研究者詳細 - 小比賀　美香子

論文 - 小比賀　美香子

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Factors related to burnout in resident physicians in Japan. 国際誌

Yoshito Nishimura, Tomoko Miyoshi, Mikako Obika, Hiroko Ogawa, Hitomi Kataoka, Fumio Otsuka

International journal of medical education 10 129 - 135 2019年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：INT JOURNAL MEDICAL EDUCATION-IJML

Objectives: We explore the prevalence and characteristics of burnout among Japanese resident physicians and identifies factors associated with burnout. Methods: A cross-sectional study was conducted three times between April 2017 and March 2018 at a Japanese teaching hospital. Resident physicians were invited to answer an online survey that included existing valid instruments related to burnout, depression, and empathy. Demographic, background, occupational, and socioeconomic data were also collected. Participants were prompted to report the average daily work hours and the specialty they wish to pursue. Results: Overall, 39/76 (51%), 27/76 (36%), and 21/76 (28%) resident physicians responded to surveys in April 2017, October 2017, and March 2018, respectively. The percentages of participants with burnout for surveys in April 2017, October 2017, and March 2018 were 7/39 (18%), 6/27 (22%), and 7/21 (33.3%). Emotional exhaustion (EE) was the only burnout component strongly correlated with the severity of depression (r = .615, p < .001; r = .706, p < .001; r = .601, p < .01). EE and depersonalization (DP) had no significant correlation with average daily working hours (β = .156, p = .343 for EE; β = .061, p = .711 for DP). Conclusions: The results suggest that capping working hours alone may not be effective in reducing burnout in Japanese resident physicians. Medical educators might need to consider not only working hours but also individual job quality and satisfaction to address burnout. Future studies may need to incorporate qualitative methods to explore the characteristics of burnout.

DOI： 10.5116/ijme.5caf.53ad

Anterior Cutaneous Nerve Entrapment Syndrome Possibly Triggered by Oral Contraceptives.

Daisuke Omura, Mikako Obika, Masaya Iwamuro, Satoko Nagao, Takahiro Nada, Takashi Matsuzaki, Yoshitaka Kondo, Fumio Otsuka

Internal medicine (Tokyo, Japan) 58 ( 10 ) 1507 - 1509 2019年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

We herein report a teenage girl who had been taking oral contraceptive pills for three months and complained of left lower abdominal pain that had continued for two months. A physical examination indicated anterior cutaneous nerve entrapment syndrome (ACNES), although no abnormality was found in various biochemical and imaging examinations. The pain was only transiently ameliorated by trigger-point injection, and neurectomy surgery was eventually effective. Sex steroids can be involved in the progress of local tissue edema causing ACNES. ACNES should be considered in cases of abdominal pain in patients taking oral contraceptives.

DOI： 10.2169/internalmedicine.1361-18

総合内科診療における主訴と生化学データの関連浸透圧マーカーに着目して査読

大村大輔, 佐藤明香, 岡浩介, 小川弘子, 花山宜久, 小比賀美香子, 大塚文男

日本病院総合診療医学会雑誌 15 ( 3 ) 175 - 175 2019年5月

Effects on postgraduate-year-I residents of simulation-based learning compared to traditional lecture-style education led by postgraduate-year-II residents: a pilot study. 国際誌

Akira Yamamoto, Mikako Obika, Yasuhiro Mandai, Taku Murakami, Tomoko Miyoshi, Hideo Ino, Hitomi Kataoka, Fumio Otsuka

BMC medical education 19 ( 1 ) 87 - 87 2019年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC

BACKGROUND: Simulation-based learning plays an important role in contemporary medical education, although there are problems providing tutors. Peer-assisted learning has begun being formally adopted in medical education. Although it is considered useful for simulation-based learning, its effectiveness remains unclear. This study was designed to compare the effect of simulation-based learning with that of traditional lectures conducted by postgraduate-year (PGY)-II residents on PGY-I residents. METHODS: This study was conducted at Okayama University Hospital over three years, for one week each year, before residents entered clinical practice. The study enrolled 76 PGY-I residents, who were randomized into two groups: simulation and lecture groups. PGY-II residents volunteered to conduct simulations and lectures. Knowledge evaluation was performed using pre- and post-tests, and self-evaluation of competence and behaviour-change and program evaluations were conducted using questionnaires. RESULTS: In both groups, knowledge test scores were found to improve significantly, and the score difference between pre- and post-tests in both the groups was not significant. Self-evaluation of competence and behaviour-change was found to be higher in the simulation group than the lecture group. The trainees in the simulation group valued the program and the PGY-II residents as teaching staff more than those in the lecture group. CONCLUSIONS: The combination of simulation-based learning and peer-assisted learning led by PGY-II residents is potentially more effective in improving the postgraduate education of PGY-I residents than the combination of lecture and peer-assisted learning.

