To evaluate clinical courses at teaching hospitals outside of Osaka City University Hospital, we used a questionnaire to ask instructors and sixth-year students about practical problems immediately after the end of the semester. This course was conducted for 7 weeks during the first semester at 24 hospitals and for 5 weeks during the second semester at 23 hospitals. In each semester about 40% of clinical practice at teaching hospitals was done in the style of clinical clerkships. About 90% of students were mostly or completely satisfied with their instructors and hospitals. Furthermore, about 70% of instructors felt more or less fulfilled by working with students and about 60% of them felt working with students was rewarding. More than 95% of instructors would be willing to teach medical students again. In conclusion, most instructors and students felt that clinical courses at teaching hospitals outside of Osaka City University Hospital were conducted without problems.

A program for early-exposure of first-year medical students to nursing and patient care was started at Osaka City University in 1994. Eighty students completed the program in the 2002 academic year. To improve methods of teaching and evaluation, we analyzed the responses of students and nursing instructors to questionnaires about satisfaction with the program after each practice session. Students were randomized to four settings (university hospital, general hospital, general emergency hospital, and general geriatric hospital). Responses of students and instructors did not differ between settings suggest that early exposure was uniform. Medical students gave higher scores for interest in and significance of early exposure, although nursing instructors did not. The success of the program of early exposure of medical students to nursing care will be used to further improve the curriculum.

Purpose: We report a case whose anal pain accompanied by rectal cancer was remarkably eliminated by subarachnoid phenol block and sacral nerve root thermocoagulation. Case Report: The subject was a sixty-one-year old male. His anal pain failed to respond to opioid whereas his pain was alleviated by subarachnoid phenol block, but was exacerbated a few weeks later. This relapsing pain was completely eradicated by sacral nerve root thermocoagulation. Conclusion: Anal pain associated with rectal cancer recurrence of pelvic space is sometimes hard to be controlled only by subarachnoid phenol block, but there is a possibility of pain control by combination use with sacral nerve root thermocoagulation. Palliat Care Res 2010; 5(2): 314-316