through this educational program, almost all had an increased interest in the possible therapeutic value of herbal medicine. The results of examinations on Kampo herbal medicine showed that this program motivated students, especially those who had less or little interest in Kampo medicine before the lecture. The lecture-style team-based format could also facilitate a mutually supportive atmosphere, because negative feelings and concerns regarding initial traditional medicine can freely be expressed. In future, pharmacists as medical staff will provide preventive and curative primary care; since, for example, the Japanese government is pressing forward to prevent metabolic syndrome, which is related to lifestyle, this project could not have been completed without the cooperation of health professionals such as pharmacists. The present educational program in Kampo medicine may also be recommended for clinical pharmacy education.