To determine the effectivenss of “clinical clerkship (CC)” in undergraduate clinical training, a questionaire was sent to 105 students who had received the classical bed side teaching (BST) in 1990 and to 103 who have received CC from 1992 through 1994. The effectiveness of clinical training was pointed out by 53, 7% of group BST and 61.8% of group CC. The numbers of effectively learned items were larger in the order of psychomotor, affective and cognitive domains in the group BST, while there were in the order of affective, psychomotor and cognitive domains the group CC, indicating that CC is more effective in learning in the affective domain than BST (p<0.01). In the affective domain, students learned by observing physicians' attitudes to patients in BST, while they learned through their own personal interactions with their assigned patients in CC. CC is therefore believed to be quite effective for students to learn humanistic attitudes.

Learning of humanistic attitudes in undergraduate medical education is increasingly expected to provide holistic care and comprehensive medical service. However, there has been no report that deals with doctors' attitudes toward patients in relation to the educational subject. Medical students, who had been implemented a clinical clerkship for two months, evaluated doctors' attitudes by questionnairs after clerkship. They scored by checklists and rating scales. In this article, we report the views of medical students on doctors' attitudes, and discuss important points for the success of the learning attitudes during undergraduate educational prosses.

Introduction: We examined whether an intervention in students’ self-assessment causes behavioral changes in how they make their assessments.
Method: Students taking part in problem-based learning were divided into 2 groups. The students of Group 1 were asked to evaluate themselves with a four-step process, whereas the students of Group 2 students were asked to evaluated themselves and to indicate how confident they were that their self-assessments were consistent with assessments by their instructors.
Results: We observed a significant difference in self-assessment patterns between the groups. Students in Group 1 overestimated their abilities, whereas students in Group 2 underestimated their abilities. However, when we compared students’ self-evaluations and their grades in lecture courses, we found that students with low grades were more likely to overestimate their ability than were students with high grades, regardless of whether they had stated how confident they were in their assessments.
Discussion: By considering their degree of confidence that their self-assessments agreed with assessments by their instructors, students might show more careful assessment behavior. However, students with low grades require a greater degree of individual guidance before exhibiting behavioral changes.

We developed a problem-oriented simulation system for medical diagnosis which works on personal computers without special equipment. In this simulation system the history of illness can be presented by voice, and physical findings are presented audiovisually through the student's actions, in a manner that closely resembles an actual medical examination. The laboratory findings are also presented through the student's actions. Students compile a database with information that they collect, create a problem list, and devise an initial diagnostic plan for the patient's most important problem. This computer-assisted system will help medical students learn diagnostic strategies in a simulated clinical setting. We believe that this system is a promising method that will facilitate problem-oriented learning in the virtual multimedia environment with special convenience for medical students to share time and facilities and to lower costs.

Myosin light chain patterns were examined in single fibers from the extensor digitorum longus (EDL) and soleus muscles of Wistar strain rats. The fiber type composition of both muscles was also determined to estimate the relationship between myosin light chain patterns and histochemical fiber types.
The results were summarized as follows ;
1. All of single fibers from the EDL muscle was typical fast type which contained fast light chains only (fLC 1·fLC 2·fLC 3), except that there was one mixed type fiber cotaining both fast and slow light chains (fLC 1·fLC 2·sLC 1·sLC 2) .
2. There were two myosin light chain patterns in single fibers from the soleus muscle. One was typical slow type which contained slow light chains only (sLC1·sLC 2) and the other, mixed type in which fast and slow light chains coexisted. Mixed type fibers were divided into eight groups based on the light chain composition. The percentage occurence of typical slow type and mixed type fibers was 35.4% and 64.6%, respectively.
3. The average percentage of type II fibers was 94.6% in the EDL muscle 5.4% in the soleus muscle.
4. These results suggest that both fast and slow skeletal muscles contain mixed type fibers. The results further imply that in slow skeletal muscle, myosin light chain pattern of mixed type occurs not only in type II but also in type I fibers.

We evaluated our undergraduate clinical clerkship system in 1992, using the multiplication method advocated by the Working Group on “Evaluation of clinical skills of medical students ” of the Japan Society for Medical Education. We divided the clinical training period into three terms: the first term was held from May through June, the second from September through October, and the third from December through January. We determined scores using checklists and rating scales in ten categories, totalled the scores for each period, and compared them between periods. The total scores for the third period were the highest, followed by those for the second period. Scores for basic knowledge, data gathering, and basic technical procedures increased with increase in the number of training hours. However, scores for manner, attitude, and interviewing skills were already high in the first period. We conclude that the multiplication method is useful for objectively evaluating students' clinical skills.

Nationwide common achievement test system for entering clinical clerkship will formally start from December 2005. Before the start, four times trial examination were carried out. Based on these trials, some problems for the test sytem were pointed out. We have analysed the problems proposed to induce more suitable examination system.