The aim of this study was to compare the educational effects of previously developed case-report scenarios and newly developed narrative scenarios used in problem-based learning (PBL) at the Yamaguchi University School of Medicine.1) Students' reports submitted after they had completed PBL sessions were reevaluated, and the educational effects were compared statistically between the 2 scenario types.2) To reevaluate the students' reports, the learning effects expected of PBL classes, reported by university medical schools in North America, were used.3) The PBL using narrative scenarios was found to be more effective, particularly for the acquisition of clinical reasoning ability and comprehensive patient treatment.4) Our results show that the scenario is an important factor in PBL.

1) A possible reason that medical students do not complete problem-oriented medical records is a problem in putting information received from patient into a problem list.
2) We invented a clinical case and asked students to list problems from the case and to establish an initial plan for admission. The exercise was effective for teaching students to complete medical records.

A student's medical interview in an objective structured clinical examination (OSCE) may be assessed slightly differently by simulated patients and by the faculty. In this study, we compared three different scores given by the faculty or simulated patients in the assessment of OSCE medical interviews conducted at our department for 3 years. Scores compared were the total score and the behavior score given by the faculty and the score given by simulated patients. The total score and the behavior score given by the faculty correlated well with the score given by simulated patients. However, for students who received a poor assessment from simulated patients, the three scores were weakly correlated; in particular, the behavior score given by the faculty differed markedly from the score given by simulated patients. These results suggest that simulated patients have a different and important viewpoint on assessment of the medical interview in an OSCE.

BACKGROUND: Medical students need interviewing skills to be effective in dealing with patients. However, it is presumed that there are some problems in evaluating the competencies medical students are required to have for practicing medicine.
OBJECTIVE: During Objective Structured Clinical Examinations (OSCE) in Japan, instructors usually evaluate examinee's behavior and attitude toward doing medical interviews. To improve the objectivity of these examinations we examined the assessment of our OSCE medical interview.
METHODS: Medical interviews are usually evaluated using a rating list. The standardized list used in most medical schools is composed of two parts: one scores the student's behavior while conducting the interview and the other evaluates the student's ability to gather information from patients. For 5^thyear student OSCE medical interviews are performed twice, before and after ward rotation. The results of two OSCEs were analyzed in terms of scores on conducting an interview, collecting patient information, and SP, or simulated patient. Data analysis of the students' behavior and attitude were taken over 3 years, from 2000 to 2002.
RESULTS: Total scores and scores on conducting interviews, collecting information, and SP's evaluation all increased when comparisons were made between before and after ward rotation. However, only the differences in the total score and SPs score in 2000 were statistically significant. Moreover, clinical skills for collecting patients' information were found to be unsatisfactory.
CONCLUSIONS: As the standardized OSCE medical interviews are performed at all medical schools in Japan today, further improvements in education and in the evaluation system will be required in the future to ensure students obtain the skills expected of them for practicing medicine.

  Committee for Information Infrastructure in the 16th term of JSME Board Members was newly created to edit Medical Education White Book issued every four years and to provide sooner and more comprehensive information infrastructure provision. MEAL was opened as a website for medical education information since August 2011. MEAL consists of glossary, articles, books and more resources using a system like Wiki or Blog on the Web. By such technological progress, not only one–way information provision from JSME but also bidirectional communication between JSME members and committees／board members became available. Internationally, similar websites are known, such as MedEdPORTAL by AAMC （Association of American Medical Colleges）, and expected to be new scholarly information added to journals.

Fifth-year medical students at the Yamaguchi University School of Medicine must pass an objective structured clinical examination (OSCE) before beginning bedside learning. Because the OSCE is performed over 3 days, examinees on later days are suspected of having an advantage over those tested on early days. In this study, mean values for each day's scores by one examiner were statistically compared in stations of the medical interview to investigate the difference in scores obtained on each of the OSCE days. In addition, for stations at which one student was evaluated by two examiners, their scores for each student were compared statistically in the same manner. We found no significant day-todaydifferences in mean values of the scores over the 3 examination days. However, significant differences were found between the two examiners' scores in 2 of 3 stations for the medical interview. Although there were no differences in scores among participants during the 3-day communication OSCE, examiner's evaluations and formats should be standardized for OSCE stations.

A nationwide survey of Japanese teachers belonging to departments of medicine was conducted to investigate their opinions about: 1) expanding medical departments into medical schools and, 2) the required subjects and selection criteria for admitting students to the faculty of medicine. We found that responses to both questions depended largely on the specialty of the teachers. With regard to the medical school design, which will cause a dramatic change in medical education in Japan, 60% of the teachers were in favor of expanding departments into medical schools.

　The education program in all medical schools in Japan has been studied and analyzed every 2 years since 1974 by the curriculum committee of the Association of Japan Medical Colleges. Based on the most recent analysis in 2015, the marked innovation of medical education, such as an integrated curriculum, active learning, and clinical clerkship, was recognized.

It remains unclear how much rehabilitation training is suitable for stroke patients aged ≥ 75 years. To investigate this, especially in convalescent rehabilitation wards, we studied 65 patients (28, ≦ 74 years；37 ≧ 75 years) with cerebral infarction hospitalized in the acute care ward and then in a convalescent rehabilitation ward. From their medical records, we collected data regarding the length of their hospital stay, total amount of rehabilitation training, and activities of daily living evaluated using the total scores of the functional independent measure (FIM) measured on admission to the acute care and convalescent rehabilitation wards, respectively. From these data, we calculated the absolute functional gain, relative functional gain, and average amount of rehabilitation training per day. The correlation of each item and age was analyzed. Items that significantly correlated with age were compared between ≦ 74 and ≧ 75 years age groups. As a result, the absolute functional gain and average amount of rehabilitation training per day were not significantly different between groups. The relative functional gain was significantly lower in the ≧ 75 years group than in the ≦ 74 years group. The total FIM scores at discharge showed a positive correlation with the amount of rehabilitation training in patients aged ≧ 75 years. We believe that a large amount of rehabilitation training is beneficial for patients aged ≧ 75 years with cerebral infarction.

It remains unclear how much rehabilitation training is suitable for stroke patients aged ≥ 75 years. To investigate this, especially in convalescent rehabilitation wards, we studied 65 patients (28, ≦ 74 years；37 ≧ 75 years) with cerebral infarction hospitalized in the acute care ward and then in a convalescent rehabilitation ward. From their medical records, we collected data regarding the length of their hospital stay, total amount of rehabilitation training, and activities of daily living evaluated using the total scores of the functional independent measure (FIM) measured on admission to the acute care and convalescent rehabilitation wards, respectively. From these data, we calculated the absolute functional gain, relative functional gain, and average amount of rehabilitation training per day. The correlation of each item and age was analyzed. Items that significantly correlated with age were compared between ≦ 74 and ≧ 75 years age groups. As a result, the absolute functional gain and average amount of rehabilitation training per day were not significantly different between groups. The relative functional gain was significantly lower in the ≧ 75 years group than in the ≦ 74 years group. The total FIM scores at discharge showed a positive correlation with the amount of rehabilitation training in patients aged ≧ 75 years. We believe that a large amount of rehabilitation training is beneficial for patients aged ≧ 75 years with cerebral infarction.