Background: Evidence on the effectiveness of exercise for cognitive recovery in patients with sarcopenia is limited. This study examined the association between group-based chair-stand exercise and cognitive improvement during convalescent rehabilitation. Methods: This retrospective cohort study included stroke patients with sarcopenia and impaired cognitive level, defined as a Functional Independence Measure (FIM)-cognitive score ≤23, admitted between 2016 and 2023. All patients received standard rehabilitation and participated in group-based chair-stand exercise twice daily. The frequency of exercise during hospitalization was recorded. The primary outcome was FIM-cognitive score at discharge. Secondary outcomes were handgrip strength (HG) and FIM-motor score. Multivariate linear regression analysis was used to examine associations between exercise frequency and outcomes, adjusting for potential confounders. Results: Of the 1,220 patients admitted, 273 sarcopenic stroke patients with reduced cognitive level (mean age 80 years; 48% male) were included in the final analysis dataset; the median frequency of performing chair-stand exercise per day was 43 (interquartile range, 20–71). Higher exercise frequency was independently associated with better FIM-cognitive score at discharge (β=0.217, p<0.001), greater HG (β=0.146, p=0.008), and improved FIM-motor score (β=0.295, p<0.001). Conclusion Frequent participation in group-based chair-stand exercise was associated with improvements in cognitive and physical function in sarcopenic stroke patients. Incorporating simple, repetitive resistance exercises into rehabilitation programs may enhance recovery outcomes in this vulnerable population.

In March 2001, Research and Development Project Committee for Medical Educational Programs proposed a model core curriculum for undergraduate medical education. In this curriculum, implementation of the clinical clerkship is strongly recommended. Two similar curriculum models were later presented by other organizations, and some differences were observed among them. We, Undergraduate Medical Education Committee, have evaluated and compared themodel core curriculum 2001 with the Japanese newer proposals as well as those of USA and UK. Here is reported our proposals for a better rewriting of the learning objectives in the model core curriculum 2001, with some emphasis on the nurture of the competence of the case presentation and decision making process.

In order to implement, or enhance the quality of clinical clerkship, it is necessary to develop good educational environment which will be appropriate to allow medical students participate in medical team services. Important things to be considered will be, (1) Systematic management of the individual department's program by the faculty of medicine, (2) Developing educational competency within the medical care team function, and (3) Nurturing students' awareness forself-diected learning and cooperative team work, and teaching- and medical staffs' awareness of their educational responsibilities. In this paper, to develop better educational environment for clinical clerkship, we propose a desirable situation of the educational organization, dividedly describing on the roles of dean, faculties, board of education, department of medical education, clerkship director, teaching physicians, residents and medical students.

The fourth reports of the discussion group on 21st century medicine and health care proposed that it was necessary to establish in medical education a core curriculum emphasizing carefully selected basic content and to expand the number of subjects that students might take electively in great numbers. Following this report, medical education model core curriculum was made by the research and development project committee for medical educational programs. This guidelines were prepared to serve as the basis for development of new medical education in the 21st century, and educational content was proposed to serve as the essential basis of material to be mastered at present and a reference for curricula constructed by individual universities. This guideline have several new viewpoint such as medical ethics, undivided basic and clinical education, pre-clinical basic skill education and clinical clerkship. In addition to this basic curriculum it will be required to addition of an elective curriculum, which is provided individual or unique training programs based on student needs and the educational principles of the each university.

We investigated the effects of evaluation of education by medical students using the minutes paper, which was developed by Professor Yasuoka, also of Tokai University. The minutes paper consists of 3 questions with 10 gradedchoices and of 8 questions with 2 graded choices. One of the 3 questions with 10 graded choices asks a general impression of a lecture. Every faculty member at the Tokai University School of Medicine should be evaluated once a year by students using the minutes paper. A total of 202 faculty members were evaluated in 1999 or in 2000, and 73 of these faculty members were evaluated in both 1999 and 2000. The faculty members were divided into 3 groups (low grade, moderate grade, and high grade) on the basis of their grades in 1999. In 2000, the low-grade group achieved higher evaluation scores, whereas the moderate-and high-grade groups did not. These results suggest that our evaluation system with minutes papers was effective for improving teaching faculty members with low grades.