DOI： 10.1186/s12909-019-1509-y

Changes in Serum Biochemical Markers in Relation to Chief Complaints and Aging in General Medicine. 査読

Daisuke Omura, Asuka Sato, Kosuke Oka, Yoshihisa Hanayama, Hiroko Ogawa, Mikako Obika, Fumio Otsuka

Acta medica Okayama 72 ( 6 ) 553 - 562 2018年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

To clarify potential relationships between chief complaints of patients and laboratory data with a focus on aging-related changes, we retrospectively analyzed the data of 843 patients who visited a general medicine department for the first time. Their chief complaints were classified into 8 major symptoms: visceral pain, somatic pain, fever, cough, dizziness, fatigue, appetite loss, and edema. We compared the laboratory data obtained from the patients with complaints with the data of symptom-free (control) patients. The serum sodium and potassium levels in the fever group were decreased compared to those in the control group. In the fever group, the serum sodium level was inversely correlated with age. The ratio of serum urea nitrogen to creatinine (UN/Cr) was increased in the appetite-loss group. There were significant age-dependent increases in the UN/Cr ratio in the appetite-loss and edema groups. Of note, serum levels of free thyroxin were lower in the dizziness group compared to the control group. In addition, the free thyroxin level was inversely correlated with age in the dizziness group but not in the asymptomatic control group. Collectively, the results indicated that osmolality-related laboratory data are strongly associated with individual primary symptoms at the first visit regardless of the final diagnosis. The consideration of age-dependent changes of these markers is helpful for diagnosing latent disorders based on various primary symptoms.

DOI： 10.18926/AMO/56372

Clinical relevance of low androgen to gastroesophageal reflux symptoms.

Ko Harada, Yoshihisa Hanayama, Miho Yasuda, Kou Hasegawa, Mikako Obika, Hitomi Kataoka, Koichi Itoshima, Ken Okada, Fumio Otsuka

Endocrine journal 65 ( 10 ) 1039 - 1047 2018年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN ENDOCRINE SOC

The aim of this study was to determine the relationships between free testosterone (FT) level and parameters including laboratory data and data from questionnaires and to determine symptoms leading to the detection of late onset hypogonadism (LOH). We retrospectively reviewed medical records of patients in whom serum FT was measured in our hospital. Aging Male Symptoms (AMS) score, self-rating depression scale (SDS) and frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) score were used for questionnaires. A total of 205 patients were included in the analysis (55.2 ± 15.6 years of age, mean ± SD). Among them, 119 patients (58.0%) had an FT level of less than 8.5 pg/mL, which fulfills the diagnostic criterion of LOH syndrome according to the clinical practice manual for LOH in Japan. It was revealed that FSSG score was inversely correlated to serum FT levels (r = -0.3395, p < 0.001), although SDS and AMS scales did not show significant correlations to FT levels. Our study revealed a high prevalence of LOH syndrome among patients in whom the majority complained of general symptoms. Although GERD symptoms are generally not considered to be typical symptoms of LOH, our study indicates that those symptoms might be clues for the detection of LOH.

DOI： 10.1507/endocrj.EJ18-0187

Clinical Characteristics of Febrile Outpatients : Possible Involvement of Thyroid Dysfunction in Febrile Tachycardia. 査読

Kosuke Oka, Yoshihisa Hanayama, Asuka Sato, Daisuke Omura, Miho Yasuda, Ko Hasegawa, Mikako Obika, Fumio Otsuka

Acta medica Okayama 72 ( 5 ) 447 - 456 2018年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

