Aichi Medical University, a peer teaching support system was introduced in the 2018 academic year to assist students with low academic performance. While the initiative yielded some positive outcomes, variations in group motivation occasionally resulted in a lackadaisical attitude. Furthermore, limited faculty involvement restricted the scope of in-depth discussions. The onset of COVID-19 in 2020 further disrupted learning modalities, leading to an increase in the number of students repeating academic years. To address these challenges, several revisions were implemented in the learning support system starting in the 2022 academic year. These changes included confirming students’ willingness to participate in study sessions, increasing the number of faculty tutors, and enabling students to form study groups autonomously. This paper discusses the evolution of our learning support system and the experiences that led to these revisions.

Since 2013, Nakatsugawa City has been holding a medical/nursing care work experience event called “Medical Kids,” aimed primarily at sixth-grade elementary school students to develop an interest in medical and nursing care and aspire to become medical/nursing care workers in the future. We investigated the current career paths of participants in this event 7 to 9 years after the event, and evaluated the impact of the event on their intentions to work in the medical and nursing care professions.　A questionnaire survey was conducted in 2022 asking 43 participants of the event from 2013 to 2015 about their current career paths. The response rate was 81.4%, with 40% employed or pursuing higher education in the medical/nursing care field, and 64% of them stated that participating in the event was an opportunity for them to choose a career path. It turned out that this event was an opportunity for them to choose a future medical or nursing career.

Context: As a contribution to this special issue of the journal featuring the computerization of the national medical licensing examination (NMLE), this paper seeks to explore the steps to shift the NMLE toward computer-based testing (CBT). Objectives: The purpose of this paper is to explore the movement of the NMLE toward CBT over the last 20 years and the merits and demerits of computerizing the NMLE. Methods: To explore the contents of committees' reports on the improvement of the NMLE, which have been held almost every five years. We also report the results of research we conducted on the computerization of NMLE. The research was supported by a grant from the Ministry of Health, Labor and Welfare (MHLW). Discussion: The former part of this paper explores the reports by the committees to improve the NMLE from 2011 onward. The latter half of this paper focuses on the result of our research from 2018 to 2020, favoring the computerization of NMLE based on the analysis of the merits and demerits of CBT.

Objective: To clarify the involvement of Japanese family physicians with patients and their families in their daily practice.Methods: Participants were Japanese family physicians with over one year of experience of full-time work in their clinics, and who were able to join the focus group discussions (FGD) and member checks. The study employed a qualitative research design with semi-structured FGD. Two analysts examined video recordings of the FGD, and the results were verified through member checks and external checks.Results: Eight physicians participated at first, but five of them dropped out because of job commitments or death. The involvement by Japanese family physicians consisted of three stages. The first stage was "the approach of repeated hypothesis testing and normalizing" as safety interventions. The second stage was "reevaluation of the family" utilizing family genograms, family conferences, and others. After exhausting all other efforts, they engaged in "accepting the one who comes to them" in collaboration with the patient and families. The outcomes included awareness of patients, their smiles due to feeling accepted, and their expressed emotions. They did not explicitly boast that they were able to engage with family members. In addition, they also needed case studies of instances of "failure." Conclusion: Japanese family physicians engaged in three-stage involvement with families.

Changing societal environments are forcing us to prepare to assume new roles as physicians. The resulting changes coming to the practice of medicine require significant medical education reforms. Specifically, there are nine factors that impact this need for change. Those factors are: 1) expanding medical knowledge, 2) introduction of various new technologies into medicine, 3) easy accessibility to medical knowledge by patients and their family members, 4) an aging population, 5) rapid development of information and communication technology, 6) the imminent arrival of artificial intelligence, 7) specialization of physicians, 8) variety of health professionals, and 9) globalization-.

Objective: To clarify how and when Japanese family physicians assess families in their daily practice.Methods: Participants were Japanese family physicians with over one year of experience of full-time work in their clinics, and who were able to join the focus group discussions (FGD) and member checking. The study employed a qualitative research design with semi-structured FGD. Two analysts examined video recordings of the FGD, and the results were verified through member checking and the checking by external members.Results: Physicians assessed families naturally while examining patients for common cold, during vaccination, and during registration in the Japanese care insurance system.Additionally, the physicians assessed the families when they observed or suspected something strange regarding the patient and/or the family.Families were assessed based on how they spent their time during special Japanese events that the family members attended together (e.g., Bon festival or Japanese style New Year holidays), the patient's illness behavior in non-reserved outpatient clinics, and their communication patterns. Furthermore, the family photograph technique for family therapy was also used for assessment.Conclusion: Participants utilized skills of family therapy such as communication patterns and family photographs. They also employed unique skills such as assessment of the families' sharing time during traditional events, assessment of the patient's illness behavior, and general assessments regarding the Japanese care insurance system.

Introduction: Consultation simulation with simulated patients has rarely been done as a training program.
Method: Fifth-year medical students in 2 neighboring universities attended the same training program at each site. The students’ performance was evaluated.
Result: Most medical students thought that this training program was valuable and that they require more opportunity to practice. Students evaluated their own performance in both medical procedures and differential diagnosis as being poor. However, about 50% of students felt that they paid careful attention to the simulated patient during physical examination. Students thought that the consultation was extremely realistic and that the series of medical procedures they performed at the first attempt was extremely difficult but increased their motivation. They thought that the feedback they received from simulated patients was beneficial.
Discussion: This education program is highly regarded by students and is suggested to be versatile.

BACKGROUND: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.
METHOD: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.
RESULTS: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.
CONCLUSIONS: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.

BACKGROUND: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.
METHOD: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.
RESULTS: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.
CONCLUSIONS: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.