Although the Trail Making Test (TMT) Part A, B, Wisconsin Card Sorting Test-KFS version (WCST-KFS) and Miyake's Verbal Paired-Associate Learning Test (MVPLT) are simple tools to evaluate cognitive dysfunction in patients with traumatic brain injury, there is very little normative data for young persons available in Japan. Therefore, we evaluated 124 healthy persons who were from 15 to 30 years old with the three assessment tools. Median numbers of TMT Part A and Part B were 23.8 seconds and 49.0 seconds, respectively. Median numbers of achieved categories, perseverative errors of the Nelson type, and difficulties of maintaining set in the WCST-KFS were 5, 2 and 0, respectively. Median numbers of correct answers for related and unrelated pairs of MVPLT were 10 and 9 at the third trial, respectively. TMT Part B and perseverative errors of the Nelson type had a negative and weak correlation with age. And related pairs of MVPLT at the first trial had a positive and weak correlation with age. The normative values obtained in this study would be a useful standard for clinical assessments and acknowledgment of disabilities.

Small group training, that is “A rehabilitation class to prepare patients for their return to society,” was created for 5 patients with higher brain dysfunction who had not yet returned to normal daily life after undergoing individual cognitive training, in order to provide them with a better insight into their disease, and to improve their communication abilities and interpersonal skills. The class consisted of 10 sessions (each session lasting 2 hours and 30 minutes) over a 4-month period, which consisted of an opening address, a short lecture, social skills training, tea time, and recreation. Before and after the class, the patients and their families were asked to complete the Dysexecutive Questionnaire, and any decrease in the difference in the scores between the patients and families suggested that the class had enhanced the patients' self awareness. The Baum test showed the patients having an increased interest in the outside world and a tendency to also have more internal energy. The Clinical Global Impression, as evaluated by the patients' families, indicated an improvement in all patients. We therefore consider this rehabilitation class to help prepare patients for their return to society to be useful as one step to encourage an increased social participation in patients suffering from a higher brain dysfunction.

Background: A workshop for training clinical clerkship staff has been held since 2009. We examined how the participants felt about the workshop.
Method: The questionnaire was sent to the participants of the workshop.
Result: Of the participants, 82％ thought that the workshop was helpful and that the benefits had continued for more than 2 years. Their motivation for undergraduate medical education was improved. They started to consider how medical students become members of a medical team and to think about the goals of medical practice. To promote further increases in the numbers of clinical clerkships, the participants cited the necessity of increasing the number of faculty advisors, encouraging medical students’ positive attitudes, changing attitudes about patients, extending the training period, and holding such workshops.
Conclusion: The workshop was beneficial for the staff, and the beneficial effects continued long after the workshop was held.

1) The Department of Tourism Medicine was established at Wakayama Medical University in 2006. "Health tourism," a project of the department combining sightseeing with health care, has involved patients with a variety of diseases.
2) As a part of training to promote the compassionate care of patients, students participated in an overnight tour for patients with Parkinson's disease and kept the patients company all the time with various types of assistance.
3) The students could understand the daily condition of patients with Parkinson's disease, which they could not do in the hospital, and had favorable relations with the patients' families. This experiential practice was an effective means for promoting the compassionate care of patients.

Objective: To investigate the role of postgraduate clinical training at the emergency department of Tenri Hospital in teaching the diagnostic process in the general outpatient department.
Method: Patients seen by 11 first-year residents at the emergency department were consecutively registered with summary sheets. Further information was added, and an analysis was performed of: 1) the distribution of chief complaints in the emergency and general outpatient departments and 2) initial diagnoses and the diagnostic process in the emergency department and the final diagnoses.
Results: The distributions of chief complaints in 89 cases in the emergency department and in 183 cases in the general outpatient department were closely correlated (p=0.0016). Diagnoses in the emergency department were correct in 58% of cases. Treatment was incorrect in 3% of cases.
Conclusion: The distributions of chief complaints in the emergency and general outpatient departments were similar. In our hospital the emergency department plays a major role in postgraduate clinical training by teaching the diagnostic process for the general outpatient department. Clinical management, including decision making for further tests and consultation, in the emergency department by first year residents did lead to any major adverse events.