Ocular and cervical vestibular evoked myogenic potentials in patients with peripheral vestibular disorders / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the ocular vestibular evoked myogenic potential (oVEMP) and the cervical vestibular evoked myogenic potential (cVEMP) in patients with vestibular diseases.@*METHOD@#From March, 2011 to March, 2012, 13 patients (14 ears) with peripheral vestibular diseases were recruited. Each patient underwent conventional oVEMP and cVEMP examinations elicited by intensive air conducted sound (short tone burst, 500 Hz) in bilateral ears.@*RESULT@#Thirteen cases (14 ears) were included in this study. They were 3 cases (3 ears) with Ramsay Hunt syndrome, 3 cases (4 ears) with acoustic neuroma, 1 case (1 ear) with VII and VIII cranial nerve trauma after head injury, 2 cases (2 ears) with vestibular neuritis, 3 cases (3 ears) with Meniere's disease, and Icase (1 ear) with unilateral hypoplasia of the internal auditory canal. Altogether, oVEMP could be elicited in only 2 ears (14. 3%) and cVEMP were found abnormal in 11 ears (78. 6%).@*CONCLUSION@#The otolithic vestibular end organs and their input pathways could be examined by cVEMP and oVEMP examinations in patients with peripheral vestibular disorders.

Characteristics of the air-conducted ocular evoked myogenic potential in the young normal Chinese subjects / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To identify the characteristics of the air-conducted ocular vestibular-evoked myogenic potential (oVEMP) in the young normal Chinese subjects.</p><p><b>METHODS</b>Twenty five normal subjects were recruited for conventional examinations of oVEMP. The subjects were 19 - 45 years of age [(24.3 ± 5.6) years], 12 males and 13 females. 500 Hz air-conducted tone burst was employed for examination. The threshold of oVEMP in each ear was examined; patterns of these waves were observed and the normal ranges of the oVEMP waves responded to 100 dBnHL were calculated.</p><p><b>RESULTS</b>All subjects were elicited with normal oVEMP N1-P1 waves in both ears. The response rate in these subjects was 100%. The threshold of oVEMP examination was (86.6 ± 3.6) dBnHL (x(-) ± s), latency N1 (10.1 ± 0.4) ms, latency P1 (14.7 ± 1.2) ms, interval N1-P1 (4.5 ± 1.0) ms, amplitude (7.9 ± 4.4) µV.</p><p><b>CONCLUSIONS</b>Air-conducted oVEMP is a kind of vestibular-ocular reflex respond to intensive sound generated by otolithic vestibular end organs. It is stable in the young normal subjects with minor variabilities.</p>

Reconstruction of Medical Education in Afghanistan / 医学教育

1) Afghanistan is one of countries facing serious health situation in the world, and Japan starts support in various area after Tokyo international conference for Afghanistan reconstruction in January, 2002.<BR>2) International Research Center for Medical Education (IRCME), the University of Tokyo, sent faculties as members of JICA expert team for Kabul in 2003 and 2004, and launched support reconstruction of medical education of Afghanistan.<BR>3) IRCME formed consortium in cooperation with Japan Society for Medical Education, International Medical Center of Japan Bureau of International Cooperation and other institutions in order to carry out Medical Education Project to support medical education development of Kabul Medical University, Afghanistan.

Evaluation of the Clinical Clerkship Program at the University of Tokyo (part 1): Student's Self-evaluation and Evaluation by Faculty / 医学教育

A clinical clerkship program was introduced at the University of Tokyo in 2002 to help students acquire clinical knowledge, skills, and attitudes by increasing their involvement in clinical activities. We assessed the learning effectiveness of clinical clerkships at the University of Tokyo Hospital by examining evaluations of student's clinical competence by themselves and by the faculty. Methods: We evaluated each clerkship with reference to overall educational goals developed in advance. We measured students' self-evaluations and evaluatio s by the faculty before and after the clerkship. Results: At the end of the 2-month clerkship, students' self-evaluation scores (3.18) were significantly higher than before the clerkship (2.71). In particular, scores for patient care were markedly higher. Evaluation scores by the faculty were also higher during (3.64) and after (3.57) clerkships than before (3.26) clerkships. Conclusion: We will use this data to make next year's clerkship programs more effective. We should also develop more-objective strategies for evaluation and establish relevant educational goals.

