The author is involved in the management of Objective Structure Clinical Examination (OSCE) for Common Achievement Tests to be implemented prior to a clinical clerkship. In this study, we discuss how to develop questions for students who will receive OSCE after a clinical clerkship, as well as potential challenges in the introduction and management of its examination system. Finally, we consider the short-term future of clinical education, given the actual situation where a specialty-specific accreditation system has been introduced according to global standards, and medical education focused on medical professionalism is being offered.

Opinions of young physicians about a course on end-of-life care which they took at the Kyushu University Medical School 10 years earlier were analyzed. Fifty-seven (23%) of 247 graduates responded to a questionnaire. All clinicians had been involved in end-of-life care to some extent. All respondents agreed that a course about end-of-life care should be included in the medical school curriculum. In general, they thought highly of the course on end-of-life care that they took in medical school. They thought that such a course should last 10 to 20 hours and should be given after the end of clinical lectures and before the start of clinical training. The respondents suggested a good basic policy would be to attach importance to contemplating the end of life rather than to simply memorizing information about end-of-life care.

A 21-hour education program for fifth-year medical students in terminal care was started at Kyushu University in 1991 with the participation of more than 20 lecturers from different specialties. Problems encountered as this curriculum was introduced are discussed. We believe that establishing a professorship in terminal care is essential for improving this curriculum.

We sent questionnaires to clinical instructors and trainees within 2 years of the latter passing the national licensure examination for medical practitioners to investigate their opinions about the examination and to improve its style. Most instructors wanted to change the examination into an ideal style; however, the trainees had positive comments about the present examination. Several problems came to light, including whether the present examination is asking the minimum requirements for initial training and what the necessary actions are for assessing clinical skills. We must take measures to improve the examination.

Purpose: Although many studies have assessed the impact of interventions to increase medical students’ empathy by improving their understanding of patients’ perspectives and feelings, the impact of hospitalization experiences remains unclear. Methods: Fifth-year medical students at Kyushu University from 2009–2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. Results: Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients’ anxiety about illness and empathy as one of the requirements of health care providers from the patients’ perspective. Conclusion This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students’ empathy by improving their understanding of patients’ perspectives and feelings.

Purpose: Although many studies have assessed the impact of interventions to increase medical students’ empathy by improving their understanding of patients’ perspectives and feelings, the impact of hospitalization experiences remains unclear. Methods: Fifth-year medical students at Kyushu University from 2009–2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. Results: Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients’ anxiety about illness and empathy as one of the requirements of health care providers from the patients’ perspective. Conclusion This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students’ empathy by improving their understanding of patients’ perspectives and feelings.

Background: Although community-based training is included in medical undergraduate education in Japan, little assessment of the outcomes of community-based education programs has been performed. The aim of this study was to investigate the outcomes of a community-based education program using a mixed method.
Methods: The study design utilized both qualitative and quantitative methods (mixed method). The subjects (n = 278) were fifth-grade medical students who were involved in the program from 2008 to 2010 inclusive. We collected two types of data: a six-item pre-and-post questionnaire (quantitative) and an open-ended questionnaire (qualitative) to evaluate the impressions this experience left on the students.
Results: Pre-and-post questionnaires were completed by 263 (95%) of 278 subjects; on all items, the scores of the post- data were significantly higher than that of pre- data (P < 0.001). From the responses given by 139 respondents (total 181, 77%) in the open-ended questionnaire survey, 10 themes were extracted: 1. Inter-professional cooperation; 2. Role and cooperation among university hospitals, community hospitals, clinics, and welfare facilities; 3. Patient-centered medicine; 4. Trust-based relationships; 5. Competency in general medicine; 6. Professionalism; 7. Medical management; 8. Communication; 9. Common diseases; and 10. Long-term care.
Conclusions: We found that medical students gained four major perspectives from their experiences: Inter-professional cooperation, trust based relationships, roles of community hospitals and clinics, and patient-centered medicine, respectively. Our findings suggest this program contributed significantly to their understanding of community medicine.

1) Japan Society for Medical Education launched a committee for the graduate education of medical educationists in Japan. The committee proposed a direction toward establishing the system, by way of discussion among the members, needs assessment, information gathering of overseas master courses, and discussion at the open meeting.2) To promote medical education in Japan, we should establish 2 systems concurrently: (1) a graduate education for medical educationists who have a broad base of theories and can lead future medical education, and (2) a broader certificate system for medical teachers who have good practical teaching skills.

1) The committee for the graduate education of medical educationists, Japan Society for Medical Education, investigated needs for the education system of medical educationists.2) A questionnaire was sent to 1831 leaders in healthcare education and the society members, and 644 replied (recovery rate 35.2%). Fifty % of the respondents agreed the necessity of medical educationists. Certificate level was most popular, however, master and PhD degrees were also considered to be necessary. 3) These results support the establishment of educational system for medical educationists in Japan.

　To encourage the broad use of simulation-based medical education and establish partnerships to promote objective structured clinical examinations after clinical clerkship among medical teachers, we hosted the first team-based clinical skills competition event for medical students in Japan, named ‘Medical Students' Simlympic Games 2014'. Thirty-six (12 teams of three) open-recruited 5th or 6th grade medical students participated in this event. Student teams performed clinical tasks at 6 stations, which actively utilized the strengths of simulators or simulated patients. Contents, composition, difficulty level, and validity were tested by trainee doctors and examined by committee members in advance. In this report, we describe our concept, executive committee formation, a variety of arrangements, the outline on the day of the event, and the results of a questionnaire targeting participants. (126 words)