Language：Japanese   Publisher：Japan Society for Medical Education  

<p>The Professionalism subcommittee of Japan Society for Medical Education has been examining a diverse range of issues related to medical professionalism education for approximately the past 20 years. In July 2015, the committee formulated and presented a draft on “ The Attributes and Competencies of Physicians: An Exploration of Professionalism” Based on this, we have been conducting educational activities on professionalism education, but we had not documented this draft. We are now re-presenting the draft here with minor lexical corrections and additional notes. The professionalism of physicians is delineated in seven attributes and competencies :</p><p>1. Sense of mission and responsibility towards society</p><p>2. Practice of patient-centered health care</p><p>3. Demonstration of integrity and justice</p><p>4. Acceptance of diverse values and sharing of fundamental values</p><p>5. Fulfilling roles as leaders/members in organizations and teams</p><p>6. Pursuit of excellence and lifelong learning</p><p>7. Self-management and career development</p><p>This document is presented with the expectation that it will contribute to future discussions on professionalism education.</p>

DOI： 10.11307/mededjapan.55.1_35

Language：Japanese   Publisher：(一社)日本医学教育学会  

日本医学教育学会プロフェショナリズム部会は過去約20年にわたり医療プロフェショナリズム教育に関する多岐にわたる論点を検討し,2015年7月には「医師の資質・能力としてのプロフェショナリズム」の原案を策定し,発表した.これを元にプロフェショナリズム教育の啓発活動を行ってきたが,この原案を文書化していなかった.今回,原案の字句の軽微な修正および注釈の追加を行い,ここに再提示する.医師のプロフェッショナリズムでは,以下の7つの資質・能力を設定する.1.社会に対する使命感と責任感 2.患者中心の医療の実践 3, 誠実さと公正性の発揮 4.多様な価値観の受容と基本的価値観の共有 5.組織やチームのリーダー/メンバーとしての役割遂行 6.卓越性の追求と生涯学習 7.自己管理とキャリア形成 この文書が今後のプロフェッショナリズム教育の議論に資することを期待する.(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J00050&link_issn=&doc_id=20240319070005&doc_link_id=%2Fed9jmded%2F2024%2F005501%2F006%2F0035-0039%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fed9jmded%2F2024%2F005501%2F006%2F0035-0039%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Publisher：株式会社医学書院  

DOI： 10.11477/mf.1402229301

Language：Japanese   Publisher：(一社)日本医学教育学会  

Language：Japanese   Publisher：(一社)日本医学教育学会  

Language：Japanese   Publisher：Japan Society for Medical Education  

DOI： 10.11307/mededjapan.53.5_454

Language：Japanese   Publisher：Japan Society for Medical Education  

<p>　Coaching is considered a systematised method of training high-performing athletes and musicians and is characterised by the provision of interpersonal support through interactive dialogue towards set goals. The word “coach” can be traced back to 15th century Europe when the town of Kocs in Hungary produced high-quality four-wheeled carriages that were used in many places, and the word “coach” came to mean a carriage. The word coach is also said to have come to be used to refer to the interpersonal support techniques used to transport important people and their belongings to their destinations. Coaching has since been widely adopted in the business world in Europe and the USA and began to spread in Japan in the late 1990s. In the medical world, literature on coaching has increased since around 2000, and coaching is now used in medical communication, hospital management and medical education. In this series of articles, examples of the introduction of coaching into professionalism education will be introduced from two perspectives: coaching for individuals and coaching for medical teams.</p>

DOI： 10.11307/mededjapan.53.5_453

Language：Japanese   Publisher：(一社)日本医学教育学会  

Language：Japanese   Publisher：(一社)日本医学教育学会  

Language：Japanese   Publisher：(一社)日本医学教育学会  

Language：Japanese   Publisher：(一社)日本医学教育学会  

Language：English   Publishing type：Research paper (scientific journal)  

Cushing's disease causes numerous metabolic disorders, cognitive decline, and sarcopenia, leading to deterioration of the general health in older individuals. Cushing's disease can be treated with transsphenoidal surgery, but thus far, surgery has often been avoided in older patients. We herein report an older woman with Cushing's disease whose cognitive impairment and sarcopenia improved after transsphenoidal surgery. Although cognitive impairment and sarcopenia in most older patients show resistance to treatment, our case indicates that normalization of the cortisol level by transsphenoidal surgery can be effective in improving the cognitive impairment and muscle mass loss caused by Cushing's disease.

