1) Yokohama City University Hospital has provided a 1-day nursing practice program during the orientation period for first-year interns since 2004. Here we report on the practice performed this year.2) After taking part in the practice, interns described the communication and consultation among the medical team as well as the nurse-patient and nurse-physician relationships. In addition, they recognized the professionalism of nursing.3) To assess the clinical outcome of this practice, we would use the attitude evaluation by head nurses of wards.

Introduction: Recently, the significance of “shared decision-making” in which patients were actively involved in decision options for treatment on the basis of informed consent, has been recognized. However, few studies concerning this issue have been reported regarding rheumatoid arthritis (RA). We conducted a questionnaire survey on patient involvement in treatment decision-making.
Methods : Five hundred RA patients who attended the May 2009 annual meeting of the RA Patient Association in Japan were enrolled in this study. A questionnaire included disease activity and severity, and preferences regarding the extent of patient involvement in deciding on treatment options. Desired and actual roles were chosen from the following descriptions: #1: I prefer to leave all decisions regarding treatment to my doctor. #2: I prefer my doctor to make the final decision after showing me the best option. #3: I prefer that my doctor makes the final decision after showing me all possible therapeutic options. #4: I prefer that my doctor and I share responsibility for deciding which treatment is best for me. And #5: I prefer that the decision about which treatment I will receive should be made by myself.
Results: The questionnaire was returned by 76.4% of the patients, 91% of whom were women, and 71% were 60 years of age or older. While 54% of the patients selected “#4” as their desired role in the decision-making process, 44% of them indicated that “#3” was their actual role, indicating that they accepted the opinion of the attending physician. The desired role was concordant with the actual role in 45% of the patients, who were more satisfied with their medical care and relied on the physician more than those whose desired and actual roles were in conflict.
Conclusion: The physician should assess individual patient preferences and tailor care accordingly.

1) The Japanese term “kenshui”was officially defined in2004when the new postgraduate medical education system began.
2) Although“kenshui”is often translated into English as “resident, ”it is best translated as “intern, ”because a kenshui rotates through many different departments.
3) A United States-style residency is more akin to what is called “koki-kenshu” in Japanese.
4) The “postgraduate year”naming system is the most precise way to describe the position of a physician in postgraduate training.

The concept of sexual minority contains lesbian, gay, bisexual, transgender (LGBT) and disorders of sex development. Despite many recent advances in rights for sexual minorities in the world, bias against them still exit. We held a workshop ‘toward better care for sexual minorities' on the 6th Annual Conference of Japan Primary Care Association 2015. Four lecturers talked about health disparities among sexual minority patients. We want this paper help reducing the readers' prejudice towards the sexual minorities and thus impact their future clinical practice.

In 2015, Tokyo Medical University launched Medical Professionalism for 2nd, 3rd, and 4th year medical students to study professionalism in a sequential manner. The lecture for the 2nd year students was taught together with a representative of LGBTQ support groups. The lecture for the fourth-year students was taught together with a urologist who was a representative of a transgender support group. In summarizing the reports of the fourth-year students who took the lecture in 2021, many students thought that learning about LGBTQ was necessary from the early grades and wanted a more active learning experience. It is necessary to consider more effective learning by devising class content and methods.

A survey was performed to examine residents' awareness of patient safety. Sixty-two residents who had just finished their first year of residency participated in the study. Of the 62 residents, 30 were training at Yokohama City University Hospital and 32 were training at other hospitals. Although all residents knew about the serious medical mishap ( “surgical mix-up” ) that had occurred at Yokohama City University Hospital in 1999, only 53% knew about the judicial verdict in this case. The residents most often believed that the mishap was the fault of the hospital and its system (82%), followed by nurses (73%), supervising doctors (62%), and residents (45%). Seventy percent of the residents knew about the “Incident Reporting System, ” but only 20% had written an incident report. Incidents experienced or observed by residents were most often medication-related. No significant differences in the results of the survey were found between residents of Yokohama City University Hospital and those of other hospitals. In conclusion, although residents recognize the importance of patient safety at the end of the first year of their residency program, they still cannot deal properly with incidents.

