We examined appropriate group size and related factors in a small-group learning system conducted in a single department with sociomedical themes. The students were randomly divided into 4-and 6-person groups, and results of evaluations of the students and teaching staff were compared. The results suggest that the smaller the group, the more committed the students are to studying. Furthermore, teaching staff should participate in group discussion to deal with inactive students or to improve group dynamics.

One hundred fifty-three activity reports, which were published by departments or divisions of social medicine in Japan from 1991 through 1998 were reviewed to examine how medical ethics and related themes were taught. We examined how many departments and divisions taught medical ethics and related themes each year, and teaching methods were examined in reports from 1998. The number of departments and divisions teaching medical ethics and related themes gradually increased. Instruction in medical ethics was conducted for medical students in the 3rd through 5th years for periods of 3 to 12 months. All instruction employed small-group learning. Most groups learned actively, by conducting such activities as field surveys outside the school.

Many medical students seem to be more interested in clinical medicine topics than in social medicine topics. Through a problem-based, small-group learning course, we examined whether students' degrees of interest differ between topics and change during learning. At the start of the course, students were more interested in clinical/practical medicine topics than in industrial/environmental health topics. However, after the course their degrees of interest in both types of topic had increased and showed no significant difference. In particular, the degree of interest in sociomedical topics increased. In problem-based learning, knowing students' interests in learning about topics helps improve teaching strategies.

To train students to study voluntarily, we introduced “voluntary learning” to both 3rd-and 4th-year medical students. Students were divided into small groups of 7 to 9. Each group independently studied a theme, including its sociomedical aspects. According to a self-administered questionnaire survey, most students approved of the learning program, although the themes and grouping of students affected their satisfaction with voluntary learning. Oral presentation of study results seemed to be useful for clarifying the contents of learning. However, oral presentation and communication skills still need improvement. Teaching skills might also be improved. Voluntary learning in small groups would be an effective method for teaching behaviors necessary for active education.

Introduction: No formal curriculum has been formulated for teaching behavioral science to undergraduate medical students in Japan.
Method: We conducted a survey using the Delphi method to investigate the required competency in behavioral science for graduates in medicine. Then, we developed an outcome-oriented curriculum for teaching behavioral science.
Results: We propose an educational module of behavioral science consisting of 15 sessions of 90-minute lectures, small group discussions, and practice.
Discussion: We recommend including not only lectures but also practices according to problem-based learning as well as team-based learning in the curriculum to achieve the target outcome.

Objective: To study the improvement of the mental health of Japanese male registered nurses, we investigated the predictors associated with the Japanese version of the 12-item General Health Questionnaire (GHQ-12). For those predictors, we focused on environments with many female registered nurses and female patients’ refusal to accept nursing services from male registered nurses.Materials and Methods: This study was conducted in 93 hospitals in the Aichi, Gifu, and Mie prefectures of Japan. The analyzed subjects were 1,216 full-time male registered nurses. The average age (standard deviation) was 34.5 (9.2) years. Multiple logistic regression analysis was conducted. A GHQ-12 score of ≤3 indicated good mental health, and a score of ≥4 indicated poor mental health. “Mental health” was a dependent variable. The independent variables were: “Age”, “Male registered nurses as important partners on the job”, “Female registered nurses’ good manners toward male registered nurses”, “Fairness regarding male registered nurses’ promotions”, and “Female patients’ refusal to accept nursing services from male registered nurses”.Results: There were 728 (59.9%) full-time male registered nurses with good mental health and 488 (40.1%) with poor mental health. The mental health of the male registered nurses who had negative feelings regarding, “Male registered nurses as important partners on the job” was significantly worse, and that of those who had negative feelings regarding, “Female registered nurses’ good manners toward male registered nurses” was also significantly worse.Conclusion: Female registered nurses must recognize that their attitudes toward male registered nurses influence the mental health of male registered nurses. Hospital managers should provide male registered nurses who cannot establish appropriate relations with female registered nurses with consultation opportunities. Such organizational action by managers is necessary.

Objective: To establish work environments that prevent Japanese nursing assistants from leaving their jobs, we investigated the associations between their job satisfaction levels and intentions to remain on their jobs.Materials and Methods: We distributed anonymous self-administered questionnaires to Japanese female nursing assistants in 30 different hospitals. Regarding job satisfaction, we investigated various items relevant to both intrinsic facets (e.g., gaining various experiences) and extrinsic facets (e.g., salary), and conducted factor analyses of those items. Standardized partial regression coefficients were then calculated using multiple regression analyses. Intention to remain on the job was the dependent variable for this study. The factor scores calculated by the factor analyses of job satisfaction and respondents’ characteristics were the independent variables. Since multicollinearity occurred, we utilized two types of statistical models. After questionnaires with one or more missing values were excluded, 618 questionnaires were analyzed.Results: Using factor analyses, we discovered six factors related to job satisfaction among nursing assistants: “Intrinsic motivation”, “Salary”, “Relationships among nursing assistants”, “Registered nurses’ attitudes”, “Fatigue reduction”, and “Opportunities for vocational skills”. In statistical model 1, “Intrinsic motivation”, “Salary”, “Fatigue reduction”, “Age”, “Employment status”, and “Certified care worker status” were significantly associated with “Intention to remain on the job”. In statistical model 2, “Salary”, “Registered nurses’ attitudes”, “Fatigue reduction”, “Opportunities for vocational skills”, “Age”, and “Employment status” were significantly associated with “Intention to remain on the job”.Conclusion: “Intrinsic motivation” and “Opportunities for vocational skills” are included in intrinsic facets. To prevent nursing assistants from leaving their jobs, raising only their extrinsic job satisfaction levels is insufficient. Because nursing assistants have not received formal nursing education, they cannot take pride in having the same skills and expertise as registered nurses. However, hospital managers must respect their feelings and establish an appropriate working environment.