We compared the effects on clinical clerkships of an electronic medical record (EMR) system and a standard medical record system. Using an EMR system, students described medical records with a problem-oriented medical record system/subject objective assessment, and plan that was much better than the standard medical record system. In the EMR system, students cannot see physicians' medical records, including laboratory data and X-ray films. Instead, students themselves must obtain the patient history and request examinations as physicians do. This system helps supervisors give suitable comments and provide data that students have requested. Directors can also evaluate supervisors by reviewing their comments. Therefore, an EMR system has the advantage of problem-oriented medical record system-based learning for students and is also useful for clinical clerkships.

Since the model core curriculum was shown in public, the discussion about the medical education is getting hot in every medical school. In the model core curriculum, the integrated course is designed with the basic sciences and the clinical medicine via pathophysiology, which will be educated by the PBL tutorial. Thus, the model core curriculum is suitable for growing up better clinician. The problem involved in the context is the lower recognition to the basic sciences and also the missing of the next generation in the teaching staff of the basic sciences. The introduction of the information technology to the medical education should be much progressive. The new integrated course with the structure and function should be designed with the information technology, which will fit to the new medical education in the 21st century.

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.

To seek longitudinal changes in metacognitive processes through problem-based learning (PBL), we analysed the contents of all comments written reflectively by the third-year students after they finished discussions in each PBL session. After dividing their comments into meaningful units, we focused on two major thematic categories and five sub-categories to be analysed.
1) The number of units decreased significantly (chi-square: p=0.02).
2) Only the proportion of units categorised as “comprehension” in “individual learning” showed significant increase (Bonferroni: p<0.001).
3) Comments in this category stated that “I don't understand so-and-so.”
4) The increase of “comprehension” as they experienced more PBL suggested that students' knowledge of ignorance as metacognition was fostered through sessions in medical PBL.

Problem-based learning (PBL) tutorials were introduced at our university in April 2001. Because a complete PBLbased curriculum could not be adopted, a transitional curriculum incorporating 3-hour PBL tutorial sessions into the traditional curriculum was introduced. More than 80% of students agreed that PBL is an effective way of learning problem solving at the bedside. Twenty percent to 40% of teachers felt that students who took PBL were more motivated for bedside learning and self-directed learning and had better at presentation than were students who did not take PBL. Because of 80% of the curriculum comprised didactic lectures, most students considered PBL tutorials a type of lecture. For this reason, motivating students to learn additional material originating from PBL tutorials was difficult. Although the combination of a traditional curriculum and PBL tutorials may appear to be a new curriculum, this type of PBL has limited value as a method for studying problem solving.