Committee report (Practice Article1) : Online Interprofessional Education / 医学教育

It is difficult to implement interprofessional education (IPE) in the classroom due to COVID-19. To share our knowledge of online IPE, we report on how we provided IPE for first-year students at two universities. At Mie University, a class was implemented to use Zoom. Quizzes and chats promoted interactions between instructors and students. At Hokkaido University of Science, an online team medical experience game was conducted via Zoom and a Learning Management System (LMS). The activity promoted interaction between students through gameplay and clear instructions. In both cases, students could successfully develop online IPE based on existing learning methods. Through their experience, it was clear that students are able to understand other professionals’ roles. They were also to commit to membership and/or teamship. On the other hand, students faced challenges with faculty familiarity and time allocation.

Working Group Report (Practice article 2) : Online Interprofessional Education Stepwise Interprofessional Education through Inter-University Collaboration at the University of Tsukuba (2) / 医学教育

@#In the second part of the second report, we introduce the Care Colloquium, an inter-university collaborative educational program between the University of Tsukuba and the Tokyo University of Science. The Care Colloquium is an interprofessional education program that uses PBL (Problem-based learning). In response to the COVID-19 pandemic, this program was implemented online using Microsoft Teams, with advance preparation including manual maintenance and communication testing. The same learning outcomes were achieved as the face-to-face implementation. Undergraduate interprofessional education tends to be a large-scale program, and the shortage of faculty and classrooms is challenging, but online education could overcome these obstacles. The development of hybrid programs that use the merits of both face-to-face and online education may lead to the promotion of interprofessional education in the future.

Working Group Report (Practice article 2) : Online Interprofessional Education Stepwise Interprofessional Education through Inter-University Collaboration at the University of Tsukuba (1) / 医学教育

For this second report, we divided the efforts of the University of Tsukuba into two parts. In the first part, we introduced the Interprofessional program, an inter-university collaborative educational program between the University of Tsukuba and Ibaraki Prefectural University of Health Sciences. Before the COVID-19 pandemic, this program was conducted using TBL (Team-based learning) in a large conference room. After the pandemic, this was conducted online (using Zoom). The main changes due to the online implementation were the following five points; (1) online faculty meetings, (2) advance distribution of materials, (3) testing using Google Forms, (4) group work using the breakout function, and (5) simultaneous editing using Google Docs. In the future, we would like to examine the possibility of new educational methods while creating innovations that are possible only through online interprofessional educational programs.

Review of Medical Training System in Japan / 医学教育

"The Ordinance of Ministry of Health, Labor and Welfare on Japanese Postgraduate Medical Training System" from 2020 was announced to each prefectural governor on July 3rd, 2018. This Medical Training system has been reviewed once every five years, and has been strongly aware of the consistency between the model core curriculum of the undergraduate medical education and the continuing professional development of Japan Medical Association. In this journal, Postgraduate Education Committee in Japan Society for Medical Education has published six installments of a series entitled "Japanese Medical Training System and Medical Education" . We reviewed the series and discussed medical education trends surrounding the postgraduate medical training system and issues in the committee. We will be reporting the information as part of the seventh installment of the series.

Analysis of Japanese Postgraduate Clinical Training System from the Perspective of Quality of Education / 医学教育

"Quality of education" has various definitions, and the definitions are classified mainly into five categories. Introducing the definition categories of "quality of education" , we analyze what aspects of the postgraduate clinical training system for physicians as an educational program have been reconsidered and redesigned. According to the analysis, we propose to introduce a programmatic assessment, which compose of several assessment methods, for evaluation at each stage of medical education from undergraduate to continuous professional development. Realizing such evaluation, we also propose to introduce a student/trainee assessment from a patient's perspective.

Postgraduate Clinical Training System～A perspective from the Community-Based Medicine / 医学教育

A community-based medicine program in the postgraduate clinical training system has been offered as a mandatory program since 2004. Training sites range from clinical attachments in rural/remote areas to public health centers in the city. The role of the program director is important for enhancing the community-based medical program and raising resident doctors. Unique training programs have been carried out, such as medical training in the afflicted area of the earthquake/Tsunami disaster area as well as an exchange program between Hokkaido and Kagoshima residents. The Japanese healthcare system is drawing global attention and local demand. Enrichment of the community-based medicine program is vital for the human resource development that makes the Japanese healthcare system innovative and sustainable.

