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.

In Japan we are rushing into an era of aging society. People will need acupunctureand moxibustion more and more in the future. ”So, to be loved by people indeed, therapists have to setour sights on“ People have acupuncture and moxibustion on a high level at any therapist. ”And we have to makeeffort to progress our stuff and technique that therapists are made of. At first, we have to make it in mind“ Do non-pain acupuncture ”to dispel anxieties and dread of patients and to feel good for their treatment. On that account, therapists have to devote aurself to our studies of traditional Japanese medicine and delicate Japanese acupuncture with Japanesque fine needles. I believe the true acupuncture and moxibustion should be the medicine to work on the life force with the technique of “Ho” and “Sha” to the acupoints on the meridians. And I believe that we should send this all over the world as a Global Standard for acupuncture. I know it is possible to have clinical effect without pricking needles, through my long experience. I can evidence it with Bi-Digital O-Ring Test. I can get clinical effect with only affixing aneedle in a specific direction. With this treatment, patients feelcomplete non-pain because they don't be pricked.I call it“ Vector Effect Needle (VEN) ” I deliver a lecture on this acupuncture.

Since the greater part of the patients who undergo acupuncture therapy show little objective symptoms, it is difficult to determine the efficacy of acupuncture on an objective basis. An attempt was made in this paper to employ the measurement of finger skin temperature, which is supposed to express the relaxed condition, in acupuncture therapy for various cases so-called neurosis, pain of simple locomotrial diseases and so on.
In each treatment session, “self-control” was undertaken prior to acupuncture: The patients were made to listen to the “Self-Control; 1st stage” tape by Ikemi through a headphone to relax themselves physically and mentally with the aid of a biofeedback device developed for self-control training. The finger skin temperature or galvanic skin response was successively recorded during each treatment session (i. e. self-control and acupuncture) in order to determine how far the patients are relaxed. The intensity of acupuncture stimulation was instantaneously adjusted according to the fluctuation in the finger skin temperature. The data obtained from patients resting in the supine position at a constant room temperature was referred to.
Each case showed a peculiar response pattern, which was almost similar in every treatment session. In some cases, there were large differences between the data obtained during “self-control” and those during acupuncture.
The patients who were in a well relaxed condition during the treatment session showed marked result: ameliorated subjective symptoms, enlarged range of joint movement and so on.
It was thought that the magnitude of acupuncture stimulation should be controled in order to make the patient relaxed.