Purpose: This study aimed to investigate the decision-making support and patients’ care progress in a palliative care outpatient clinic at a community hospital. Methods: We conducted a retrospective examination of patients who visited our palliative care outpatient clinic and subsequently died between January 2020 and December 2021. The clinic, staffed by two palliative care physicians, operated twice weekly and accepted patients irrespective of their treatment status. Result: 93 patients were included in the analysis. At the onset of the outpatient clinic, 72 patients were asked about their preferred location for end-of-life care should their condition deteriorate. Of these, 25 patients preferred to receive end-of-life care in a palliative care unit (“PCU” group). Another 25 patients initially sought medical treatment at home through home-visits but later expressed a preference for care in a palliative care unit as their condition worsened (“home-visit→PCU” group). Additionally, 17 patients preferred home care from the end-of-life until death (“home-visit” group). Among the “PCU” patients, 96% received care in a palliative care unit, and 84% passed away in the same unit. In the “home-visit→PCU” group, 76% received care through home visit, and 80% passed away in a palliative care unit. In the “home-visit” group, 76% of patients received care at home, and 47% passed away in their own homes. Conclusion: These findings suggest that delivering end-of-life care in patients’ preferred locations is feasible with continuous decision-making support provided in the palliative care outpatient clinic.

Based on the social context of an aging society and surveys conducted since 2020, the need for comprehensive perspectives and approaches that consider patients'psychosocial background and a cross-organ perspective has been identified. As a result, a new quality and ability, namely comprehensive attitudes toward patients, has been established as part of the core curriculum for medical education in FY2022. Specific learning objectives include "holistic perspectives and approaches," "community perspectives and approaches," "life perspectives and approaches," and "social perspectives and approaches". An educational design that draws on multiple learning theories to enable reflection on one's own way of being has been proposed to integrate abstract and concrete, conceptual and experiential, and self and others perspectives. It is expected that this medical education will lead to improvement in the well-being of individuals, families, and communities.

In the 2022 revision of the Model Core Curriculum, a new "Educational Strategies and Assessment" section was added as a further development in outcome-based education. By adding a chapter on strategies and evaluation, which is an important element of the curriculum, and linking it to qualities and abilities, we have devised a way for learners and instructors to make use of the Core Curriculum more easily. In addition, 11 example of strategy and assessment cases are included as Good Practice to encourage practical application. However, since these are only examples, we hope this chapter will be further developed as universities create strategies and evaluations that make the most of their unique characteristics.

For this second report, we divided the efforts of the University of Tsukuba into two parts. In the first part, we introduced the Interprofessional program, an inter-university collaborative educational program between the University of Tsukuba and Ibaraki Prefectural University of Health Sciences. Before the COVID-19 pandemic, this program was conducted using TBL (Team-based learning) in a large conference room. After the pandemic, this was conducted online (using Zoom). The main changes due to the online implementation were the following five points; (1) online faculty meetings, (2) advance distribution of materials, (3) testing using Google Forms, (4) group work using the breakout function, and (5) simultaneous editing using Google Docs. In the future, we would like to examine the possibility of new educational methods while creating innovations that are possible only through online interprofessional educational programs.

In the second part of the second report, we introduce the Care Colloquium, an inter-university collaborative educational program between the University of Tsukuba and the Tokyo University of Science. The Care Colloquium is an interprofessional education program that uses PBL (Problem-based learning). In response to the COVID-19 pandemic, this program was implemented online using Microsoft Teams, with advance preparation including manual maintenance and communication testing. The same learning outcomes were achieved as the face-to-face implementation. Undergraduate interprofessional education tends to be a large-scale program, and the shortage of faculty and classrooms is challenging, but online education could overcome these obstacles. The development of hybrid programs that use the merits of both face-to-face and online education may lead to the promotion of interprofessional education in the future.

It is difficult to implement interprofessional education (IPE) in the classroom due to COVID-19. To share our knowledge of online IPE, we report on how we provided IPE for first-year students at two universities. At Mie University, a class was implemented to use Zoom. Quizzes and chats promoted interactions between instructors and students. At Hokkaido University of Science, an online team medical experience game was conducted via Zoom and a Learning Management System (LMS). The activity promoted interaction between students through gameplay and clear instructions. In both cases, students could successfully develop online IPE based on existing learning methods. Through their experience, it was clear that students are able to understand other professionals’ roles. They were also to commit to membership and/or teamship. On the other hand, students faced challenges with faculty familiarity and time allocation.

Introduction: This study compared perceptions of interprofessional collaboration and recognition of work between clinic/small hospital staff and those at regional core hospitals.Methods: An anonymous, self-administered questionnaire was administered to the staff at 4 clinics/small hospital and those at 3 regional core hospitals responsible for regional medical care. The following items were compared between the 2 groups: Assessment of Interprofessional Team Collaboration (AITCS) Japanese version, Readiness for Interprofessional Learning Scale (RIPLS) Japanese version, workplace satisfaction, and relationship with neighboring facilities.Results: The subjects were 74 staff members at clinics and small hospital and 576 staff members at regional core hospitals; their average ages were 41.9 years and 40.6 years, respectively. Compared to staff at regional core hospitals, those at the clinics and small hospitals had significantly higher AITCS scores, RIPLS scores, and workplace satisfaction, and they also considered their institutions to have better relationship with neighboring facilities.Conclusion: The staff of clinics and small hospital were more aware of interprofessional collaboration than hospital staff, and were more satisfied with their workplaces. Understanding the underlying organizational differences may facilitate vertical integration in community-based integrated care systems.

Introduction: We investigated the relationship between knowledge of the common cold and desire for medical treatment.Methods: We administered an anonymous self-questionnaire about the common cold to citizens receiving health checkups in City X, Ibaraki Prefecture, between August and September 2012. We assessed citizens' knowledge about the common cold and whether they sought medical treatment for it, in addition to their demographic attributes.Results: We included 1079 citizens (response rate, 74.5%) in the analysis. The majority of participants believed that receiving intravenous (IV) infusions or injections for the common cold led to faster recovery times (75.9%). Roughly half of the participants (42.0%) did not believe that antibiotics are not effective against virus-based colds, while 28.6% were unsure. Finally, endorsement of the questionnaire items "taking cold medications early leads to faster recovery" (OR: 1.61) and "IV infusions or injections lead to faster recovery times" (OR: 1.86) were associated with a desire for medical treatment.Conclusion: Our results indicate that patients' knowledge about the common cold and their understanding of treatment options available at medical institutions were inadequate. Furthermore, we found that an awareness of how cold medicines, IV infusions, or injections may shorten treatment duration was associated with a desire for treatment.