Evaluation of the Clinical Clerkship Program at the University of Tokyo (part 2): Course Evaluation and Faculty Evaluation by Students / 医学教育

The purpose of this study was to evaluate the clinical clerkship program at the University of Tokyo Hospital. We report results of course and faculty evaluations by students and of qualitative evaluations, such as students, free comments and group interviews. Methods: Each item of the course and faculty evaluations was related to the overall educational goals developed in advance. Students evaluated the course and faculty immediately after the course ended. Results: Students rated the clerkship program favorably overall, but the scores of thesecond month (3.38) were lower that those of the first month (3.63). Although learning basic clinical procedures is not the main educational goal of the clerkship, students varied widely in their opportunities to perform procedures. Scores of faculty evaluations ranged from 2.93 to 3.87 in the first month and were lower in the second month for all but two items. Interviews revealed that students had fewer learning experiences in the second month because new residents started their rotations at that time. Conclusion: The results suggest that the scheduling of clinical clerkships should be changed. The contents of clerkship need further consideration.

National Survey of Programs to Teach Evidence-based Medicine to Undergraduates in Japan / 医学教育

We conducted a national survey to examine the status of programs to teach evidence-based medicine (EBM) to undergraduates in Japan. Our survey specifically focused on four areas: 1) recognition of a need to teach EBM, 2) the present status of programs to teach EBM to undergraduates, 3) details of the timing of existing EBM teaching programs and of departments responsible for it. Sixty-four schools (80%) responded. Nearly all respondents agreed that EBM should be taught, and most agreed that it should be taught both before and after graduation. Most respondents stated that departments must collaborate when preparing to teach EBM. At the time of the survey, 22 medical schools (34%) had already started programs to teach EBM and 28 (42%) were planning to do so. Existing programs mainly targeted 4th-year students, but the department responsible for the programs varied among schools. Further evaluation of the effectiveness of existing programs is now needed.

Introducing Evidence-Based Medicine Into Undergraduate Medical Curricula: Results of a Nationwide Survey in Japan / 医学教育

We conducted a nationwide survey in 2000 regarding undergraduate medical education in Evidence-based Medicine (EBM) in Japan. We asked faculty members responsible for medical education at each medical school 1) whether there are any barriers to teaching EBM, 2) what these barriers are, and 3) what educational resources are needed to overcome them. Responses were received from 64 schools (80%). More than half of the respondents reported barriers to teaching EBM. We identified two kinds of barriers: before EBM is introduced, skepticism toward the concept of EBM and the value of teaching EBM is encountered; later, problems of organizing a curriculum and shortages of staff and materials are encountered. To overcome these barriers, we need: 1) to establish organizations for coordinating educational programs among medical schools, 2) to hold seminars for faculty development, 3) to develop EBM curricula and teaching materials, and 4) to provide computer facilities and appropriate networks.

Results of a Survey on Clinical Competence to Be Evaluated by the National Physicians' License Examination / 医学教育

The clinical competence needed by every beginning resident and the present status of such competencewere examined in August 1998 through questionnaires distributed to clinical educators and the nursing staff of university hospitals and clinical training hospitals designated by the Ministry of Health and Welfare. Completed questionnaires were returned by 576 (65.9%) of clinical educators and nursing staff. With a cluster analysis of the necessity and the present status of clinical competence, 21 items for clinical competence were identified as those most requiring evaluation by the national examination. These 21 items included 11 items for clinical competence in the cognitive domain, 8 items in the psychomotor domain, and 2 in the affective domain. In about half of the direct answers obtained from clinical educators, evaluations were considered necessary for 15 items of clinical competence, of which 13 belonged to the cognitive domain. These results were consistent with the present status. However, practical examinations have also attracted increasing attention, as the results included strong demands that the national examination evaluate some basic clinical skills, such as physical examination and measurement of vital signs. However, about 30 % of authorities governing the national examination thought no changes are needed in the national examination.

Report of the 16th Annual Conference on Medical Student Selection. Is Bachelor's Degree "Must" to Apply to Medical Schools? / 医学教育

This is a report of the 16th Annual Conference on Student Selection held on August 30, 1997 in Tokyo. The main topic of discussion was the subject whether bachelor's degree must be required to medical school applicants. Advantages, disadvantages and expected future problems concerning the proposal by the advisory committee of the Ministry of Education and Culture are widely discussed.

