Faculty development （FD） programs have been held all over Japan since the change to the postgraduate clinical training system in 2004. The programs, however, have not been well evaluated in Japan. The objective of our study was to elucidate the effectiveness of 2-day FD workshops at the University of the Ryukyus. We conducted a survey and test about clinical education involving 172 physicians of the University of the Ryukyus from October 2006 to March 2007. Of the total, 42 of them had participated in our FD workshop between 2003 and 2006, and 130 of them had not participated in it. The average follow-up period of the participant group was 24 months after workshops. The participant group （n＝42） had more knowledge of curriculum design and development, giving feedback, and educational techniques than the non-participants （n＝130）. The participant group also had a more enthusiastic attitude than the nonparticipants.
　Our study suggests that the 2-day FD workshops at the University of the Ryukyus could be effective for nurturing knowledge and attitudes toward clinical education, but may have a limited effect on changes in practice and networking among physician instructors.

Although several cases of a dumbbell tumor of thoracic nerve roots have been reported, reports on the surgical procedures for a dumbbell tumor of the first thoracic (T1) nerve root are rare. Surgeons should be cautious, especially when performing a surgical procedure for a dumbbell tumor of the T1 nerve root because the tumor is anatomically located adjacent to important organs and because the T1 nerve root composes the lower trunk of the brachial plexus with the eighth cervical nerve root. We present cases with dumbbell tumors of the T1 nerve root that were treated with combined surgical treatment to remove the tumor. We first performed video-assisted thoracic surgery (VATS) to release the organs anteriorly and then performed posterior spinal surgery in the prone position. The combined VATS and posterior spinal surgery may become a standard surgical procedure for the treatment of dumbbell tumors of the T1 nerve root.
Brachial Plexus ; Prone Position ; Spinal Cord Neoplasms ; Surgical Procedures, Minimally Invasive ; Thoracic Nerves* ; Thoracic Surgery, Video-Assisted*

The Hawaii-Okinawa Medical Education Fellowship is a longitudinal FD program developed and administered by the John A. Burns School of Medicine at the University of Hawaii and Okinawa Prefecture to train young clinical teachers who will play a central role in residency education. The program also supports the building of networks among clinical teachers. Each year, around six participants learn the skills required of clinical teachers through monthly seminar participation and a year-round curriculum development project. To date, about 60 physicians have completed the fellowship, and many of them are active as clinical teachers at medical institutions in Okinawa. The community of practice consisting of the graduates of this fellowship is gradually expanding. It is expected to contribute more and more to the enhancement of clinical education in Okinawa.