We retrospectively analyzed the cases of 148 febrile patients whose body temperature (BT) was ≥ 37.5°C at our hospital. We categorized them into seven groups; those with bacterial and viral infection, nonspecific inflammation, neoplasm, connective tissue disease (CTD), drug-induced disease, and unidentified causes. Our analysis revealed that the patient's BT at the 1st visit (BT-1st visit) and highest BT during the febrile period (BT-max) differed significantly among all categories except neoplasm. The greatest difference between BT-1st visit and BT-max was highest in the CTD group (1.5°C). Positive correlations of heart rate and C-reactive protein (CRP) level with BT-max and a negative correlation between serum sodium level with BT-max were uncovered. The serum thyroid-stimulating hormone (TSH) level and the ratio of TSH/free thyroxine were negatively correlated with BT-max, especially in the viral infection group, suggesting the existence of occult thyrotoxicosis in accord with a febrile condition, possibly leading to febrile tachycardia. A febrile gap between BT-1st visit and BT-max (except in the neoplasm group) was shown, in which BT-max was correlated with thyroid function. Clinicians should recognize the fluctuation of BT when diagnosing febrile patients, and tachycardia in such febrile patients may be, at least in part, associated with subclinical thyroid dysfunction.

DOI： 10.18926/AMO/56242

Manifestation of Central Diabetes Insipidus in a Patient with Thyroid Storm.

Akiko Nakamichi, Kazuki Ocho, Kosuke Oka, Miho Yasuda, Kou Hasegawa, Masaya Iwamuro, Mikako Obika, Kammei Rai, Fumio Otsuka

Internal medicine (Tokyo, Japan) 57 ( 13 ) 1939 - 1942 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

We herein report a case of central diabetes insipidus complicated with thyroid storm. A middle-aged woman who was receiving treatment for Graves' disease suddenly complained of polydipsia, polyuria and general fatigue. Laboratory tests showed hyperthyroidism, hypernatremia, hypoosmolar urine and a decreased plasma vasopressin level. The occurrence of central diabetes insipidus with hyperthyroidism was revealed on the basis of pituitary magnetic resonance imaging, a water deprivation test and a desmopressin test. The clinical co-existence of diabetes insipidus and hyperthyroidism is very rare; however, the complication should be considered when hypernatremia and/or dehydration progress in patients with Graves's disease as a common autoimmune-related etiology.

DOI： 10.2169/internalmedicine.0063-17

Clinical relevance of low androgen to gastroesophageal reflux symptoms 査読

Ko Harada, Yoshihisa Hanayama, Miho Yasuda, Kou Hasegawa, Mikako Obika, Hitomi Kataoka, Koichi Itoshima, Ken Okada, Fumio Otsukalo

ENDOCRINE JOURNAL 65 ( 10 ) 1039 - 1047 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN ENDOCRINE SOC

The aim of this study was to determine the relationships between free testostemne (FT) level and parameters including laboratory data and data from questionnaires and to determine symptoms leading to the detection of late onset hypogonadism (LOH). We retrospectively reviewed medical records of patients in whom serum FT was measured in our hospital. Aging Male Symptoms (AMS) score, self-rating depression scale (SDS) and frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) score were used for questionnaires. A total of 205 patients were included in the analysis (55.2 +/- 15.6 years of age, mean +/- SD). Among them, 119 patients (58.0%) had an FT level of less than 8.5 pg/mL, which fulfills the diagnostic criterion of LOH syndrome according to the clinical practice manual for LOH in Japan. It was revealed that FSSG score was inversely correlated to serum FT levels (r = -0.3395, p < 0.001), although SDS and AMS scales did not show significant correlations to FT levels. Our study revealed a high prevalence of LOH syndrome among patients in whom the majority complained of general symptoms. Although GERD symptoms are generally not considered to be typical symptoms of LOH, our study indicates that those symptoms might be clues for the detection of LOH.