Teaching Medical English. A Survey Report on the Present Status of Medical English Education and Plans for Its Improvement / 医学教育

The working group to improve foreign language education in medical schools established in 1994 and chaired by K. Uemura, M.D. sent questionaire about their present curricula and future plans for teaching English to the deans of all 49 public and 31 private medical schools from January 9 to March 9, 1995, and collected the responses from 30 (61.2%) public, 24 (77.4%) private, in total 54 (67.5%) medical schools. The teaching of useful English includes English conversation in 37 (68.5%), medical English in 34 (63.0%), and structures of medical papers in 9 (16.7%) schools. Medical English is also taught as extracurricular and other activities in 40 (74.1%) schools. These figures have increased as compared with the ques-tionaire conducted two years previously. English conversation can be taught to junior (1st & 2nd yrs) students, for whom medical English can only be taught on general medical topics such as the medical care delivery system, bioethics, roles of physicians, and primay care. Therefore medical English is more and more taught to middle-class (3rd & 4th yrs) and senior (5th & 6th yrs) students. It seems necessary to annually conduct a workshop for medical English teachers to improve their strategies of teaching.

Teaching Medical English. A Report of Questionnaires on "Workshop for Teaching of 'Medical English'" / 医学教育

“The first workshop to improve ‘Medical English’ teaching” was held on October 7-8, 1995 in Hamamatsu. An invited guest was Mr. Glendinning from Institute of Applied Language Studies, University of Edinburgh. As questionnaires for this workshop were performed, we report a result of questionnaires. Most participants shared their daily wonder or questions about ‘Medical English’ with others, and this was very beneficial for them. The techniques for ‘Medical English’ education, instructed by Mr. Glendinnign, was impressive for participants. As the program of the workshop was a little conceptual rather than practical, this point should be improved for the next time because most participants expected to learn more practical skills. Participants answered that this kind of annual workshop was useful and should be continued.

Teaching Medical English. A Model Curriculum for Medical English Teaching in Medical Schools / 医学教育

The working group to improve foreign language education in medical schools established in 1994 and chaired by K. Uemura, M.D. here proposes a model curriculum for teaching useful English in medical schools at three levels. The major objectives are listening, speaking, rapid reading, and sentence structuring including paragraphing for junior (1st & 2nd yrs) students, reading medical papers and charts in English, structures of medical scientific papers, and listening to medical English for middleclass (3rd & 4th yrs) students, and writing and orally presenting papers in English on given medical subjects are for senior (5th & 6th yrs) students.

Teaching Medical English. A List of English Teaching Materials for Medical Purposes / 医学教育

The Working Group for the Improvement of Foreign Language Education in Medical Schools in Japan, organized in 1994 and chaired by Prof. K. Uemura, M.D. lists here English teaching materials for medical purposes. More than half of the materials listed are those that one of the group members, T. Ohki, has used or wants to use in his classes. The list has been enlarged due to the responses to the questionnare sent to those who participated in the first workshop held in 1995. The list is divided into 12 categories: listening & reading, writing, medical terminology, pronunciation, textbooks for training the four skills, essays on medicine, fictional stories about medicine & medical doctors, medical ethics and terminal care, handbooks for medical students and doctors, writing medical charts, self-teaching materials. and video materials.<BR>It is hoped that the materials listed here will supplement a model curriculum for teaching ‘useful’ English in medical schools, as proposed by the working group.

Initial Two-Year Clinical Training Program in Postgraduate Medical Education / 医学教育

In 1991, the committee on postgraduate clinical training proposed revised behavioral objectives for basic clinical training in the initial two years. We present here a model for a clinical training program that should enable most residents to attain these objectives within two years.<BR>The program begins with orientation for 1-2 weeks, including a workshop on team care, and nursing practice.<BR>Basic clinical skills for primary care and emergency managements should be learned by experience during rotations through various clinical specialities. All staff members, even senior residents, should participate in teaching beginning residents in hospitals.

Objectives of post-graduate clinical training / 医学教育

Japanese medical graduates are recommended to receive clinical training for more than two years after graduation, because undergraduate clinical training is insuffiicient.<BR>In 1976 the committee of postgraduate clinical training proposed the objectives of basic clinical training after graduation of medical schoool and in 1981 the committee proposed the objectives for the first postgraduate year of training and the methods of clinical skill assessment.<BR>We here present the revised objectives of basic clinical training after graduation of medical school.<BR>It is emphasized that clinical trainees should have basic clinical skills of primary and emergency care during the two year training.<BR>These clinical skills include interviewing techniques, skills in physical examination and interpretation of physical findings, laboratory skills, skills relating to diagnosis and managements, communication skills to other doctors and to other medical co-workers and terminal care.