DOI： 10.2169/internalmedicine.8326-21

PubMed

Authorship：Lead author   Language：Japanese   Publisher：(一社)日本医学教育学会  

患者が増加の一途をたどる糖尿病の治療において、インスリン療法の重要性はより一層高まっている。しかし、実臨床では患者の心理的抵抗や、医師の患者教育に対する懸念により、インスリン導入が遅れているとの報告がある。その一因として、医師が実際のインスリン自己注射や患者側の視点を十分に理解していないことが考えられ、これらを学生時代から効果的に学習する方略を導入した。本教育実践は臨床実習中の医学部学生を対象に、インスリン注射模型を用いた経験学習や担当患者へのインタビュー、各自の体験の共有や小グループ学習で構成され、学生が医療者と患者のインスリン療法に対する認識の違いを理解するのに有用と考えられ、ここに報告する。(著者抄録)

DOI： 10.11477/mf.1416202008

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Background</title>
The COVID-19 pandemic has created a need for educational materials and methods that can replace clinical clerkships (CCs) for online simulated clinical practice (online-sCP). This study evaluates the impact of using simulated electronic health records (sEHR) for inpatients, and electronic problem-based learning (e-PBL) and online virtual medical interviews (online-VMI) for outpatients, for an online-sCP using a learning management system (LMS) and online meeting system facilitated by a supervising physician.


</sec><sec>
<title>Methods</title>
The sEHR was reviewed by medical students and subsequently discussed with a supervising physician using an online meeting system. In the e-PBL, medical students reviewed the simulated patients and discussed on the LMS. For the online-VMI, a faculty member acted as an outpatient and a student acted as the doctor. Small groups of students discussed the clinical reasoning process using the online meeting system. A mixed-method design was implemented. Medical students self-assessed their clinical competence before and after the online-sCP. They answered questionnaires and participated in semi-structured focus group interviews (FGIs) regarding the advantages and disadvantages of the practice.


</sec><sec>
<title>Results</title>
Forty-three students completed the online-sCP during May and June 2020. All students indicated significant improvement in all aspects of self-evaluation of clinical performance after the online-sCP. Students using sEHR reported significant improvement in writing daily medical records and medical summaries. Students using e-PBL and online-VMI reported significant improvement in medical interviews and counseling. Students also indicated CCs as more useful for learning associated with medical interviews, physical examinations, and humanistic qualities like professionalism than the online-sCP. Eight FGIs were conducted (<italic>n</italic> = 42). The advantages of online-sCP were segregated into five categories (learning environment, efficiency, accessibility, self-paced learning, and interactivity); meanwhile, the disadvantages of online-sCP were classified into seven categories (clinical practice experience, learning environment, interactivity, motivation, memory retention, accessibility, and extraneous cognitive load).


</sec><sec>
<title>Conclusions</title>
Online-sCP with sEHR, e-PBL, and online-VMI could be useful in learning some of the clinical skills acquired through CC. These methods can be implemented with limited preparation and resources.


</sec>

DOI： 10.1186/s12909-021-02586-y

PubMed

Other Link： http://link.springer.com/article/10.1186/s12909-021-02586-y/fulltext.html

Language：Japanese   Publisher：(一社)日本老年医学会  

Language：Japanese   Publisher：(一社)日本糖尿病学会  

Language：Japanese   Publisher：千葉医学会  

Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: Sodium glucose cotransporter-2 (SGLT2) inhibitors are widely used for diabetes treatment. Although SGLT2 inhibitors have been clinically observed to increase food intake, roles or even the presence of SGLT2 in the central nervous system (CNS) has not been established. We aimed to elucidate potential functions of SGLT2 in the CNS, and the effects of CNS-targeted SGLT2 inhibitors on food intake. RESEARCH DESIGN AND METHODS: We administered three kinds of SGLT2 inhibitors, tofogliflozin, dapagliflozin, and empagliflozin, into the lateral ventricle (LV) in rats and evaluated their effects on food intake. We also evaluated the effects of tofogliflozin administration in the third (3V) and fourth ventricle (4V). Intraperitoneal administration of liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist known to suppress food intake, was combined with central tofogliflozin to elucidate whether GLP-1 signaling antagonizes the effect of central SGLT2 inhibitors on food intake. To elucidate potential molecular mechanisms mediating changes in feeding, hypothalamic areas associated with food intake regulation were harvested and analyzed after intracerebroventricular administration (ICV) of tofogliflozin. RESULTS: Bolus ICV injection of tofogliflozin induced a robust increase in food intake starting at 1.5 hours postinjection, and lasting for 5 days. No effect was observed when the same dose of tofogliflozin was administered intraperitoneally. ICV dapagliflozin and empagliflozin significantly enhanced food intake, although the strength of these effects varied among drugs. Food intake was most markedly enhanced when tofogliflozin was infused into the LV. Fewer or no effects were observed with infusion into the 3V or 4V, respectively. Systemic administration of liraglutide suppressed the effect of ICV tofogliflozin on food intake. ICV tofogliflozin increased phosphorylation of AMPK and c-fos expression in the lateral hypothalamus. CONCLUSIONS: SGLT2 inhibitors in the CNS increase food intake. SGLT2 activity in the CNS may regulate food intake through AMPK phosphorylation in the lateral hypothalamic area.

