11. Diversity is Strength: Creating a Safer Environment at Juntendo University Hospital / 医学教育

Juntendo University Hospital (1051 beds) set up a working group focusing on SOGI (sexual orientation and gender identity) in May 2021. To date, more than 300 staff members play a rale as ally members in rarious hospital departments to promote a safer environment for patients of all SOGI. This initiative has been spreading to the medical school and other parts of the university to ensure a safer space for everyone. Providing hospital staff opportunities to meet with LGBTQs people in person at a SOGI seminar seems to bring a transformative impact on the participants.　Understanding a patient's background is imperative to provide better care for any patient. This article illustrates how we facilitate the process of enabling hospital staff to support patients with various SOGI.

"Easy Japanese" for Everyone: Another Way to Enhance Communication Skills for Promoting Partnerships with Patients Including Those from Overseas / 医学教育

Many healthcare professionals believe they must speak English to communicate with patients from overseas. However, a survey revealed more than 70% of overseas patients comfortably use Japanese in their daily life. Therefore “Easy Japanese” has been promoted at municipal offices, tourism agencies, or schools attended by children with ties to overseas countries. However, Easy Japanese is not known to clinical staff.　This article introduced an overview of “Easy Japanese” and the educational materials we have developed for busy clinicians. As the number of international residents has been increasing, hospitals must be equipped with medical interpreters and “Easy Japanese.” Easy Japanese is also helpful for the elderly, especially those with hearing and/or cognitive impairment. Medical interpreters and sign-language interpreters often express the merits of “Easy Japanese,” which is a valuable tool for multicultural societies and should be implemented in medical education.

Tips for Successful Submission to Medical Education Journals / 医学教育

Medical Education Journal is the official journal of the Japanese Society for Medical Education. There are seven categories including original research papers and practice research articles. It is essential that original research is designed based on clear research questions and conducted using valid and reliable methodology. Literature review and discussions utilizing theoretical frameworks should not be omitted. This article illustrates the critical points in preparing full research papers and the lessons learned from unaccepted manuscripts. New category, Practice report: introduction of a new approach, is explained in this issue.

Learning Social Determinants of Health through Immersion in Community: Student-Selected Components at Juntendo University / 医学教育

We provide “student-selected components (SSCs) “ for 3rd-year students at our school. They work with local NGOs and identify SDH that affect the underserved population including people in isolation, poverty and/or homelessness. Since most students are from privileged families, those encounters made a strong impression on students who create a short video to advocate for people they have met. We describe the process of developing this program and explain the models and theories that underpin this education.

Teaching and Learning Social Determinants of Health (SDH) in Times of Social Disparity / 医学教育

In the Model Core Curriculum for Medical Education revised in 2016, the aim to teach "social determinants of health (SDH) " appeared for the first time. In times of social disparity, socio-economic conditions, including unemployment and low income, sometimes discourage people from doing follow up visits to the clinic due to the copay. This happens despite the universal coverage of health insurance. The socio-cultural environment also affects individual health. For example, the sexual minority suffers from depression and suicidal risk due to prejudice in our society. The WHO states that SDH are mostly responsible for health inequities and should be tackled by health professionals. In this article, we discuss why we should teach medical students SDH and how we could implement the program to an already overloaded curricula.

Global Trend in Medical Education / 医学教育

Education is socially constructed. How health care is provided also affected by many factors including culture, history, and economy as well as insurance system in a country. Medical school is responsible for fostering physicians who can respond to societal needs in the era of health inequality. Based on the experts' opinions and changes in the description of chapters in medical education textbooks, we will review the global trend of medical education and discuss the challenges

Using Photography to Improve Attitudes Towards English Practice and Foster Habits of Mind / 医学教育

Although medical students in Japan are required to study English, one of the greatest problems faced by instructors is how to motivate students. Medical students in particular may find little value in studying English because they may not be able to see it as particularly necessary for achieving their career goal of becoming a medical doctor. At Juntendo University, when English instructors asked students directly about their attitudes towards English study, some of them said, quite directly, that they did not think it was important to take English classes. For this reason our goal was to introduce a style of English class that took students focus away from something they might potentially not value to something they might find more meaningful. It is also our philosophy that English classes should be more than just language lessons. They should also contribute to the overall process of raising well rounded and capable health care professionals. In order to get students interested in English classes and teach them valuable lessons that will help them become better doctors in the future, we turned to photography.

Simulation of Disaster Relief:Active Learning on Roles of Rescuers and Sufferers / 医学教育

We have conducted an active learning session for participants in various fields using a scenario in which university students encountered a great earthquake during a field trip. The program was unique because it not only gave participants an opportunity to simulate providing support, it also allowed them to simulate receiving support.

Recent Trends of Medical Education Reforms in United Kingdom: / 医学教育

Background: Globalization urges us to discuss rationale and policy towards establishing a medical education accrediting body in Japan. Experience of General Medical Council （GMC） suggests us some useful lessons.<br>Method: Based on our visits and investigation into in GMC, we inquire how Quality Assurance （QA） was introduced in UK with what incentives and how QA has brought reforms in the medical schools in UK.<br>Result: Since 2003, GMC has changed its policy for QA from ‘inspection’ to ‘dialogue’. Dialogical QA asks a medical school to think critically of their education and consider vigorous actions for further improvements.<br>Discussion: Implications from the experience of GMC are: 1.QA process in GMC makes medical schools take robust steps towards changes, 2. Sharing the rational and policy for QA created the solid base for its effective implementation, 3. There are possible difficulties in establishing structure to do an enormous amount of coordinating work, which is necessary for constructing ‘dialogue with medical schools’.

