OBJECTIVE: To demonstrate the feasibility of webinars, web-based real time interactive seminars, for geographically distant medical students and their tutors.
METHODS: Six participants from 5 medical schools in Japan were self-selected 3rd to 6th year medical students. A North American medical educator served as their webinar tutor. The students and tutor used home computers to participate in the webinar.
RESULTS AND CONCLUSIONS: A total of twelve webinars were held, 4 with a tutor and 8 without the tutor. Unstructured tutoring formats included symptom-related differential diagnoses, role-play and patient case discussions. We suggest webinar is a feasible technology to supplement the clinical training of medical students at medical universities.

OBJECTIVE: To demonstrate the feasibility of webinars, web-based real time interactive seminars, for geographically distant medical students and their tutors.
METHODS: Six participants from 5 medical schools in Japan were self-selected 3rd to 6th year medical students. A North American medical educator served as their webinar tutor. The students and tutor used home computers to participate in the webinar.
RESULTS AND CONCLUSIONS: A total of twelve webinars were held, 4 with a tutor and 8 without the tutor. Unstructured tutoring formats included symptom-related differential diagnoses, role-play and patient case discussions. We suggest webinar is a feasible technology to supplement the clinical training of medical students at medical universities.

Background: Japanese medical student education lacks emphasis on teaching clinical reasoning skills. To partially remedy this situation, we developed a prototypic web-based module for tutors to teach clinical reasoning. We report the medical students’ opinions of this module.
Methods: Twenty-four students from two Japanese medical universities were randomly assigned to the two tutored virtual classrooms, each classroom with six students, or to the self-study group, 12 students, after taking the Internet-based Sequential Question and Answer pretest. After four weeks, each of the 24 students took the Sequential Question and Answer posttest. The entire 24 students answered a questionnaire about the Sequential Question and Answer tests; all 12 tutored students answered a questionnaire about the web-based tutored module.
Results: Although both tutored and self-study Sequential Question and Answer posttest scores increased, the increases of the tutored group’s posttest compared to the self-study posttest group were not statistically significant (p = 0.066). Ninety-two percent of the students rated the Sequential Question and Answer tests as an improved way to learn case presentation and clinical reasoning. Moreover, 79% of students felt that the Sequential Question and Answer tests were an effective way to learn clinical information. The tutored students rated the web-based tutored seminars as an ‘excellent to fair’ method to learn clinical reasoning using a five-point ‘excellent to poor’ scale.
Conclusions: We developed a prototypic web-based module for tutors to teach clinical reasoning to medical students. The students’ opinion supported the modular components of the web-based seminar format, Sequential Question and Answer test, and the tutoring syllabus as an effective way to improve learning clinical reasoning, case presentation, and medical information. Students also suggested refinements of the prototypic module.

Background: At present clinical reasoning skills are not systematically taught in Japanese medical universities. We developed a prototypic preliminary module for clinical tutors to introduce clinical reasoning to Japanese medical students. We hypothesized that tutored medical students would outperform self-study students.
Method: Using the web-based Sequential Question and Answer test that rewarded history and differential diagnosis as proxies for clinical reasoning, we compared the pre and posttest scores of 12 randomized fifth grade tutored students at two universities during four tutor-led 1.5-hour web-based seminars using a structured syllabus to 12 randomized self-study students.
Results: The tutored and self-study groups’ pretest scores were statistically similar at about 40 out of 100 weighted correct points. The tutored students’ posttest scores were 62 points, significantly greater (p = 0.007) than the pretest mean 42 points, compared to the self-study students’ posttest scores of 52 points, significantly greater (p = 0.012) than pretest mean 40 points. The difference between the two posttest groups was of borderline statistical significance (p = 0.08).
Conclusions: We successfully assessed a prototypic module for tutors to introduce clinical reasoning to Japanese medical students. The tutored students achieved higher scores than the self-study students. Further research is needed to exploit the potential of our modular clinical reasoning system.