In the guidance of technical aspects in the “new nursing staff training guidelines” prepared by the Ministry of Health, Labor and Welfare in December 2009, We were using an e-learning method. We evaluated the achievement of nursing technology item 69 and examined the problems to be solved for the future basic nursing technical guidance. The subjects in the present study were 53 persons who joined the of rookie nursing staff of our hospital in April 2013 (new nurses are all fresh from college). Of the goals indicated in the guidelines, nursing technology item 69 was prepared for the group training course using e-learning. The trainees learned with a focus on simulation. After that each department carried out OJT and evaluation. 　　We aggregated achievement evaluations and carried out questionnaire surveys on the use of e-learning in June, September and March of the following year. We compared and examined the evaluations of achievement in comparison with the previous year evaluations. In March 2014 when the new nursing staff training program ended, it was found that those who attained “a measure of reach 1: can” or “2: as possible under the guidance” accounted for 36.5% of the total number of recruits in 2013, compared to 34.9% in 2012. The ratio of those who highly evaluated “a measure of reach 4: have knowledge” remarkably increased from4.5% to23.4%, and that of inexperienced persons or people who did not evaluate decreased from 29.2% to 4.2%. This showed that the self-learning and utilizing e-learning at their own pace proactively helped them to acquire basic nursing skills. However, a problem remained that too much time was required for evaluation, because it has been actually evaluated over 100 fields due to detailed e-learning items, the limited number of desk-top computers.

A new educational program for the medical doctor was introduced at Tokyo Women's Medical College in 1990 with a 4-year tutorial education model as its core. To develop the program for educational training more efficiently, current facilities were reviewed on a large scale, and various types of equipment and supplementary materials were made available. We are now investigating utilization and problems of the current program. Supplies and materials of tutorial rooms and mirror rooms have been used effectively. The library has become increasingly useful as a place for independent study and research. However, audiovisual materials have not yet been made fully available. We suggest that further improvements to the system and fostering an environment of open access to information are necessary to increase the accessibility of the support system for tutorial education.

Tutors must understand their role in advance so that tutorial education can be conducted smoothly and effectively. These abilities and attitudes require training. At our school, tutors serve as faculty for basic courses and clinical courses. We assessed their training conditions and future tasks. Of the 1, 077 faculty members who received tutor training between 1988 and 1997, 935 are current faculty members who have completed in-service training (basic course, 115; clinical course, 820). Before 1989, training was on campus, but since 1990 it has been conducted at Shirakawa Seminar House with a 2-day program. The number of working tutors per year is 192, with a basic course to clinical course ratio of 3: 7. About half of the faculty members in the basic course have had four or more experiences as tutors, whereas most clinical course faculty members have had only one experience. Thus, many tutors have had no experience. In a questionnaire survey after undergoing the training program, most participants felt that they were able to understand the theory of tutorial education and the actual role of the tutor and that they were able to concentrate on off-campus training that was removed from their everyday work. To provide added impetus to tutorial education, we suggest that in the future, in addition to the understanding and mutual cooperation of those involved, it will be necessary to provide an advanced program to train tutors who have appropriate abilities and attitudes.

Tokyo Women's Medical University introduced tutorial education in 1990 for 1st-through 4th-year students. To examine the effectiveness of this system in a basic-medicine course, questionnaires were given to all 2nd-year students. Many students felt that they had become accustomed to performing self-learning tasks through collecting information themselves and discussing their findings in a group; in particular, they found that tutorial education markedly improved their communication skills. A few students thought that this method helped them develop the ability of logical/critical thinking and analytic skills from multiple viewpoints. These findings suggest that an assessment system should be established by which students themselves could recognize the extent to which they have developed their abilities, which was the aim of tutorial education.

Personal interviews and group discussions were conducted with all 2nd-year students to examine how they feel about tutorial education used as the core of the basic-medicine course and how they recognize the importance of developing their abilities, which was the aim of this course. Many students showed slight anxiety about the results of their learning with tutorials, felt inadequate in their self-learning ability, and hoped the guidance by instructors would be improved. These findings suggest that students' anxiety will decreased and their willingness to learn will increase if their developed abilities are evaluated appropriately and if they receive adequate feedback. These findings also suggest that a retraining program for experienced instructors is needed to improve their guidance skills and to reinforce the importance of their role.