1.Transforming Medical Students' Perceptions Through a Self-Regulated Learning-Driven Emergency Medicine Clerkship Model
Chiemi HAMADA ; Chihiro KAWAKAMI ; Rintaro IMAFUKU ; Osamu NOMURA ; Ken OTSUJI ; Takuya SAIKI
Medical Education 2025;56(3):149-159
Background: Clinical clerkship training does not always provide an ideal environment for self-regulated learning (SRL) among medical students, and how students manage their learning during this period remains unclear. This study aims to explore how medical students perceive their SRL during clinical clerkship training in the emergency medicine department. Methods: Semi-structured interviews were conducted with 28 fifth-year medical students at University A. Thematic analysis was performed using the SRL cyclical model as a theoretical framework. Results: Eight themes were identified, including the emergence of professional identity through clinical training, the flexible selection of learning goals and tools in uncertain environments, and the appropriate planning of next-day goals and learning strategies through dialogue. Discussion: The findings suggest that dialogue with colleagues, participation in team-based care, and clerkship structures grounded in the cyclical SRL model positively influence the transformation of students' perceptions of SRL.
2.Socio-economic and Educational Backgrounds of First-Generation College Students in Medicine: A Nationwide Cross-Sectional Online Questionnaire Survey
Yasuyuki SUZUKI ; Osamu NOMURA ; Koji TSUNEKAWA ; Takuya SAIKI ; Yuko TAKEDA
Medical Education 2025;56(3):171-175
Objective: To determine the socio-economic and educational backgrounds of first-generation college students (FGCs) among Japanese medical students, with the aim of contributing to the improvement of medical school admissions. Methods: A nationwide cross-sectional online questionnaire survey was conducted. A total of 1,849 medical students and 295 nursing students participated. Results: The proportion of FGCs among medical students was 12.1%, lower than that among nursing students (39.4%). The backgrounds of FGCs were compared with those of non-FGCs (students whose parents were university graduates). FGCs were more likely to come from small cities and from outside the Kanto/Kansai regions. They reported lower annual family incomes and had fewer doctors or dentists among their relatives. FGCs attended cram schools less frequently, were more likely to have graduated from national or public high schools, and had higher academic grades. They applied exclusively to national or public medical schools, were more likely to take regional quota or recommended AO entrance examinations, passed these exams immediately after high school graduation, and were more often enrolled in their first-choice and national or public medical schools. FGCs also expressed a stronger intention to work in less-populated areas in the future. Discussion: The backgrounds of FGCs differ significantly from those of non-FGCs. Further investigation into the challenges and potential of FGCs in medicine is warranted.
3.The Practice and Educational Significance of Inquiry-Based Learning by Medical Students in the Community: From the Perspective of “Third-Generation Health Professions Education”
Miyuki TAKAHASHI ; Osamu NOMURA ; Ritsuki TAKAHA ; Yuito TAKADA ; Fumiya ASANO ; Hiroaki KAWASHIRI ; Takuya SAIKI
Medical Education 2025;56(3):189-193
In health professions education in the 21st century, there is a need to move toward a third-generation educational practice oriented toward the transformation of healthcare and social systems. However, few examples of the development of such an educational model have been reported. In the context of community-based health professions education-where universities, governments, and hospitals are attempting to co-create a new type of health professions education, we have developed an educational model grounded in the principles of third-generation health professions education, including problem inquiry and interdisciplinarity. It is a project- and inquiry-based learning model that suggests the possibility for second-year medical students to contribute to social change, however small, through their proactive involvement in the inquiring, investigating, and proposing solutions to local problems. Further dissemination and validation of this model, which embodies the philosophy of third-generation health professions education, are anticipated.
4.Socioeconomic Background of Medical Students Who Intend to Work in Less-Populated Areas
Yasuyuki SUZUKI ; Osamu NOMURA ; Koji TSUNEKAWA ; Yuko TAKEDA ; Takuya SAIKI
Medical Education 2025;56(6):367-371
OBJECTIVE: To examine the socioeconomic backgrounds of medical students who intend to practice in less-populated areas.METHODS: A nationwide online questionnaire survey was conducted among 1,822 Japanese medical students (1,024 from public universities and 798 from private universities) across 40 medical schools.RESULTS: Regarding preferred future practice locations, 25.2% of students intended to work in areas with populations over 1,000,000; 36.8% in areas with 200,000-1,000,000; 17.2% in areas with 50,000-200,000; and 4.8% in areas with fewer than 50,000 residents. Students who intended to work in less-populated areas (population >200,000) were more likely to have grown up in such areas, come from families with lower annual incomes, have fewer physician parents, have graduated from public high schools, and be enrolled in regional quota programs. Logistic regression analysis identified having a family background in a less-populated area (OR 9.46) and enrollment in a regional quota program (OR 2.72) as significant predictors of the intention to work in less-populated areas.DISCUSSION: There is a correlation between medical students’ intentions to work in less-populated areas and their socioeconomic backgrounds, which are important factors to consider when addressing the uneven distribution of physicians in Japan.
5.Developing Change Agents in Health Professions Education: A Needs Assessment for a Practice-Based Program Grounded in Systems and Design Thinking
Chihiro KAWAKAMI ; Osamu NOMURA ; Kaho HAYAKAWA ; Miyuki TAKAHASHI ; Minami KIHARA ; Yuka URUSHIBARA-MIYACHI ; Takuya SAIKI
Medical Education 2025;56(6):373-378
This study aimed to identify new competencies for an educational program designed to cultivate the ability to improve health professions education from an overview and interactive perspective, in response to its increasing complexity. At the Center for Medical Education Development, Gifu University, a competency framework was drafted based on systems thinking, design thinking, and adaptive leadership. A questionnaire survey was conducted to assess the needs of potential participants. The survey targeted 138 medical university staff members who attended the 91st Medical Education Seminar. Multiple regression analysis revealed that willingness to participate was significantly associated with being a healthcare professional and having strong motivation for collaborative improvement. Based on these findings, four competencies were identified: (1) organizational analysis, (2) problem evaluation, (3) improvement design, and (4) collaborative improvement. This study introduces a marketing-informed perspective into FD/SD development, offering a learner-centered approach to educational design and highlighting the importance of collaboration between healthcare professionals and administrative staff in driving educational reform.
