Aim: We investigated what medical students learned on the clinical clerkship in our hospice and how their images of hospice care were changed, with self-reported questionnaires. Methods: Descriptions given in the contents were analyzed using a content analysis method based on Berelson’s methodology. A total of 20 students who participated in the program responded. Results: From their responses, 212 descriptions were extracted and 59 codes elicited. The codes were inductively classified and categorized based on content similarities. Eleven categories were generated: “care for quality of life of patients and families,” “characteristics and effects of palliative care” “practical approaches to end-of-life medicine,” “hospices’ positions in the healthcare system” “development of trust-based relationships with patients and their families,” “cooperation among healthcare professionals,” “appropriate attitudes toward patients and their families,” “being with patients when they pass away,” “opinions of patients and their families,” “characteristics and threats of cancer,” and “mental health for healthcare workers.”The students were found to have acquired a more positive image of hospices. Conclusion: They reported gaining valuable experience from the direct encounters with patients and their family, and that they had acquired behavior appropriate for physicians, as well as knowledge and skills about the basic palliative care.

  A look at the reports of accidents or near accidents in our hospital revealed that the incidence of falls or stumbles in children was at the top of the list in frequency. In the past five years, our pediatric ward has experienced an average of about 10 such cases annually. Regarding the risk of falling, advice is given by nurses to parents during the orientation session when their babies and little children are hospitalized. However,the advice was entirely subjective - not going by any rule or guidelines. Recently, an assessment score sheet for the risk factors for falling and a preventive measure against falls was drafted and trial used, with the result that changes were observed in the way the nurses in their 20s watch and take care of the little patients. Moreover, they became able to look after the infants according to their age, developmental stage and disposition. The use of the common pamphlet helped the young nurses gain selfconfidence even though they are inexperienced in child-rearing and nursing.  From these results, we concluded that the uniform guideline and order of priority led to the improvement of the quality of nursing in the nurses in their 20s.

Background: There is increasing demand for clinical clerkships in palliative medicine, though conventional medical education has focused only on providing students with sufficient medical knowledge and skills. In Japan, there is no standard program for palliative medicine in undergraduate medical education. Our hospice, in cooperation with a clinical clerkship for palliative medicine launched by Tokyo Medical and Dental University, has developed its own comprehensive bedside learning curriculum. Aim: This study aimed to evaluate the efficacy of the program. Methods: The curriculum involves not only experience in hospice care, ward rounds, and interviews with terminally ill patients, it also provides each medical student with educational sessions moderated by certified hospice nurses and pharmacists. We conducted a self-administered five-point scale questionnaire (with a higher score indicating higher satisfaction) to assess students’ satisfaction and understanding of the program. We also conducted a questionnaire on basic palliative medicine knowledge before and after the program. Results: Twenty students took part in the program. Ratios of scores of 4 or 5 for satisfaction and understanding of the program were 100% and 95%, respectively. Mean rates of correct answers on the pre-program and post-program test were 51% and 85%, respectively; showing a marked increase and emphasizing the educational significance of our curriculum. Students evidently benefit from the experience of bedside learning, and 95% reported having recommended the program to their juniors. Conclusion: These outcomes suggest the program is effective toward developing a standard education program in palliative medicine.

To limit the spread of coronavirus disease 2019 (COVID-19), restrictions on visitation were implemented in palliative care units (PCUs) during the pandemic, requiring inpatients and their families to be separated. In July 2023, Saiseikai Utsunomiya Hospital lifted the restrictions on visiting in the PCU after implementing thorough infection control measures. During the study period (May 8, 2023 to September 17, 2023), 80 patients were admitted to the PCU, no COVID-19 cases were reported, and no visitors reported becoming infected after visitation. The average number of visitors per day during the first 2 months after restrictions were lifted was 23, with a median stay of 83 minutes per visit. The percentage of visitors who were relatives of inpatients was 89% after restrictions were lifted. The average bed utilization rate was 45% during the 2 months before the decision to lift the restrictions, and was 76% during the 2 months after restrictions were lifted, recovering to the pre-pandemic level. These results demonstrate that visiting restrictions in PCUs can be lifted without increasing the incidence of COVID-19 if thorough infection control measures are taken.