Cognitive apprenticeship and reflective practice are fundamental educational theories supporting postgraduate clinical training. Community hospital rotations provide ideal opportunities to apply these theories. However, community hospitals face challenges in securing educational time due to faculty shortages and heavy clinical workloads, leading to on-the-job training becoming the primary educational approach. Consequently, opportunities for structured instruction and reflection may be limited, potentially hindering the implementation of cognitive apprenticeship and reflective practice. To address this mismatch between educational needs and available resources, we implemented a remote educational conference focused on clinical questions (CQs) arising from residents' clinical experiences. Unlike traditional clinical conferences that focus on determining patient management, this initiative centers on reflective dialogue based on CQs formulated by residents themselves. By integrating experiential learning theory and reflective practice theory and focusing specifically on the latter three steps of cognitive apprenticeship, we successfully constructed an effective educational model for remote learning environments. This practice enables high-quality medical education that transcends geographical constraints and is considered valuable for future community-based medical education.

Because the corona disaster made group medical training difficult, we conducted resuscitation training for new students and basic medical skills training for fourth-year students without face-to-face instruction using video learning, assessment, and ICT. In the resuscitation training, the students were allowed to take a mannequin home and film themselves performing the resuscitation while learning by video. Later, group and peer assessment were conducted via Zoom, and a significant increase in self-assessment was observed. In the basic medical skills training, the students filmed their own implementation at their own pace while learning by video, and the teachers later conducted video assessment and feedback. The lack of face-to-face instruction made it possible to implement the limb spine training, which had not been possible in previous years. It is necessary to adjust the timing of the video registration by the students and the video assessment by the teachers, and to make further improvements to the system.

Endoscopic papillectomy (EP) for ampullary adenomas achieves cure rates ranging from 76% to 90%, and recurrence rates are as high as 33%. If remnant or recurrent lesions after prior EP are endoscopically visible and are not suspected of intraductal extension into the biliary or pancreatic duct, repeated snaring and cutting can be performed until all visible lesions are completely resected. However, endoscopic ablative therapies, particularly argon plasma coagulation, can be attempted for tiny or uncertain remnant and recurrent lesions. In addition, intraductal radiofrequency ablation has recently been attempted for residual intraductal lesions after EP at several institutions. Although still under investigation, it has shown some promise. It might be offered as an alternative to surgery, particularly in patients who are unfit for surgery or those who refuse to undergo surgery.

Xenon beam wide wave-length including ultraviolet, visible and ultrared rays.
What effects are produced for the human body by using xenon beam effective on the removal of the living body pain?
After patients suffering from low back pain were radiated by xenon beam, their finger-floor distances were measured.
It was examined and compared with the results after using micro wave therapy.
As a result, in xenon beam therapy group, the more the number of times of stimulation was, the shorter the finger-floor distances became gradually, and after more than five times of stimulation, shortening of them was apparent (p<0.01).
Moreover it was known that shortening could be kept in xenon beam therapy group.

Xenon photorays are incoherent waves like the sun rays, but it shows a bright line spectrum. Each bright line exhibits a form similar to the laser spectrum waves. The microwaves have been conventionally used to deliver stimulation to the deep tissues. The effects of the xenon photorays and microwaves on the range of motion in scapulohumeral periarthritis were compared.
Our findings indicated that xenon photorays were superior to the conventional microwaves in bringing about improvement of the range of motion in scapulohumeral arthropathy.