Competency-based medical education guidelines are context-based: Lessons from national guidelines in five countries.

Background And Objectives: The global shift towards competency-based medical education (CBME) has led to the development of national guidelines for CBME implementation (CBME Guides). The characteristics of CBME Guides from CBME-developed countries were analysed to inform the revision process for the CBME Guide in Japan, a CBME-developing country.

Methods: Document analysis of CBME Guides from Canada, Singapore, the Netherlands, the United Kingdom, and the United States was conducted by six Japanese medical education experts.

Identifying teaching competencies for medical residents using a modified Delphi method.

Purpose: This study aimed to identify the teaching competencies of medical residents.

Methods: A modified Delphi study was conducted from January to March 2017. Twenty-four panelists (six medical educators, program directors, chief residents, and residents each) from various facilities in Japan participated in the study.

Competency lists for urban general practitioners/family physicians using the modified Delphi method.

Background: In recent years, the growing global urbanization and urban population have resulted in the emergence of various health problems unique to urban areas. Therefore, training general practitioners and family physicians who can tackle the complex health problems of urban areas and improve the health of urban people is one of the most important issues of our time. However, findings on competencies for urban general practitioners (GP) and family physicians (FP) were limited.

Development of Versatile and Interactive Model Lessons in Kampo Medicine Education.

Objective: To develop versatile and interactive model classes by generating the contents of Kampo classroom sessions that can be taught by instructors who are not familiar with Kampo medicine.

Methods: In 2018, we conducted Kampo classroom sessions among fourth-year medical students at Kyushu University in which we incorporated new content. A videotaped digest edition of the classes was sent to Kampo medicine instructors in medical schools throughout Japan.

Long-term clinical clerkship improves medical students' attitudes toward team collaboration.

Objectives: To examine the related factors associated with medical students' attitudes toward team collaboration.

Methods: This cross-sectional study targeted medical students, residents, and doctors. A survey was conducted from 2016 to 2017 using the Japanese version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC-J), which evaluated "working relationship" and "accountability.

Educational Approaches That Enhance Online Clinical Clerkship during the COVID-19 Pandemic.

Objective This cross-sectional national study determined which educational approaches are associated with the effectiveness of online clerkship for medical students. Method A survey was conducted for medical students at 78 medical schools in Japan from May 29 to June 14, 2020. It comprised the following aspects: (a) participants' profiles, (b) number of opportunities to learn from each educational approach (lecture, medical quiz, assignment, oral presentation, observation of a physician's practice, clinical skill practice, participation in interprofessional meetings, and interactive discussions with physicians) in online clerkship, (c) frequency of technical problems, and (d) educational outcome measurement (satisfaction, motivation, knowledge acquisition, skill acquisition, change in self-study time, and understanding of the importance of medical care team).

Processes of increasing medical residents' intrinsic motivation: a qualitative study.

Objectives: This study aimed to determine qualitatively how medical residents develop intrinsic motivation to learn and work in clinical training settings.

Methods: This study was a descriptive qualitative study, which is widely used in healthcare research. We conducted a semi-structured interview aimed to explore key participants' in-depth experiences and perspectives regarding intrinsic motivation.

Predicting the effectiveness of the online clinical clerkship curriculum: Development of a multivariate prediction model and validation study.

Given scientific and technological advancements, expectations of online medical education are increasing. However, there is no way to predict the effectiveness of online clinical clerkship curricula. To develop a prediction model, we conducted cross-sectional national surveys in Japan.

Massive hemothorax from injury of an anonymous vein after intercostal chest drain placement: A case report.

Background: Placement of an intercostal chest drain (ICD) is an essential procedure in the management of patients with chest injuries. However, ICD placement can have complications. Here, we report a case of massive hemothorax due to injury of an anonymous vein associated with ICD placement.

How culture affects validity: understanding Japanese residents' sense-making of evaluating clinical teachers.

Objectives: Traditionally, evaluation is considered a measurement process that can be performed independently of the cultural context. However, more recently the importance of considering raters' sense-making, that is, the process by which raters assign meaning to their collective experiences, is being recognised. Thus far, the majority of the discussion on this topic has originated from Western perspectives.

Does the hospitalization immersion experience improve medical students' understanding of patients' perspectives? A qualitative study.

Purpose: Although many studies have assessed the impact of interventions to increase medical students' empathy by improving their understanding of patients' perspectives and feelings, the impact of hospitalization experiences remains unclear.

Methods: Fifth-year medical students at Kyushu University from 2009-2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors.

Lists of potential diagnoses that final-year medical students need to consider: a modified Delphi study.

Background: Contrastive learning is known to be effective in teaching medical students how to generate diagnostic hypotheses in clinical reasoning. However, there is no international consensus on lists of diagnostic considerations across different medical disciplines regarding the common signs and symptoms that should be learned as part of the undergraduate medical curriculum. In Japan, the national model core curriculum for undergraduate medical education was revised in 2016, and lists of potential diagnoses for 37 common signs, symptoms, and pathophysiology were introduced into the curriculum.

Human PD-1CD8 T Cells Are a Cellular Source of IL-21 in Rheumatoid Arthritis.

Background: Rheumatoid arthritis (RA) is a prototypical autoantibody-driven autoimmune disease in which T-B interactions play a critical role. Recent comprehensive analysis suggests that PD-1CD8 T cells as well as two distinct IL-21-producing PD-1CD4 T cell subsets, follicular helper T (Tfh) and peripheral helper T (Tph) cells, are involved in the pathogenesis of RA. Herein, we aimed to clarify a generation mechanism of IL-21-producing CD8 T cells in humans, and to characterize this novel subset in patients with RA.

