Impact and Further Assignment of the Accreditation for Medical Education / 医学教育

Japan Accreditation Council for Medical Education, JACME, was established in 2015. Since then, JACME has evaluated education programs in medical schools based on the global standards set by World Federation for Medical Education. 54 medical schools have been recognized as of June 1, 2021.In this paper, we review past evaluations and discuss the impact and challenges of the field-specific evaluation of medical education.

Significance and Perspective of Medical Education Program Accreditation / 医学教育

Japan Accreditation Council for Medical Education (JACME) was established in 2015 and recognized by the World Federation for Medical Education (WFME) in 2017. The accreditation by JACME for medical education programs formally and fairly started in April, 2017. It consists of internal quality assurance through self-evaluation by applying medical schools and external quality assurance by the JACME committee. Although it is tough work for medical schools to receive accreditation, it is mostly accepted as being useful for quality improvement and the enhancement of medical education.

Significance and Perspective of Medical Education Program Accreditation / 医学教育

Japan Accreditation Council for Medical Education (JACME) was established in 2015 and recognized by the World Federation for Medical Education (WFME) in 2017. The accreditation by JACME for medical education programs formally and fairly started in April, 2017. It consists of internal quality assurance through self-evaluation by applying medical schools and external quality assurance by the JACME committee. Although it is tough work for medical schools to receive accreditation, it is mostly accepted as being useful for quality improvement and the enhancement of medical education.

Medical Education in Hungarian Medical Schools / 医学教育

Recently, there has been an increase in the number of Japanese students who want to practice medicine in Japan after receiving their education in a Hungarian medical school and passing the Japanese national examination for medical practitioners. It is of great concern whether they received a sufficient amount of medical education to meet the public trust. Researchers from Japan visited Hungary and observed their medical education system. There are 4 national medical schools that have international courses for educating students from abroad in English. Three of those schools also offer education in German. The Japanese researchers observed international courses being taught in English at Semmerwise University in Budapest and Debrechen University in Debrechen, the 2nd biggest city in Hungary. Although the international education system is not much different from other European countries, some systems such as small group tutorial education, assessment via oral examination, and the requirement of a graduation thesis stood out as key strengths of the Hungarian education system.

The current education program in all medical schools in Japan / 医学教育

<p>　The education program in all medical schools in Japan has been studied and analyzed every 2 years since 1974 by the curriculum committee of the Association of Japan Medical Colleges. Based on the most recent analysis in 2015, the marked innovation of medical education, such as an integrated curriculum, active learning, and clinical clerkship, was recognized.</p>

6. Assessment of Faculty Activity and Development in the Accreditation Standards / 医学教育

<p> Accreditation for medical education has been introduced in several countries to ensure and improve the quality of education programs in medical schools. In the standards for accreditation, the assessment of faculty activity and development is described as important to improve medical education. The balance of teaching, research, and service functions is considered in the assessment. The results of the appraisal are reflected in the faculty's appointments, promotions, and compensation increases in many countries.</p>

4. Investigation of educational achievements of medical department faculties and healthcare providers using a rating form to evaluate medical education performance / 医学教育

<p>Introduction: Compared with faculties in clinical and medical research departments, those in medical departments are not appropriately evaluated in terms of their contributions to or achievements in medical education. Therefore, the aims of this study were to investigate the contributions of medical department faculties to medical education, and to examine differences in contributions according to duty positions and specialties.</p><p>Methods: Five-grade self-assessments in relation to 20 items on a rating form for performance in medical education, which was developed by the Japan Society for Medical Education's Committee for Performance Evaluation, were carried out by medical department faculties in Japanese universities. The data were then totalized and analyzed.</p><p>Results and Discussion: Although faculties belonging to departments other than medical education units did not actively participate in examinations or the education system, they still made contributions to lectures and practice. In addition, faculties with positions with more duties tended to show greater participation in the education system.</p><p></p><p>Conclusion: Based on these findings, we recommend the use of a rating form as a standard scale to evaluate performance in medical education.</p>

