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.

To demonstrate the quality assurance of the comprehensive examination of sixth-year students at Nippon Medical School, 4 undergraduate examinations were compared with the national examination for medical practitioners (NEMP) using scatter graphs and Pearson's correlation coefficient. Of the 93 sixth-year students at Nippon Medical School, 57%(n=53) reported their scores on the NEMP in response to a request from the Academic Quality and Development Office. Correlation coefficients of the grade point average (years 1 to 5), average scores on graduation examinations of 24 subjects, scores on the trial examination of NEMP, and scores on the sixth-year comprehensive examination with overall scores on the NEMP were 0.62, 0.46, 0.68, and 0.63, respectively. These results suggest that the sixth-year comprehensive examination is more suitable than are graduation examinations for predicting the NEMP score.

To demonstrate the quality assurance of comprehensive examinations for fourth-year students at Nippon Medical School, scores on comprehensive examinations were compared with those on a trial of computer-based testing (CBT) of a nationwide medical and dental student evaluation system in 2003. Pearson's correlation coefficients between scores of two comprehensive examinations and the CBT score were 0.45 and 0.67, and the correlation coefficient between the average score of the two comprehensive examinations and the CBT score was 0.55. Fourth-year comprehensive examinations are useful tools for summative evaluation and prediction of CBT performance.

Advances in genetic medicine has rapidly been applied to clinical practice. However, many medical students have not studied biology or genetics in high school. There is little chance to think in Japan medical education about how to treat genetic information appropriately in the setting of clinical medicine. The timing and contents of a clinical genetics education program in medical school has hardly been discussed in Japan. This paper discusses the clinical genetics educationduring the medical-science and clinical-medicine stages at Nippon Medical School.
1) An exercise on information gathering and role-play (for 180 minutes) about color vision deficiency were performed during the second-year molecular genetics course.
2) A clinical genetics course (45 minutes 18 classes) in the fourth year was started in 2002 as a part of an integrated medical curriculum with courses classified by organ system.
3) This clinical genetics course included systematic lectures for knowledge acquisition, lectures by patient support groups, exercises in drawing pedigrees, role-play, and discussions of ethical issues. Students evaluated this course favorably.
4) Some topics in clinical genetics can be effectively presented at an early stage of medical education as part of an introduction to medicine. To maximize the educational effects and increase the possibility that students understand the importance of medical genetics, clinical genetics education in medical school will be performed after the student have grasped a basic understanding of diseases through lectures about clinical subjects.

There are some methods of evaluating teaching: student-, self-, peer- and third person-evaluation etc. Validity, reliability and feasibility are required for assessing the quality of teaching. Therefore, we examined the reliability of teaching evaluation by medical students in Nippon Medical School in comparison with peer evaluation.
1) Twenty-four clinical lectures during the same school year were arbitrarily chosen as objectives. Correlations between student- and peer-evaluations in both generalized ratings and global assessment were analyzed by Pearson's correlation coefficient and Spearman's correlation coefficient by rank.
2) In generalized ratings, a significant correlation between the evaluations was demonstrated (r=0.532, p=0.0056), while a marginal correlation between the evaluations was observed in global assessment (p=0.0492).
3) The results probably provide evidence of the reliability of teaching evaluation by medical students.
4) The criteria for evaluation and the validity of questionnaires should be defined for a more reliable teaching evaluation by medical students.

A survey was conducted to better understand the current status of training of simulated and standardized patients (SP) in medical education and training protocol of SP training at each site, and to determine the future planning of the committee
1) Methods: A series of questions regarding the SP and SP training was sent to all 80 medical schools in Japan.
2) Results: Responses were received from 68 medical school (85%). According to the survey result, 43 medical schools (63%) trained their own SP. The total numbers of SP reported in this survey were 1,036 with ratio of male to female 1:3. The average numbers of SP at each medical school were 24 (range 5 to 87). SP training protocols were included basic training (88%) and to prepare common achievement test OSCE (84%), classes (74%) and advanced OSCE(60%). Only 6 medical school (14%) had the systematic curriculum for SP training.
3) Conclusion: To produce standardized, accurate SP training for medical education, the committee recommends to establish the standard curriculum and portrayal requirements for SP training.

1．The basic training curriculum for simulated and standardized patients （SPs） was provided by the 16th Medical Simulation Committee based upon a nationwide field survey that was conducted by the committee in 2009 and other data.
2．The curriculum consists of 3 essential programs: interpersonal communication, medical education involving SPs, and the medical interview.
3．The medical interview program was composed of basic issues, comprehension of scenarios, acting role and performance, and feedback and assessment.
4．The training facilities or institutions were recommended to properly assess the performance quality of SPs in the educational setting by means of a specific and clearly defined evaluation method.

The preparation for influenza pandemic has become very important. However, no standardized educational package against pandemics has been established to date. We developed a simulation–based education drill for Japanese medical students based on the package developed by U.S. medical school. The drill was adapted to 201 medical students, and was evaluated by self–administered questionnaires.
1)More than 90% of the students indicated that the use of this drill is appropriate to experience a simulated pandemic situation, and to learn skills and attitudes such as teamwork and communication.
2)Up to 65% of the students answered they learned a "very clear image" for the "Importance of working as a team with other professionals".
3)The results suggest that this simulation–based education drill make the students aware not only of the need for the preparation for pandemic but also the importance of team–based approach.

At Nippon Medical School, a "Basic Clinical Training Course" is provided as an introduction to clinical medicine. Medical students undergo initial clinical skills training with simulators. We describe the technique of effective training to acquire clinical skills and the results of student evaluations and a questionnaire survey.1) The training consisted of 8 practicums, including internal examination, funduscopic examination, otoscopic examination, breast examination, auscultation (heart sounds and lung sounds), and collection of blood samples. Medical students moved in rotation once per time period (45 minutes) and performed practical training in each unit, which comprised 2 practicums.2) The training with the prescribed number of 50 students in 4 time periods was efficiently performed for 2 days and required 9 trainers per day. Student evaluations and a questionnaire survey revealed the interest and enthusiasm of medical students and showed they thought highly of the training.3) The training was efficiently performed and was thought to help reduce the teaching load of instructors. The educational effect of the training can be strengthened by increasing the convenience of the clinical simulation laboratory, by reinforcing the education of clinical skills and attitudes in clinical clerkship, and by evaluating these factors after the completion of the clinical clerkship.