There are some issues concerning the domains of “attitude” and “habit” which are indispensable for medical students, such as motivation for problem-based learning and acquiring skills for smooth communication with medical staff and patients. In addition, some well-known limitations exist in medical education in these domains. Kochi Medical School has introduced an admissions-office (attitude-evaluation) system for enrollment selection to assess the abilities that applicants have acquired through experiences since birth. Although this system has a very short history, a follow-up survey 1 year after admission strongly suggests that this type of entrance examination system based on attitude evaluation is effective.

The abundant computer-based materials for medical education developed in Europe and North America have found limited use in Japan. To remedy this situation, the usefulness of such educational materials for Japanese students should be clearly presented, because issues of language and cost are involved. For detailed evaluation of educational material, collaboration with the developing institution is necessary. Kochi Medical School participated in an international collaborative study proposed by the University of British Columbia to evaluate computer-based educational materials. The study evaluated computer-based educational materials for clinical-skills training (CyberPatient) developed at the University of British Columbia. Fourteen medical educational institutions from six countries participated in the study. Kochi Medical School's portion of the study was successfully performed in December 2001. However, we found four problems related to this collaborative study: dealing with foreign languages in educational materials, establishing rapid communication, flexibly coping with sudden changes in study design, and guaranteeing the coherence of the study design among collaborating institutions.

Computer-based testing (CBT) has been used in Japan since 2002 to assess medical students' basic and clinical medical knowledge, based on the model core-curriculum, before they start clinical clerkships. For effective CBT, multiplechoice questions must accurately assess the knowledge of students. Questions for CBT are submitted by all medical schools in Japan. However, only 40% of questions are chosen for CBT and used at random; the other 60% of questions are rejected because of poor quality. Toimprove the ability of medical staff to devise questions, workshops were held at 30 medical schools. The acceptance rate of questions from schools where workshops were held was significantly increased. The workshops were extremely effbctive for improving the quality of questions.