Objective: Teachers of various departments are in charge of medical interview training classes with the participation of simulated patients. However, it is not clear whether there are differences in feedback (FB) among teachers. The objective was to examine differences in FB among teachers, investigate effective FB methods, and evaluate the effect of an FB manual.
Methods: We conducted a questionnaire survey of students to assess their evaluation of FB by teachers. In the meantime, we transcribed and analyzed teachers' FB on the basis of video recordings. We created a teacher's manual for FB on the basis of these results. We conducted a similar survey the following year.
Results: The evaluations from students included many positive opinions, such as "we heard from the teachers about their clinical experiences" . Analysis of the videos showed significant differences in the contents of FB among groups. The performance of the interview strongly influenced the content of the FB. Variations in each group tended to be reduced the following year.
Conclusions: 1) There were significant differences in FB among teachers. 2) FB that includes the clinical experiences of the teacher and discussion among students may enhance the learning effect. 3) Introduction of the manual increased the relevance of FB.

　It is necessary to perform out-patient training in order to acquire the basic medical skills of primary care. However, the actual situation of out-patient training has not been clarified in Japan. Therefore, we performed a survey of out-patient training by junior residents at university hospitals throughout Japan.

　A questionnaire survey was performed on out-patient training for junior residents at 80 university hospitals (main hospitals) nationwide. We received responses from 39 hospitals. The hospitals where out-patient training by junior residents was performed numbered 34, and there were 26 hospitals in which the training in out-patient reception hours is being performed. Hospitals which received training on related hospitals were also noted. There were many hospitals receiving a few patients with common symptoms. It is important to conduct training in university hospitals in cooperation with local hospitals.

In the core curriculum for Medical Education, “Ethics and bioethics of medicine” is listed under the heading of “professionalism” . Medical ethics covers research ethics and clinical ethics. Clinical ethics deals with dilemmas encountered in the clinical practice.　When educating students on the four principles of medical ethics (respect for autonomy, beneficence, justice and nonmaleficence), it seems that it is effective for them to learn through experiencing a clinical ethics conference. However, it is difficult for students to experience an actual conference. Tence the in class use of case examples which will be introduced here.　One drawback to this approach is that there are many cases where the ethical dilemma is not clear even when those cases are presented at a clinical ethics conference. It is important to “discover the problem” through conference discussions, and interactions that cultivate ethical sensitivity. This is also one of the major goals of education.

Case 1 was a 28-year-old female who had epigastric discomfort and epigastralgia for three months. These symptoms were accompanied with dizziness, faintness and hot flush. Right after taking ryokeijutsukanto, her dizziness, faintness and chillness of foot disappeared with improvement of gastrointestinal symptoms after two weeks. Case 2 was a 40-year-old female who presented prolonged nausea and epigastralgia for eight months. She also complained of dizziness and strong globus sensation when taking meals. After taking ryokeijutsukanto, her appetite improved in a week and gastrointestinal symptoms improved in 3 weeks. Case 3 was a 15-year-old female whose complaints were nausea, epigastric discomfort, palpitation, dizziness and globus sensation consequent to swaying feeling after riding a roller coaster. These symptoms including nausea improved after taking ryokeijutsukanto with 3g of magnolia bark for a week. Case 4 was a 28-year-old male who presented severe appetite loss and epigastric discomfort when he got tired. He also complained of faintness. His faintness disappeared after taking ryokeijutsukanto for 2 weeks. His appetite also improved after four weeks. Clinical courses of these cases suggest that ryokeijutsukanto may be useful for the treatment of upper gastrointestinal symptoms including functional dyspepsia, i.e. fluid retention with qi-counterflow.