In Japan, awareness has increased in recent years of the importance of evaluating clinical educators. In Europe and North America, the Objective Structured Teaching Evaluation (OSTE), which employs standardized students, multiple stations, video recording, and scoring by multiple observers, is used to evaluate clinical educators. We report on the implementation of an OSTE in Japan.1) Ten clinician-educator physicians participated in the OSTE, which comprised 5 stations and included standardized residents. The stations were video-recorded, and the educators were assessed by 7 different evaluators.2) The educators were evaluated with a checklist and a 5-point scale. We assessed the reliability and validity of the checklist and analyzed the background characteristics of the clinician educators.3) The factors most closely associated with high ratings on the checklist and the 5-point scale were: having a history of attendance at a seminar for clinician-educators, having greater than 5 years experience as an educator, and not being an internist. There was no interobserver variability among the evaluators.4) The generalizability of the checklist was 0.81, and its reliability index was 0.83. The correlation coefficient between the total scale score and the checklist score was 0.8. 5) Although biases by participants were identified, our project suggests that the OSTE could be used in Japan to objectively evaluate the teaching skills of clinician-educators. Further research on the OSTE in Japan is warranted.

Introduction : We initiated an ambulatory care training program at five community hospitals in Nagasaki, including hospitals on remote islands, for the residents of Nagasaki University Hospital. We examined the educational effect of the ambulatory care training program in meeting the achievement targets for clinical training.
Methods : The study included all residents (n=49) working in Nagasaki University Hospital in 2012. Following completion of the ambulatory care training program, the residents answered a questionnaire on the number of patients and their symptoms, inaddition to a self-assessment, and assessment by their supervisor.
Results : The mean number of patients seen was 3.29 persons / training session. The number of symptoms to be encountered, which are established by Ministry of Health, Labour and Welfare, was positively correlated with the total number of patients seen. Although residents initially had a low rating of self-assessment on diagnosis or treatment, this rating tended to increase with time. The gap in levels on assessment of history taking, diagnosis, or treatment by residents versus those by the supervisors reduced with time in the program.
Conclusion : Our ambulatory care training program is an effective program for meeting the achievement targets in clinical training for residents.

The physiological functions of expiratory isoprene, which is abundantly contained in human breath, are not well known. Recently, breath isoprene has been proposed to be related to oxidative stress, although no direct evidence has been reported. Therefore, the purpose of this study was to investigate the relationship between breath isoprene and oxidative stress status. Ten healthy male subjects performed a 20-min submaximal step-load cycling exercise, the intensity of which corresponded to a 60% peak oxygen uptake after a 10-min rest. Breath isoprene excretion during the exercise was calculated from the product of minute ventilation and isoprene expiratory concentration. To evaluate the oxidative stress, we collected blood samples from the subject’s fingertips before and immediately after the end of the exercise, and then diacron reactive oxygen metabolites (d-ROMs), which is an index of oxidative stress level, and biological antioxidant potential (BAP), which is an index of antioxidant potential, were measured. The breath isoprene concentration at the rest was significantly positively correlated with the ratio from BAP to d-ROMs (BAP/d-ROMs), which is an index of latent antioxidant potential (r = 0.63, P < 0.05). Furthermore, the change in breath isoprene excretion from before to after the exercise was significantly negatively correlated with the change in d-ROMs (r = -0.73, P < 0.05) and positively correlated with the change in BAP/d-ROMs (r = 0.88, P < 0.01). These results suggest that isoprene might play a role in the control of oxidative stress.