Specialty Training System and Postgraduate Education in Japan / 医学教育

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

Specialty Training System and Postgraduate Education in Japan / 医学教育

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

Medical Professionalism and Continuing Professional Development in the Next Amendment of the Postgraduate Clinical Training System / 医学教育

Under the current postgraduate clinical training system for physicians, three principles have been emphasized in its basic tenets; cultivation of character appropriate for physicians, generation of awareness to the societal role of medical science and healthcare, and mastery of basic clinical skills needed to respond appropriately to injuries and illnesses frequently encountered in general practice. In accordance with its quinquennial review rule, the Clinical Training Committee under the Medical Caucus of the Healthcare Professions Council released draft revisions of a notification published by the Director general of the Health Policy Bureau of the Ministry of Health, Labor and Welfare in March, 2018. The document is entitled "On the operation of the ordinance concerning the postgraduate clinical training prescribed in the paragraph (1) of Article 16-2, Medical Practitioners Act" .　A Key distinction of the revised draft is new learning outcomes featuring core values shared by physicians: commitment to physicians' societal mission of public health, altruistic behavior, respect for humanity, and maintaining one's own integrity. Another key distinction is securement of longitudinal consistency in the set of required faculties, from medical school curriculum to continuing professional development programs. Further improvements in systems and environments to enhance devotion to life-long learning are needed.

Present undergraduate medical education with connection to Postgraduate education / 医学教育

Medical education at college is the very first step of life-long learning as a medical doctor. Curricular reforms in Japan took place in the early 21st century, and can be exampled by the development of a model core curriculum, the emergence of the CAT (common achievement test) examination, the development of clinical clerkship and so on. The International accreditation of medical schools has just started spring of 2017. It highlights outcome-based education, which accelerates the connection of undergraduate education with postgraduate training.

Cooperative learning: the perceptions of University A's nursing students and factors influencing those perceptions / 医学教育

Background: To obtain suggestions regarding the methods of cooperative learning in basic nursing education, the nursing students' perceptions of cooperative learning and the relationship between such perceptions and their influencing factors were elucidated.Methods: Anonymous, self-administered questionnaires were conducted among 131 nursing students at University A in the Chubu region of Japan.Results: Binomial logistic regression confirmed that cooperative learning experiences in high school, learning satisfaction at University A, social support, styles of handling interpersonal conflicts, and undervaluing others in regard to assumed competence were significant influencing factors on the cooperative work recognition scale.Discussion: Factors, including professional identity, communication ability and students' past negative experiences, may have an effect on the recognition of cooperative work. This suggests the need for the continued investigation of the aspects of cooperative learning that take these factors into account.

Interprofessional education in home-care: Collaboration of medical and rehabilitation students / 医学教育

　In the coming ″Super-aging society″ , collaboration between medical professionals and health workers in home-care will be critical. Thus, undergraduate interprofessional education is important for the improvement of a collaborative attitude. We ran a 2-day IPE program for a medical and a rehabilitation student focused on collaboration for patients who have chronic diseases and problems in Activities of Daily Life (ADL) . As a result, one showed marked improvement in ADL while the other did not. Students learned not only roles and perceptions of other professionals but also a sense of worth and an appreciation of the difficulty of patient-centered home-care.

"Diabetes Education Class IPE" -Challenge to promote new IPE (interprofessional education) with real patients- / 医学教育

<p>　The WHO reported the importance of IPE (Interprofessional Education) in order to implement team-based medicine smoothly. Some Japanese medical educational institutes presented their IPE programs, which involved real patients, but most IPE programs used scenario-based or standardized patients. Moreover, few reports showed IPE programs for diabetic patient education. We created a new program, called the "Diabetes education class IPE" . Participants were 2 medical, 4 nursing, 4 pharmacy, and 3 dietician students. The students experienced the planning and management of and reflection on diabetes education classes. As a result of reflection, the "Diabetes education class IPE" was viewed as a useful IPE program.</p>

Investigation of scenarios for healthcare education by multidisciplinary faculty / 医学教育

  In scenarios developed by a multidisciplinary faculty for interprofessional education, practical problems that emerged included: “medical incident” and “shortage of medical resources” from the perspective of patient and families,” and “information sharing,” “evaluation and feedback,” and “insufficient feeling of accomplishment” from the perspective of health-care professionals. Discussions identified “interprofessional collaboration,” “mutual understanding for professionalism,” and “embodiment of professional culture” as key words for problem solving. Finally, scenarios were developed in the hospital, home-care, nursing, or community care settings that referred to 2 themes, “end of life” and “dementia.” Pilot case studies performed with health care professionals demonstrated the utility of the scenarios and the effectiveness of interprofessional education.