Lessons on large-scale OSCE in Canadian Qualifying Examination Part II after post-graduate residency / 医学教育

<p>　Based on our experience of visiting the Medical Council of Canada and observing large-scale OSCE (objective structured clinical examination) in Canadian Qualifying Examination Part II , we report differences operation system, implementation status, and examination questions compared to Japan. This very important examination after the post-graduate residency program may provide several invaluable tips when we introduce nation-wide clinical performance examinations.</p>

Medical Education and National Examination in Canada / 医学教育

　Because Canada is an extremely large country, the main issue in medical education in Canada is fostering physicians who are highly competent in practical skills. For this reason, clinical clerkships and the national examination for evaluating clinical skills and attitudes in Canada are quite advanced. The Canadian medical education system can provide useful information for Japan.

The seamless link between undergraduate medical education and postgraduate training and the elimination of the uneven distribution of physicians among disciplines and regions in France / 医学教育

　France’s sophisticated system of medical education achieves a seamless link between undergraduate education and postgraduate training and has eliminated the uneven distribution of physicians among disciplines and regions. The Épreuves Classantes Nationales （national ranking examination）, introduced in 2004, improved the uneven distribution of physicians among disciplines and regions. Although the medical board examination is not used in France, the unique medical education system, which develops both general practitioners and specialists, provides useful information for improving medical education in Japan.

Medical Education and the National Licensure Examination in Germany / 医学教育

　Medical education in Germany has undergone significant reforms since the new law, “Regulation of the Licensing of Doctors,” was introduced in 2003. The major point of the reforms is the shift from theoretical education to practical clinical training. The national licensure examination consists of 2 parts: an examination for knowledge of basic medicine in the second year of medical school, and an examination for clinical knowledge and skills after clinical clerkships. These reforms should provide useful information for the reform of medical education in Japan.

A 2012 nationwide survey on the application of simulation-based education in medical schools in Japan / 医学教育

Because recent changes in medical care security policy have made clinical skills training difficult, even in teaching hospitals, training with suitable models and simulators is becoming essential for medical students to acquire clinical skills. On the basis of these changes, we performed a nationwide survey on the prevalence and application of clinical skills laboratories for clerkships in Japan. Registered questionnaires were sent to all medical schools in Japan （n＝80） in December 2012. The response forms were filled out by clinical instructors and by the staff responsible for the skills laboratory. The response rate was 94% （75 of 80 schools）. Seventy-one schools （95%） have already installed clinical skills laboratory; however, floor area and availability varied greatly among schools. Floor space ranged from 24 to 2,250 m2 （median, 214 m2）. The number of uses of the facility by medical students in the 2011 school year ranged from less than 100 to more than 10,000 （median, 1,402）. Forty-two schools （59%） had a resident director for the skills laboratory. Simulators of most universities （> 90%） were venopuncture simulators, lung-sound simulators, basic life support mannequins, heart-sound simulators, surgical suture trainers, and automated external defibrillator trainers, and all were frequently used. These results suggest considerable differences among schools in simulation-based learning environments during clinical clerkships. Although most medical schools in Japan have their own clinical skills laboratories, their size, service, and frequency of use vary greatly.

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’.

A Clerkship based on Legitimate Peripheral Participation:A case study of McGill University / 医学教育

  A case study of a clerkship at McGill University school of medicine was conducted based on the data such as an observation, interview, and documents. A clerkship was constructed by three components. The basis of the structure was competency–based education. Medical students starts learning from active observation and later by supervised practice. The curriculum was supported by the educational theory such as legitimate peripheral participation, zone of proximal development and TARGET model, which sheds the light on some key elements to transfer into Japanese clerkship.

