Background and purpose: With the increase in the number of international medical students, there is an urgent need to develop programs to foster communication skills in Japanese, but the communication problems of international medical students are not clear. Methods: Semi-structured interviews and questionnaires were conducted with 10 international students to identify communication difficulties during clinical practice. Results: Regarding communication with patients, the frequently reported difficulties were difficulty in hearing elderly voices, difficulty with dialects, and difficulty with onomatopoeia. As for communication with health care professionals, the top concerns were not being able to understand jargon and difficulty in speaking concisely using technical terms. Discussion: Language input is a major problem. In educational institutions, they need to listen to a variety of speakers, learn frequent onomatopoeia, and practice oral case reports.

The International University of Health and Welfare School of Medicine accepts 20 international students every year. In this paper, we report on the practice of “Medical Japanese Class” for these international students. The “Medical Japanese Class” is a class in which students learn medical terminology through listening, speaking, reading, and writing activities, and make presentations in Japanese based on the knowledge they have learned in English. This is a combination of the Language for Specific Purposes model and the Sheltered model, of Content-Based Language Instruction. We designed and implemented a lesson in which Japanese instructors used medical materials to introduce medical terminology and expressions. Medical faculty checked the application and correctness of medical content.

Purpose: Although many studies have assessed the impact of interventions to increase medical students’ empathy by improving their understanding of patients’ perspectives and feelings, the impact of hospitalization experiences remains unclear. Methods: Fifth-year medical students at Kyushu University from 2009–2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. Results: Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients’ anxiety about illness and empathy as one of the requirements of health care providers from the patients’ perspective. Conclusion This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students’ empathy by improving their understanding of patients’ perspectives and feelings.

Purpose: Although many studies have assessed the impact of interventions to increase medical students’ empathy by improving their understanding of patients’ perspectives and feelings, the impact of hospitalization experiences remains unclear. Methods: Fifth-year medical students at Kyushu University from 2009–2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. Results: Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients’ anxiety about illness and empathy as one of the requirements of health care providers from the patients’ perspective. Conclusion This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students’ empathy by improving their understanding of patients’ perspectives and feelings.

Abstract:

 This study examined the ability of medical students to self-assess basic clinical competence and learning strategies including simulation-based medical education for sixth-year medical students (n=903) at nine universities in Japan. About 40% of 27 procedures to achieve clinical skills in a model curriculum were taught using simulators with or without clinical training in hospitals. We noted that significant numbers of procedures were not practiced through any learning strategies. Higher self-assessment scores were observed among students in 4 schools who had more frequent learning opportunities through simulation-based education than among those with less frequent opportunities in 5 schools.

　The author is involved in the management of Objective Structure Clinical Examination (OSCE) for Common Achievement Tests to be implemented prior to a clinical clerkship. In this study, we discuss how to develop questions for students who will receive OSCE after a clinical clerkship, as well as potential challenges in the introduction and management of its examination system. Finally, we consider the short-term future of clinical education, given the actual situation where a specialty-specific accreditation system has been introduced according to global standards, and medical education focused on medical professionalism is being offered.

　To encourage the broad use of simulation-based medical education and establish partnerships to promote objective structured clinical examinations after clinical clerkship among medical teachers, we hosted the first team-based clinical skills competition event for medical students in Japan, named ‘Medical Students' Simlympic Games 2014'. Thirty-six (12 teams of three) open-recruited 5th or 6th grade medical students participated in this event. Student teams performed clinical tasks at 6 stations, which actively utilized the strengths of simulators or simulated patients. Contents, composition, difficulty level, and validity were tested by trainee doctors and examined by committee members in advance. In this report, we describe our concept, executive committee formation, a variety of arrangements, the outline on the day of the event, and the results of a questionnaire targeting participants. (126 words)

Background: Although community-based training is included in medical undergraduate education in Japan, little assessment of the outcomes of community-based education programs has been performed. The aim of this study was to investigate the outcomes of a community-based education program using a mixed method.
Methods: The study design utilized both qualitative and quantitative methods (mixed method). The subjects (n = 278) were fifth-grade medical students who were involved in the program from 2008 to 2010 inclusive. We collected two types of data: a six-item pre-and-post questionnaire (quantitative) and an open-ended questionnaire (qualitative) to evaluate the impressions this experience left on the students.
Results: Pre-and-post questionnaires were completed by 263 (95%) of 278 subjects; on all items, the scores of the post- data were significantly higher than that of pre- data (P < 0.001). From the responses given by 139 respondents (total 181, 77%) in the open-ended questionnaire survey, 10 themes were extracted: 1. Inter-professional cooperation; 2. Role and cooperation among university hospitals, community hospitals, clinics, and welfare facilities; 3. Patient-centered medicine; 4. Trust-based relationships; 5. Competency in general medicine; 6. Professionalism; 7. Medical management; 8. Communication; 9. Common diseases; and 10. Long-term care.
Conclusions: We found that medical students gained four major perspectives from their experiences: Inter-professional cooperation, trust based relationships, roles of community hospitals and clinics, and patient-centered medicine, respectively. Our findings suggest this program contributed significantly to their understanding of community medicine.

We sent questionnaires to clinical instructors and trainees within 2 years of the latter passing the national licensure examination for medical practitioners to investigate their opinions about the examination and to improve its style. Most instructors wanted to change the examination into an ideal style; however, the trainees had positive comments about the present examination. Several problems came to light, including whether the present examination is asking the minimum requirements for initial training and what the necessary actions are for assessing clinical skills. We must take measures to improve the examination.