1) We have developed two forms to evaluate students' oral presentation skills (important but hard to teach in the medical school curriculum): one is a peer review form for an audience to evaluate a presenter's performance, and the other is a form for a presenter to evaluate his or her own performance.2) The evaluation process is simple: evaluators fill out the forms by checking the items for evaluation. With these evaluation forms students can get tips for improving their presentations because technical suggestions are written near each item.3) The forms were beneficial for both students and instructors, because students could get tips for improving their presentations, and instructors could concentrate their efforts on scientific content after the students' presentations.

Gifu University School of Medicine has introduced a new learning method for medical science, named tutorial system. To assess the efficacy of the method, we conducted a questionnaire survey of students' medical knowledge, attitudes to learning, communication ability, and social behavior. The questionnaire was given to instructors/attending physicians involved in clinical education. Results of the evaluation were compared to those of previous medical students. Our results suggest that the tutorial system in our medical school result in an improvement over the previous curricula.

Three new genes of Cryptosporidium parvum were cloned, including a gene encoding methionine aminopeptidase, one encoding chaperonin containing T-complex protein 1 delta (TCP-1 delta) and one with unknown function. DNA sequence analysis indicated that these genes are quite conserved, but there were some base pair differences between genotype I and genotype II isolates. These differences were confirmed by PCR-restriction fragment length polymorphism (PCR-RFLP) analysis of the 3 genes from 41 isolates collected from different hosts and geographical origins. In brief, the band patterns generated by endonuclease Hind III or Hinf I restrictions of the gene of methionine aminopeptidase, Sac I restriction of the gene of chaperonin, or Ava II restriction of the unknown gene could differentiate the isolates of C. parvum into genotype I and genotype II. PCR primers based on these genes amplified only C. parvum genes. Even a single oocyst was detectable with these PCR primers. Thus the results provided further evidence that genotype I and genotype II are distinct, and our three new primers can be used to detect and characterize C. parvum isolates with high sensitivity.

Medical students in Japan often want to do clinical rotations abroad. Preparation for these important clinical experiences is essential to maximize the learning opportunities. Language ability is only one small part of assuring success.1) It is important to consider the hospital where the rotation will take place, the specific rotation, the living arrangements and commuting to the hospital. Preparation before the rotation should include practice in performing and writing a complete patient history and physical examination.2) It is very helpful to have a cell phone while abroad, as well as a credit card. Students must bring a white coat, and it is recommended that they also bring a Japanese textbook in the field they will study.3) While on a clinical rotation, students must be active participants in patient care and in discussions. They must be aggressive about answering questions during ward rounds. Students must be aware of many cultural differences to have good relationships with patients and colleagues.

The author emphasizes the importance of liberal arts education in the medical school curriculum to prepare for the coming AI era when the medical practice undergoes drastic changes. The implementation of AI results in the gift of time and the gift of labor in medicine, which we can use to create time for liberal art education. New graduate doctors should be skillful in their current medical practice and flexible to coming changes. They should also contribute to public opinion about medicine.

We propose a new video system with four cameras aimed in different directions for use in objective structured clinical examinations (OSCEs) to 1) minimize the examiner's burden and 2) standardize the examiner's evaluation. The system consists of four charge-coupled device video cameras, several microphones, and a video tape recorder. The OSCE of each student was recorded with four cameras simultaneously aimed in different directions so that the student's performance could be viewed and evaluated at the examiner's convenience. Two trials for this system were undertaken at different times. More than 80% of those participating in the trials thought that this system was useful for examining the basic skills of medical students as part of the OSCE, and more than 70% thought that the system would increase educational efficacy. This system may improve the reliability and efficiency of OSCE.

To assess the effectiveness of a problem-based learning tutorial system introduced at Gifu University School of Medicine in 1995, we conducted a questionnaire survey of medical knowledge, attitudes about learning, communication ability, and social behavior in sixth-year medical students. The questionnaire was given to instructors and attending physicians at community hospitals who were involved in clinical education. Many of the evaluators felt that students who trained with the tutorial system showed improved understanding, a more active attitude toward learning, and a better attitude toward patients than did students who received traditional, lecture-based education.

The Common Achievement Tests Organization performed the first nationwide trial of computer-based testing (CBT) used to assess students entering the clinical phase of medical education. Seventy-seven medical schools participated in the trial. We compared performance on the national CBT with performance on preclinical tests administered at Gifu University School of Medicine. Despite some methodologic differences between the national CBT and our system, the overall results correlated well. Students who did poorly on the national CBT also did poorly on Gifu University's preclinical test. Correlation of these two performance scales suggests that nationwide CBT could be used to accurately assess preclinical skills.

Medical recording is an important learning issue for the clerkship curriculum. Privacy laws require that medical students' access to patient information be managed by faculty members. The Workshop of Medical Education was convened at the Medical Education Development Center, Gifu University, in October 2004 to discuss the management of electronic medical recording systems for clinical clerkships. The purpose of this article is to propose management guidelines and rules for electronic medical recording systems for clinical clerkships in Japan.

A 22-year-old woman had been treated with a Ross operation for aortic root aneurysm and aortic regurgitation 10 years previously. In the initial Ross operation, a handmade tri-leaflet conduit was used for the right ventricle outflow tract (RVOT) reconstruction. The conduit was prepared preoperatively, by sewing a folded 0.1 mm expanded polytetrafluoroethylene (ePTFE) membrane onto the luminal cavity of the 24 mm woven double velour vascular graft, thereby creating a tri-leaflet valve. During ambulatory follow up after discharge, dilation of the pulmonary autograft had been observed, and its maximal diameter reached 60 mm. Furthermore, preoperative a pressure study revealed a 25 mmHg pressure gradient between the right ventricle and the pulmonary artery. At the time of reoperation, we performed an aortic root replacement combined with RVOT conduit replacement. A 24-mm woven double velour vascular graft integrating a 21-mm On-X mechanical prosthesis was used for aortic root replacement. A handmade ePTFE tri-leaflet conduit, 26 mm in size, was used to replace the previous RVOT conduit. The operation was successful, and the postoperative course was uneventful. The explanted conduit was sent for microscopic examination, which revealed that the graft was covered by a fibrocollagenous membrane. On the contrary, no surface membrane was found on the ePTFE valve. Moreover the microscopic examination showed cystic medionecrosis of the pulmonary autograft. Both dilatation of the pulmonary autograft and RVOT conduit failure were successfully treated at the second operation. However this young patient will require follow-up of the mechanical prosthesis and RVOT conduit for the rest of her life.