The Medical Education Curricula for Students Selected by Nagoya University for Medically Underserved Areas / 医学教育

  To respond to the physician shortage, the capacity of medical schools has been increased through selective admission of student to practice in medically underserved areas; however, neither a system nor a curriculum for such students has been established. At Nagoya University, selected students have been admitted, and the division of Education for Community–Oriented Medicine was established in fiscal year 2009. We have introduced special curricula for these students, such as a seminar for community–oriented medicine, training for medical research, local hospital tours, and a special interprofessional education course. In fiscal year 2013, community medicine is expected to be implemented as a compulsory subject in the 4th year curriculum. For the education of students selected to practice in medically underserved areas, we believe that older students serving as role models and cooperation with other organizations and community are important.

Establishment of a clinical training system beyond the regions and the teaching hospitals / 医学教育

  Teaching hospitals play an increasingly important role in clinical training, and improvement of the education system is required. To effectively utilize limited human and material resources for clinical education and to enhance clinical education and medicine treatment throughout a region, cooperation between hospitals is essential. However, cooperation for clinical education training beyond prefectures or training hospitals cannot be said to be sufficient. The Kisogawa Medical Conference, a collaborative system of 5 training hospitals located around the Kiso River estuary, held medical lectures, hands–on seminars, and joint–hospital case conferences. Cooperation in medical education training and exchanges beyond prefectures and training hospitals is expected to lead to substantial improvements, not only in medical education training, but also in medical care throughout a region.

A questionnaire survey about community medicine in residency programs in the Tohoku–Hokuriku region of Japan / 医学教育

In 2004 a program of community health and medicine was included in the national residency system. However, the contents and achievements of this program have not been adequately studied. We surveyed residents, program directors, and collaborating facilities for clinical training in community medicine in the Tohoku–Hokuriku region of Japan about the contents, practices, training period, curriculum development, and other aspects of the program.<br>1)We conducted a survey of 230 residents who had completed the program, 82 program managers, and 101 collaborating facilities.<br>2)The survey consisted of surveys of residents (survey 1), of program directors (survey 2), and of collaborating facilities (survey 3) and asked about the programs' consistency with the training objectives of the Ministry of Health, Labour and Welfare and satisfaction with community medicine.<br>3)Approximately 70% of residents, program managers, and collaborating facilities believed the training period for community medicine is appropriate.<br>4)Furthermore, 69.1% of residents, 65.5% of program directors, and 85.2% of facilities believed that the community medicine program in the national system was important or very important.<br>5)Training programs should be enhanced so that residents "understand and practice health care in outlying and rural areas" and to increase active involvement of program directors.

A workshop to promote interprofessional health care collaboration in the community / 医学教育

1)A workshop to promote interprofessional health–care collaboration in the community is reported.<br>2)The three topics discussed were: "the needs of an interprofessional network in the community," "barriers that can prevent the promotion of an interprofessional network in the community," and "strategies to overcome the barriers."<br>3)The critical issues identified were, communication, information sharing, and leadership. Working to improve the health–care system and clarifying and promoting the significance of an interprofessional network were also identified as critical issues.

Personal declaration of involvement in community medicine by medical residents on local FM radio / 医学教育

1) A program entitled Doc MMC was broadcast on FM Mie, a local FM radio station.“The Doc MMC Declaration”was performed on this program by residents.<BR>2) The declarations were classified into six groups: “Affection, ”“Contribution to Community Medicine, ”“Knowledge and Skill, ”“Special Training Course Selection or Self-Activation, ”and “Others.”<BR>3) This kind of broadcasting may enhance the motivation of residents and facilitate the understanding of medical issues by the community.