1) I observed the educational and faculty development systems at the Case Western Reserve University Schoolof Medicine for three weeks.
2) Emphasis to develop, communication skills was acknowledged. Effective and personalized curriculum with skillful simulated patients, video recording system, and trained preceptor, was practiced.
3) Extensive discussions were practiced toward a major curricular renovation in 2007. Highly motivated basic and clinical teachers, as well as students were contributing the project.
4) Medical students in the US may take an advantage of computer literacy and abundant web-based resources which areprovided in English.

OBJECTIVEIn this study, we used an intervention approach to examine the effects of physical exercise on elderly people living at home in a rural area.

METHODSTwo regions in a village were randomly assigned as the control and intervention regions. The subjects were 60 years of age or older and were able to carry out their activities of daily living independently. The numbers of subjects were 56 and 81 for the control and intervention regions, respectively. In the control region, lectures on health were provided twice. In the intervention region, instructions on ten types of physical exercise were provided six times during this three-month study. In addition, the subjects in the intervention region were instructed to do, exercises by themselves at home three days per week. The effects were compared by evaluating motor functions in maximum step length, 10-m full-power walking parameters, right knee extension torque, right hip flexion torque, and stepping time on a 40-cm staircase; data were obtained before and after the intervention.

RESULTSAnalysis of covariance (ANCOVA) showed significant improvements in right maximum step length, the mean of the right and left maximum step lengths, and right hip flexion torque in the intervention region.

CONCLUSIONThe three-month physical exercise program improves the motor functions of the elderly.