Clinical skills evaluation of the United States Medical Licensing Examinatio / 医学教育

・We visited the National Board of Medical Examiners and the Clinical Skills Evaluation Collaboration Center to discuss with the examiners the present state of the USMLE （United States Medical Licensing Examination）, to which clinical skills evaluation has been introduced.<br>・Evidence that the introduction of clinical skills evaluation to the USMLE has affected the reform of medical schools curricula in the United States supports the necessity of introducing clinical skills evaluation to the Medical Board Examination of Japan.

Team–Based Learning at the Duke–NUS Graduate Medical School Singapore / 医学教育

1)We visited the Duke–NUS Graduate Medical School Singapore to learn the administration and management of, and the theory behind, team–based learning (TBL), a candidate educational method to replace the problem–based learning tutorial.<br>2)TBL motivates students to prepare for and engage in discussion. The grading of performance in TBL, certain characteristics of assignments, and the use of peer evaluation all promote individual and group accountability for learning.<br>3)To obtain the maximum overall benefit from TBL and to exploit group dynamics for effective learning, well–designed assignments are the key.

Assessment of training in cardiac auscultation using a simulator / 医学教育

The use of simulators for skills training has become widespread. However, no quantitative analysis has been performed to determine whether simulation-based medical education is useful for improving the acquisition of clinical skills. The educational effect must be evaluated to further develop stimulation-based education. A seminar for cardiac auscultation was held, with the skills laboratory taking the initiative; the effectiveness was verified, and various problems were identified.1)The skills laboratory held a series of training seminars to examine the effectiveness of simulation-based education.2) Sixteen medical students participated in the seminars. One seminar lasted 120 minutes, including 60 minutes of lectures and 60 minutes of skills training. All students attended the three seminars. A questionnaire survey, a written examination, and a skills test were administered to all students three times (before, immediately after, and 5 months after the seminars).3) The students were extremely satisfied with the seminars. The students believed their cardiac auscultation skills had improved and that this improvement was still present 5 months later. After the seminars, the heart sound simulators were used more frequently than before the seminar.4) The results of skills testing after the seminars were better than those before the seminars and remained better 5 months later. However, results of a written examination 5 months after the seminars were similar to those before the seminars.5) The seminars in the skills laboratory were effective for improving students' auscultation skills and increased the effective use of mannequins in the skills laboratory.

A questionnaire survey concerning the distribution and equipment of clinical skills laboratories in Japanese medical schools: Simulation-based skills training courses in clinical skills laboratories / 医学教育

1) Simulation-based training is critical for medical students to acquire clinical skills. We sent questionnaires to all 80 medical schools in Japan asking about the status of clinical skills laboratories and received responses from 73 medical schools.2) Fifty-nine schools have skills laboratories. Forty-nine schools have curricula integrating simulation-based skills training. The 3 most common apparatuses are venopuncture trainers, basic life support mannequins, and skin-suturing trainers. Lung and heart sound auscultation trainers, advanced cardiac life support mannequins, and ophthalmoscopy trainers are used at more than 50 schools.3) Thirty-two of the 59 schools have simulation-based skills-training courses that are not included in the undergraduate medical curriculum. Medical staff and people in the community are participating. The four most common courses are, in descending order, basic life support, intermediate cardiac life support, advanced cardiac life support, and automated external defibrillation, which are held at more than 16 schools.

The Advantage of an Integrated Basic and Clinical Medical Curriculum Exemplified by the Study of Hematology / 医学教育

1) At Dundee University, which has an excellent history of medical education and where the objective structured clinical examination was developed, hematology and dermatology play integrated roles in the second semester of the first-year curriculum. 2) Integrated curriculums, exemplified by the study of hematology, are expected to be introduced to medical schools in Japan.

Medical Education in Korea / 医学教育

The medical school system of Korea was patterned after the system used in the United States. Objective structured clinical examination/complete physical examination will be introduced to the national medical board examination in 2009.Medical educators insist on the importance of clinical clerkships and have introduced simulation-based learning in new curricula.We report on whether this new system is working well or not for possible use in the reform of medical education in Japan.