DOI： 10.1136/bmjdrc-2020-002104

PubMed

Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞はじめに　2020年に発生した新型コロナウイルス感染症(coronavirus disease 2019:COVID-19)のパンデミックにより,医学部5～6年生の臨床現場でのクリニカル・クラークシップは中止となり,オンラインでの実習のみを行うこととなった。千葉大学脳神経内科ではもともと4週間の実習期間が与えられており,「重要な脳神経内科疾患の患者に対して,適切な問診,診察,基本的検査を実施し,その結果を解釈し,診断することができる」ことを学習目標にしている。その目標達成のため,COVID-19流行前はTable 1のようなスケジュールで実習を行っていた。4週間のうちで少なくとも2名以上患者を受け持ち,毎朝の診療グループ回診前に学生1人で担当患者に会って診察し,アテンディング(教育専任教員)との30分程度のミーティングにて状況を整理した後に,グループ回診に参加する。グループ回診では,回診前に学生は担当患者の1分程度のプレゼンテーションを行い,担当医からフィードバックを受ける。さらに,回診中に診察手技を評価され,フィードバックも受ける,という形式で病棟実習を行っていた。そのほかに外来見学やいくつかの講義,シミュレーターを用いた腰椎穿刺の実習も行っていた。また最終週には,テーマを自由に決めて5分間でプレゼンテーションを実施し,学生同士で評価を行ってもらっていた。プレゼンテーションの最終評価は教授が主に担当し,4週間で受け持った症例のプレゼンテーション内容を評価していた。実習全体の評価は,アテンディング,病棟主治医,教授の3名がそれぞれ行い,その平均をもって評点していた。オンラインのみの実習を余儀なくされた際にはTable 2のようなスケジュールで実習を行った。前半2週間は,外来受診患者の現病歴から疾患カテゴリー診断と神経学的部位診断を行い鑑別疾患を考えるという訓練を,急遽作成した40程度の模擬症例を用いて繰り返し行った。後半の2週間は入院患者の模擬症例を作成し,入院までの現病歴から疾患カテゴリー,病変部位診断を考え,それを基に鑑別診断を挙げ,必要な神経診察を提案してもらうようにした。さらに,神経診察の結果から部位診断を絞り込み,診断に必要な検査を考え,その結果から確定診断,治療計画を考えるトレーニングを行った。当時の実習学生は一度に14人おり,2人ずつを1ペアとして同じ症例を担当してもらい,さらに,プレゼンテーション内容について他のペアが評価・質問するようにした。カンファレンスや講義はすべてオンラインで実施した。実地で実習が可能になった後も,オンラインでできる講義やカンファレンスへの参加,最終評価は引き続きオンラインで行った(Table 3)。病棟実習,外来見学,シミュレーターを用いた手技の実習はオンラインでは代替が困難であり,でき得る限り実地での実習を継続することが望ましいと感じられた。

Authorship：Lead author   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Event date： 2024.8

Presentation type：Symposium, workshop panel (public)  

Event date： 2024.8

Presentation type：Symposium, workshop panel (public)  

Event date： 2023.7

Presentation type：Symposium, workshop panel (public)  

Event date： 2023.1

Presentation type：Symposium, workshop panel (public)  

Event date： 2022.8

Language：Japanese   Presentation type：Poster presentation  

Event date： 2022.8

Presentation type：Poster presentation  

Event date： 2021.3

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

File： R2肥満学会シンポジウム抄録_SLIM-TARGET.docx

Event date： 2021.1

Presentation type：Oral presentation (general)  

Language：Japanese  

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Presentation type：Poster presentation  

Presentation type：Oral presentation (general)  

Language：Japanese  

Language：Japanese  

Presentation type：Symposium, workshop panel (public)