7.Advancing the Japanese Medical Education Journal: Academic Evolution and the Significance of Submission Guideline Revisions
Yuko TAKEDA ; Takuya SAIKI ; Michio SHIIBASHI ; Hiroshi NISHIGORI ; Makoto KIKUKAWA ; Yasushi MATSUYAMA ; Mariko NAKAMURA ; Takami MAENO ; Shizuma TSUCHIYA ; Rintaro IMAFUKU ; Akiteru TAKAMURA ; Jun TSURUTA ; Machiko YAGI ; Yuka MIYACHI ; Haruo OBARA ; Kazuya NAGASAKI ; Osamu NOMURA ; Yuki KATAOKA
Medical Education 2025;56(2):87-98
The role of academic journals evolves with the times. Academic publishing is diversifying, shifting from traditional paper-based formats to broader dissemination through open access. In response to these developments-and to contribute to ongoing progress in medical education-Medical Education (Japan) has undertaken a comprehensive revision of its submission guidelines. As of January 17, 2025, all submissions, peer reviews, and editorial processes are being conducted in accordance with the updated guidelines. The Editorial Board convened a round-table discussion to explore recent developments, beginning with the revision of the submission guidelines. This discussion elaborates on the journal's role and its relevance to the academic community, including society members, authors, and readers. It features statements from participating editorial committee members and highlights the key issues discussed, including the criteria each member uses to evaluate manuscripts. The aim is to offer insight into the journal's editorial stance and decision-making process.
9.Facilitating Early Departure from Examination Rooms to Alleviate Congestion Among Medical Students
Osamu NOMURA ; Yuki SOMA ; Hiroshi KIJIMA ; Hiroyuki HANADA
Medical Education 2023;54(6):549-553
Background: The management of medical student examinations has been affected by the COVID-19 pandemic, necessitating measures to prevent overcrowding at the entry/exit flow line of the examination room. Specifically, one method to mitigate congestion at the examination room exit is to allow students to leave early after completing their exams.Methods: This study utilized the regular final examination in emergency medicine for fourth-year medical students at Hirosaki University. Students were permitted to leave the room early, up until 20 minutes before the 60-minute examination period concluded. We included 130 participants in the study and conducted a multiple logistic regression analysis with the test score (higher (1) or lower (0) than the average score) as the dependent variable and the presence or absence of early withdrawal, gender, bachelor transfer status, and regional quota student status as independent variables.Results: Of the 130 fourth-year medical students included in the study, 14 (10.8%) left the exam room early. The multiple logistic regression analysis indicated that bachelor transfer students (odds ratio (OR) = 4.20, 95% confidence interval (95% CI) 1.24-14.18) and female students (OR = 2.56, 95%CI 1.24-5.25) tended to achieve statistically significantly higher scores. However, early leavers (OR = 1.78, 95%CI 0.53-5.95) and regional quota students (OR = 1.72, 95%CI 0.78-3.78) did not exhibit a significant association with the highest scores.Discussion: We found that there is no significant association between early exit of medical students and exam scores in our emergency medicine examinations. Therefore, implementing early dismissal can be justified as a measure to ensure a smooth flow of students when leaving the room.
10.Nine Hereditary Movement Disorders First Described in Asia: Their History and Evolution
Priya JAGOTA ; Yoshikazu UGAWA ; Zakiyah ALDAAJANI ; Norlinah Mohamed IBRAHIM ; Hiroyuki ISHIURA ; Yoshiko NOMURA ; Shoji TSUJI ; Cid DIESTA ; Nobutaka HATTORI ; Osamu ONODERA ; Saeed BOHLEGA ; Amir AL-DIN ; Shen-Yang LIM ; Jee-Young LEE ; Beomseok JEON ; Pramod Kumar PAL ; Huifang SHANG ; Shinsuke FUJIOKA ; Prashanth Lingappa KUKKLE ; Onanong PHOKAEWVARANGKUL ; Chin-Hsien LIN ; Cholpon SHAMBETOVA ; Roongroj BHIDAYASIRI
Journal of Movement Disorders 2023;16(3):231-247
Clinical case studies and reporting are important to the discovery of new disorders and the advancement of medical sciences. Both clinicians and basic scientists play equally important roles leading to treatment discoveries for both cures and symptoms. In the field of movement disorders, exceptional observation of patients from clinicians is imperative, not just for phenomenology but also for the variable occurrences of these disorders, along with other signs and symptoms, throughout the day and the disease course. The Movement Disorders in Asia Task Force (TF) was formed to help enhance and promote collaboration and research on movement disorders within the region. As a start, the TF has reviewed the original studies of the movement disorders that were preliminarily described in the region. These include nine disorders that were first described in Asia: Segawa disease, PARK-Parkin, X-linked dystonia-parkinsonism, dentatorubral-pallidoluysian atrophy, Woodhouse-Sakati syndrome, benign adult familial myoclonic epilepsy, Kufor-Rakeb disease, tremulous dystonia associated with mutation of the calmodulin-binding transcription activator 2 gene, and paroxysmal kinesigenic dyskinesia. We hope that the information provided will honor the original researchers and help us learn and understand how earlier neurologists and basic scientists together discovered new disorders and made advances in the field, which impact us all to this day.


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