Objective  Everyone has the right to obtain information through understandable language. Nevertheless, it has been pointed out that in Japan, a language barrier prevents it. Plain Japanese (easy Japanese) has been proposed as a solution. Plain Japanese is a language form simplified to be suitable for non-native Japanese peoples’ Japanese abilities. However, there are limited studies on healthcare professionals’ use of plain Japanese. The objectives of this study were to examine changes, moreover associations between knowledge and rephrasing skills among nursing students.Method  Eighty nursing students were subjected to this study. We conducted a lesson on “plain Japanese”. Data were collected before and after the lesson using questionnaires. We compared the number of knowledge items and rephrasing scores before and after the lesson. After the lesson, we also compared the number of knowledge items between the high rephrasing score group and the low rephrasing score group. We compared perceptions about communication with non-native Japanese people before and after the lesson.Results  Seventy-two nursing students participated in this study. There was a significant difference in the number of knowledge items before and after the lessons（from 2 to 8) (p<0.05). Rephrasing skills scores were increased as well (from 3 to 4) (p<0.05). The positive answers about “plain Japanese” increased after the lesson. However, the median number of knowledge items among the high rephrasing score group was 10 and the median number among the low rephrasing score group was 8 after the lesson. There was no significant difference between the two groups (p>0.05). Conclusions  Overall, both the number of knowledge items and rephrasing skills scores were increased. However, it is unknown whether the increase in rephrasing skills were improved based on increased knowledge. Students will more specific knowledge and repetitive practice to improve skills in using plain Japanese.

The abundant computer-based materials for medical education developed in Europe and North America have found limited use in Japan. To remedy this situation, the usefulness of such educational materials for Japanese students should be clearly presented, because issues of language and cost are involved. For detailed evaluation of educational material, collaboration with the developing institution is necessary. Kochi Medical School participated in an international collaborative study proposed by the University of British Columbia to evaluate computer-based educational materials. The study evaluated computer-based educational materials for clinical-skills training (CyberPatient) developed at the University of British Columbia. Fourteen medical educational institutions from six countries participated in the study. Kochi Medical School's portion of the study was successfully performed in December 2001. However, we found four problems related to this collaborative study: dealing with foreign languages in educational materials, establishing rapid communication, flexibly coping with sudden changes in study design, and guaranteeing the coherence of the study design among collaborating institutions.

Introduction  It has been pointed out that in Japan the language barrier prevents non-native Japanese speakers from accessing medical services and health information. “Yasashii Nihongo” is considered as a way to overcome this barrier. This is not the language native speakers use but a version adjusted to suit the audience’s Japanese ability. This study aimed to describe nursing students’ skills in rewriting Japanese medical information for non-native Japanese residents and knowledge for the skills and to examine a trial intervention to improve their skills and knowledge.Methods  A cross-sectional study and an interventional study were conducted. In each study, data were collected through self-reported questionnaires targeting nursing students. Their skills and knowledge were summarized. The associations between skills and knowledge were examined, as well as the association between skills in rewriting two example sentences. In the interventional study, a workshop teaching “Yasashii Nihongo” was offered to participants. Changes in skills and knowledge after the intervention were also assessed statistically.Results  In the cross-sectional study, a median general score to assess skills was four out of five, and the number of knowledge items was two out of sixteen.  In the interventional study, an association between skills in the two example sentences was found (p-value = 0.04). However, there was no significant difference in skills or knowledge before and after the intervention.Conclusion  In the cross-sectional study, participants suggested only few knowledge items of “Yasashii Nihongo”, but they suggested high skill scores. In the intervention study, we could not confirm the effectiveness of teaching “Yasashii Nihongo”. To increase the knowledge level of nursing students and to use the knowledge in actual rewriting, it is necessary to reconsider the teaching contents and to allow appropriate time for the intervention.

Introduction: Tramadol (TRM) has been included as a weak opioid at the second step of the WHO analgesic ladder and has been widely used in palliative medicine. Here we report a case of amelioration of cancer pain by TRM therapy in a female patient with myasthenia gravis (MG). Case:The patient was a 70’s woman who was diagnosed with advanced endometrial carcinoma and suffered from chest pain caused by chest metastasis. 25 mg of a TRM capsule was orally administered three times a day. The dose was increased to 50 mg twice a day. It was resulted in sound pain relief with transient muscle weakness but without a myasthenic crisis.