Objective : The purpose of this study was to examine the relationships between levels of self-efficacy on health behavior of outpatients with rheumatoid arthritis (RA) and patient's assessment of RA conditions.
Methods : A cross-sectional study was performed using a self-administered anonymous questionnaire between October and December 2010 on 406 RA outpatients who consecutively visited 3 urban hospitals in Japan. The following variables were investigated ; (1) the scale of self-efficacy on health behavior in chronic disease patients (CD-SES), which has 2 subscales : active coping behavior with disease (14 items) and controllability for health (10 items). (2) The demographic data ; age, gender, duration of disease, treatment. (3) patient's assessment of RA conditions : painful joint count, swollen joint count, serum C reactive protein (CRP), patient estimate of global status (PGS) which was measured on a 100-mm visual analogue scale (0=best score), functional disability according to Japanese version of modified Health Assessment Questionnaire.
Results : CD-SES data were obtained from 191 patients. 80% was female with mean age 64.4 yr. Total CD-SES scores significantly correlated with age, PGS and functional disability. The scores of active coping behavior with disease correlated with age, and the scores of controllability for health correlated with PGS. The other variables such as painful joint counts, swollen joint counts, and serum CRP showed no relationship with the scores of self-efficacy.
Conclusion : Self-efficacy on health behavior of RA patients related to PGS and functional disability. The longitudinal study is necessary to ascertain whether the psychological support enhances self-efficacy, and affects clinically important outcome measures such as PGS.

Objectives: The aim of this study was to explore the first-year medical students’ perception of their learning from a lecture about sexual minorities.
Methods: In September 2012, a physician and a gynecologist first lectured about sex differences, reproductive medicine, and sexually transmitted infections. Next, the representative of a support group for a sexual minority talked about the prejudice and discrimination toward sexual minorities. He showed a video about a high school student who had publicity revealed his sexual orientation. We analyzed the students’ reports by the qualitative data analysis method Step Coding and Theorization. The students’ descriptions were extracted, coded by contents, and then grouped into several categories.
Results: Many students were surprised at the percentage of persons belonging to a sexual minority. By watching the DVD they came to realize that homosexuals are just like other persons in most ways. They mentioned the need for correct knowledge about sexual minorities.
Conclusion: We believe that the educational session about sexual minorities is meaningful for and valued by medical students, and medical care for sexual minorities should be taught to medical students.

Since the publication of To Err is Human in 1999, medical schools around the worldhave been discussing ways to teach medical students about patient safety. To deepen the understanding of patient-safety curriculums used in the United States, Dr. Matthew Weinger, director of the San Diego Center for Patient Safety and a professor at the University of California, San Diego, School of Medicine (UCSD), was invited to participate in around-table discussion on “Patient Safety Curriculum for Medical Students” held at Yokohama City University. Althoughthere have been active discussions in journals and within medical school faculties, no discernable consensus has emerged in the United States, other than that patient safety should become part of the educational system. The patient-safety curriculum used at UCSD and the curriculums promoted by the Department of Veterans' Affairs National Center for Patient Safety are introduced.

In autumn 2005, a 15-hour patient-safety education program was incorporated into the core curriculum for fourth-year medical students at the Yokohama City University School of Medicine. Sixty students took part in the program. The goals of the curriculum are for students to understand the prevalence and origins of medical errors and to increase awareness of the physician's responsibility for patient safety. Because typical learning methods, such as didactic lectures, might not be effective, we developed an experimental or case-based learning method. Educational modalities included small-group discussion of medical errors, role-playing of medical error disclosure, and experience operating infusion pumps. In addition, to bridge the gap between educational systems and hospital systems, we collaborated with other healthcare workers, such as nurses and hospital pharmacists. Students evaluated the program favorably; most recommended continuing the curriculum for future medical student classes.