Type 1 helper T cells generate CXCL9/10-producing T-bet effector B cells potentially involved in the pathogenesis of rheumatoid arthritis.

Efficacy of B-cell depletion therapy highlights the antibody-independent effector functions of B cells in rheumatoid arthritis (RA). Given type 1 helper T (Th1) cells abundant in synovial fluid (SF) of RA, we have determined whether Th1 cells could generate novel effector B cells. Microarray and qPCR analysis identified CXCL9/10 transcripts as highly expressed genes upon BCR/CD40/IFN-γ stimulation.

Generation of a novel CD30 B cell subset producing GM-CSF and its possible link to the pathogenesis of systemic sclerosis.

Systemic sclerosis (SSc) is a T helper type 2 (Th2)-associated autoimmune disease characterized by vasculopathy and fibrosis. Efficacy of B cell depletion therapy underscores antibody-independent functions of B cells in SSc. A recent study showed that the Th2 cytokine interleukin (IL)-4 induces granulocyte-macrophage colony-stimulating factor (GM-CSF)-producing effector B cells (GM-B ) in humans.

Measuring social interdependence in collaborative learning: instrument development and validation.

Background: In health professions education, several collaborative learning approaches have been used. As collaborative learning has a theoretical background of social interdependence theory, a theory informed and valid instrument to measure social interdependence is required to evaluate and compare several learning approaches. The aim of this study was to develop an instrument (the SOcial interdependence in Collaborative learning Scale; SOCS) to measure students' perceived social interdependence in collaborative learning and validate it.

Effect of the iExaminer Teaching Method on Fundus Examination Skills: A Randomized Clinical Trial.

This randomized clinical trial compares the effect of the iExaminer teaching method on fundus examination skills with the traditional teaching method.

A Medical Record Peer-Review System to Evaluate Residents' Clinical Competence: Criterion Validity Analysis.

In contrast to input evaluation (education delivered at school) and output evaluation (students' capability at graduation), the methods of outcome evaluation (performance after graduation) of medical education have not been sufficiently established. To establish a method to measure the quality of patient care and conduct outcome evaluation, we have been developing a peer review system of medical records. Here, we undertook a pilot study to evaluate the criterion validity of our system by using "evaluation by program directors (supervisors in the hospitals)" as a criterion standard.

Induction of neutralizing antibodies against tier 2 human immunodeficiency virus 1 in rhesus macaques infected with tier 1B simian/human immunodeficiency virus.

We previously developed CCR5-tropic neutralization-resistant simian/human immunodeficiency virus (SHIV) strains and a rhesus macaque model of infection with these SHIVs. We induced the production of neutralizing antibodies (nAbs) against HIV-1 by infecting rhesus macaques with different neutralization-resistant SHIV strains. First, SHIV-MK1 (MK1) (neutralization susceptible, tier 1B) with CCR5 tropism was generated from SHIV-KS661 using CXCR4 as the main co-receptor.

Competencies necessary for becoming a leader in the field of community medicine: a Japanese qualitative interview study.

Objectives: To clarify competencies for inclusion in our curriculum that focuses on developing leaders in community medicine.

Design: Qualitative interview study.

Setting: All six regions of Japan, including urban and rural areas.

Development of culture-sensitive clinical teacher evaluation sheet in the Japanese context.

Aim: Many instruments for evaluating clinical teaching have been developed, albeit most in Western countries. This study aims to develop a validated cultural and local context sensitive instrument for clinical teachers in an East Asian setting (Japan), Japanese Clinical Teacher Evaluation Sheet (JaCTES).

Methods: A multicenter, cross-sectional evaluation study was conducted.

A first report of East Asian students' perception of progress testing: a focus group study.

Background: Progress testing (PT) is used in Western countries to evaluate students' level of functional knowledge, and to enhance meaning-oriented and self-directed learning. However, the use of PT has not been investigated in East Asia, where reproduction-oriented and teacher-centered learning styles prevail. Here, we explored the applicability of PT by focusing on student perceptions.

Generation of a neutralization-resistant CCR5 tropic simian/human immunodeficiency virus (SHIV-MK38) molecular clone, a derivative of SHIV-89.6.

Previously, we reported that a new genetically diverse CCR5 (R5) tropic simian/human immunodeficiency virus (SHIV-MK38) adapted to rhesus monkeys became more neutralization resistant to SHIV-infected plasma than did the parental SHIV-KS661 clone. Here, to clarify the significance of the neutralization-resistant phenotype of SHIV in a macaque model, we initially investigated the precise neutralization phenotype of the SHIVs, including SHIV-MK38 molecular clones, using SHIV-MK38-infected plasma, a pooled plasma of human immunodeficiency virus (HIV)-infected individuals, soluble CD4 and anti-HIV-1 neutralizing mAbs, the epitopes of which were known. The results show that SHIV-KS661 had tier 1 neutralization sensitivity, but monkey-adapted R5 tropic SHIV-MK38 acquired neutralization resistance similar to that of tier 2 or 3 as a clone virus.

Comparison of students' encountered diseases and available diseases at clerkship sites by exploratory multivariate analysis: Are encountered diseases predictable?

Background: Students in clerkship are expected to gain clinical expertise by interacting with real patients in clinical situations. Monitoring and predicting the students' encounter diseases (EDs) is important for providing an optimal experience. EDs should be compared with the available diseases (ADs) at the clerkship site and with the required diseases described in some guidelines for the clinical curriculum.