Teaching and Learning Clinical Medicine at King’s College London School of Medicine / 医学教育

1）King’s College London School of Medicine is the largest medical school in UK with 470 students for each year in their 5 year course with variation of a fast track 4 year for graduate students and extended 6 year for some entrants. The current curriculum endeavours to meet the requirements addressed in “Tomorrow’s Doctors （2009）” prepared by General Medical Council.<br>2）An integrated curriculum has been implemented and students’ encounter with patients will start from the first year of medical school. During the 1st and 2nd year, students learn basic medical science through issues raised in case–based scenarios, which include discussion of clinical ethics and involves inter professional education （IPE）.<br>3）During the 3rd and 4th years, hospital clinical rotations are provided and seminars and bedside teaching are main components of the weekly schedule. Clinical clerkship is provided for final year students who are expected to become ready as junior doctors; 8weeks in medicine, 8 weeks in surgery and 8 weeks in General Practice.<br>4）Eighteen ％ of clinical rotation component is conducted in community where General Practitioners （GPs） take active roles in teaching. King’s longitudinal health education programmes have been provided to enable students to understand community and to take initiative roles in advancing health and well being of their future patients, populations and communities.<br>5）Although hospital rotation programmes may vary among hospitals, logbooks are utilised to insure students have undertaken standard clinical opportunities and activities, while OSCEs and written examination are utilised to assess students’ achievement.

Medical Education at the Arabian Gulf University College of Medicine and Medical Sciences, a Consortium Medical School / 医学教育

1) In 1982, the Arabian Gulf University College of Medicine and Medical Sciences (AGU), a new regional medical school based in the Kingdom of Bahrain, was established by a consortium of six Arabian Gulf countries and has succeeded in effbcting changes in medical education in the region.<BR>2) High school graduates must be nominated by the relevant ministry in their respective countries to apply to the AGU. Two thirds of the students are women.The entire curriculum is conducted in English, and the AGU provides remedial classes to improve students' English skills during the first year.<BR>3) The AGU has adopted the educational philosophy of problem-based learning since its inception.During the clinical clerkship phase, students revisit basic medical sciences with emphasis on their clinical application.The creativity and innovation of the AGU's programs in the commumity are designed to meet community needs and invite the greater participation of community faculty

What Motivates Community Physicians to Participate in Office-based Education? / 医学教育

Increased emphasis on community-based education in medicine requires close collaboration with and cooperation from general practitioners. This study examined what motivates community physicians to participate in office-based education, to explore the most appropriate method for recognizing physicians' efforts and keeping them motivated with their precepting role. A large majority of respondents to a questionnaire survey thought that the opportunity to learn from their own teaching was an important reward. When the preceptors were asked what support would be most appropriate, a teaching certification plaque, continuing medical education courses, and a title were ranked highest, while financial reward was listed as the least important. Considered most essential by community preceptors were constructive feedback from students, medical-school instructors' understanding of the importance of community-based medicine, and the instructors' enthusiastic promotion of primary-care education.

Evaluation of the Model Core Curriculum for Clinical Clerkship / 医学教育

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.

Postgraduate Ambulatory Care Training at Government-accredited Teaching Hospitals: Results of a Nationwide Survey in Japan / 医学教育

Although postgraduate training in an ambulatory care setting is recognized as beneficial in Japan, such training has not been widely implemented. In April 2001 we surveyed all 389 accredited teaching hospitals in Japan about their ambulatory care training. We asked 1) whether they provide a postgraduate training program in ambulatory care, particularly for problems commonly encountered in primary care settings, 2) if such a program was provided, how it was organized, and 3) if such a program was not provided, what the reasons were. One hundred eighty physicians responsible for the residency programs of 120 hospitals replied (response rate, 87%). Most residents at these hospitals see patients in outpatient clinics regularly during their training. Many faculty members supervise their residents at the outpatient clinic and also see their own patients. Sixty-eight percent of the respondents did not set teaching objectives for ambulatory care training. Frequently mentioned barriers to providing ambulatory care training were limited space and tight outpatient schedules. To promote postgraduate ambulatory care training in accredited teaching hospitals, adequate resource allocation and a national policy are needed.

Teaching Ambulatory Care Medicine in Japan: A Nationwide Survey / 医学教育

Teaching ambulatory-care medicine is essential for primary-care education. However, few studies of ambulatory-care training have been done in the past decade. We performed a nationwide survey to examine whether and how ambulatory medicine is taught to medical students and residents. We sent questionnaires to all medical schools (n=80) and accredited teaching hospitals (n=389) in February 2001. The response rates were 83.3% and 79.2%, respectively. Fifty-one (78.5%) of the 65 medical schools provided ambulatory-care education, although the programs varied considerably from school to school. Only 104 teaching hospitals (26.7%) had an ambulatory-care training program.

Educational Program for Prehospital Trauma Life Support in the United States / 医学教育

To provide a “gold standard” for care of trauma patients, the American College of Surgeons Committee on Trauma developed Advanced Trauma Life Support (ATLS) in 1979. Prehospital Trauma Life Support (PHTLS) courses are based on ATLS and provide a prehospital trauma care philosophy that stresses the need to multisystem trauma as a unique entity with specific requirements. We participated in “provider courses” and “instructor courses” of PHTLS and were the first Japanese to be certified as PHTLS instructors. PHTLS was designed as a scenario-based program for prehospital care-providers of all levels. PHTLS courses are internationally recognized continuing education programs utilizing various teaching skills. This is the first report on PHTLS courses, which we believe are beneficial for prehospital emergency health care professionals and educators.