1.Clinical Reasoning Web-based Prototypic Module for Tutors Teaching 5th Grade Medical Students : A Pilot Randomized Study
Gerald H. Stein ; Hironobu Tokunaga ; Hirotaka Ando ; Mikako Obika ; Tomoko Miyoshi ; Yasuharu Tokuda ; Yoshinori Noguchi ; Mitsuyo Kinjo ; Shun Kohsaka ; Hitoshi Honda ; Yuka Kitano ; Hidetaka Kitazono ; Hitomi Kataoka ; Hidekazu Terasawa
General Medicine 2015;16(1):13-25
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.
2.The Factors Associated with Chill Syndrome Using Terasawa's ki, ketsu and sui (qi, blood and fluid) Diagnostic Score
Iwata OZAKI ; Mitsuyo NOGUCHI ; Mika MIGITA ; Hideki IKEDA ; Aya KAKIZOE ; Hidetoshi SATO ; Kazumichi KURIYAMA
Kampo Medicine 2020;71(1):1-7
To determine the physical symptoms and ki, ketsu and sui (qi, blood and fluid) factors associated with the presence of hie-sho (chill syndrome). Total 118 healthy university students (66 males and 52 females, median age 22 years, range 21-29) were enrolled. A cross-sectional study about the presence of chill syndrome in participants was performed. Terasawa's ki, ketsu and sui diagnostic score was used to identify the presence of physical symptoms. Number rating scale (NRS) was used to classify the chill and NRS more than 5 was defined as chill syndrome based on Furuya's report. Eighteen students (4 males and 14 females) were documented as chill syndrome. The multivariate analysis of physical symptoms identified female (OR 4.65, p = 0.0427), heavy sensation of head (OR 2.98, p = 0.0190) and chill of extremities (OR 1.94, p = 0.0480) as significantly associated factors with chill syndrome. The score of ki-kyo (qi deficiency), ketsu-kyo (blood deficiency) and suitai (fluid retention) showed higher score in students with chill syndrome compared to students without chill syndrome in univariate analysis. Being female and two indicators of qi abnormalities including heavy sensation of head and chill of extremities were associated with the presence of chill syndrome in university students.