Educational Practice Based on Hypothesis-Driven Physical Examination / 医学教育

During the coronavirus pandemic, we focused on Hypothesis-Driven Physical Examination (HDPE), which is performed while considering physical examination and differential diagnosis as issues that can be learned without directly having contact with patients. We created HDPE scenarios with students who elected general medicine in Clinical Clerkship 2, and we implemented HDPE using that scenario on the last day of the clerkship. The scenario was created online and HDPE was conducted face-to-face. Students could learn correct medical examination techniques and manners through mutual learning. In addition, they could acquire communication and lifelong learning abilities through cooperative learning. We were able to enhance the learning effect through mutual learning that works on the students’ own intrinsic motivation in terms of both creating scenarios for the framework of cognitive apprenticeship and implementing HDPE.

Applications of Orento Based on“Upper Heat and Middle Cold” / 日本東洋医学雑誌

Orento is generally used for upper gastrointestinal symptoms. We have used orento for various diseases based on “upper heat and middle cold”. As a result of the evaluation of 30 responders to orento, the most frequent sign of “upper heat” was “yellow tongue coating” (29/30 responders), while the most frequent sign of “middle cold” was “preference for warm foods and beverages” (27/30 responders). Compared with the non-­responder group, the responder group showed significantly higher frequencies of “gastrointestinal cold”, which is the sum of “preference for warm foods and beverages” and “aggravation of gastrointestinal symptoms by cold foods and beverages” (29/30 responders, p = 0.047), and “upper/lower gastrointestinal symptoms” (29/30 responders, p = 0.014). These results suggest that “yellow tongue coating” is the most important sign for “upper heat” while “gastrointestinal cold” is the most important sign for “middle cold”. As Kampo patterns for orento, gastrointestinal symptoms often occur, but there is a possibility of upper or lower gastrointestinal symptoms, skin disorders, and sleep disorders.