DOI： 10.1507/endocrj.EJ18-0187

症例報告典型的な経過を辿った急性食道粘膜病変の1例査読

岩室雅也, 大田剛由, 岡田裕之, 山岡英功, 柏原尚子, 大重和樹, 長谷川功, 小比賀美香子, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 10 ( 2 ) 41 - 45 2016年6月

記述言語：日本語出版者・発行元：日本病院総合診療医学会

症例は発熱とコーヒー残渣様嘔吐を呈した75歳女性。糖尿病、腎後性腎不全、腎盂腎炎および菌血症、肺血栓塞栓症、深部静脈血栓症などの多数の基礎疾患を有していた。上部消化管内視鏡検査では下部食道に全周性の潰瘍を認めたほか、十二指腸にも広範な潰瘍がみられ、急性食道粘膜病変および十二指腸潰瘍と診断した。絶食とし酸分泌抑制薬と胃粘膜保護薬を投与するとともに基礎疾患の治療を行ったところ、食道および十二指腸の潰瘍は急速に改善した。(著者抄録)

その他リンク： http://search.jamas.or.jp/link/ui/2017072974

女性医師のライフイベントを考慮したキャリア支援：岡山大学アンケート調査査読

片岡仁美, 関明穂, 川畑智子, 勅使川原早苗, 岩瀬敏秀, 小比賀美香子, 大西弘高

医学教育 47 ( 2 ) 111 - 123 2016年4月

記述言語：日本語出版者・発行元：日本医学教育学会

<p>目的 : 女性医師のライフイベントとキャリアについて調査し支援に必要な要素を検討する.</p><p>方法 : 岡山大学卒業・入局の女性医師1,374名にライフイベント, 就労, 満足度等についての質問票を送付した.</p><p>結果 : 臨床医360名の解析を行った. 結婚, 出産時期は多くが適切としたが (82.1%, 65.2%), 若年層で遅くなる傾向があった. 子どもがいる医師 (70.2%) では臨床の満足度は変わらなかったが, 研究, 教育の満足度が低かった. 常勤の原職復帰者 (32.2%) は非常勤者と比べ満足度が高かった. 復職時に上司の理解, 家族のサポート等が必要とされた.</p><p></p><p>考察 : 理解の促進を含む環境整備とキャリア教育・支援が望まれる.</p>

DOI： 10.11307/mededjapan.47.2_111

その他リンク： http://search.jamas.or.jp/link/ui/2016270204

特別座談会子育て世代の女性医師のワークライフバランス-真の男女共同参画とは- 査読

西村真紀, 村田亜紀子, 小比賀美香子, 森敬良

治療 97 ( 12 ) 1646 - 1653 2015年12月

Extracurricular activities to promote English skills at Okayama University Medical School (Special feature : extracurricular activities) 査読

Mahmood Sabina, Obika Mikako, Miyoshi Tomoko

Journal of medical English education = 日本医学英語教育学会会誌 : official journal of Japan Society for Medical English Education 14 ( 3 ) 113 - 116 2015年10月

Nurturing the Art of Professionalism in Japanese Medical Students at Okayama University Medical School 査読

International Journal of School and Cognitive Psychology 2 ( 2 ) 128 - 128 2015年6月

Medical Students' Opinion of a Web-based Module to Teach Clinical Reasoning and Knowledge

Gerald H. Stein, Hironobu Tokunaga, Hirotaka Ando, Mikako Obika, Tomoko Miyoshi, Yasuharu Tokuda, Yoshinori Noguchi, Hitomi Kataoka, Hidekazu Terasawa

JOURNAL OF GENERAL AND FAMILY MEDICINE 16 ( 2 ) 76 - 83 2015年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY

Background: Japanese medical student education lacks emphasis on teaching clinical reasoning skills. To partially remedy this situation, we developed a prototypic web-based module for tutors to teach clinical reasoning. We report the medical students' opinions of this module.Methods: Twenty-four students from two Japanese medical universities were randomly assigned to the two tutored virtual classrooms, each classroom with six students, or to the self-study group, 12 students, after taking the Internetbased Sequential Question and Answer pretest. After four weeks, each of the 24 students took the Sequential Question and Answer posttest. The entire 24 students answered a questionnaire about the Sequential Question and Answer tests; all 12 tutored students answered a questionnaire about the web-based tutored module.Results: Although both tutored and self-study Sequential Question and Answer posttest scores increased, the increases of the tutored group's posttest compared to the self-study posttest group were not statistically significant (p = 0.066).Ninety-two percent of the students rated the Sequential Question and Answer tests as an improved way to learn case presentation and clinical reasoning. Moreover, 79% of students felt that the Sequential Question and Answer tests were an effective way to learn clinical information. The tutored students rated the web-based tutored seminars as an 'excellent to fair' method to learn clinical reasoning using a five-point 'excellent to poor' scale.Conclusions: We developed a prototypic web-based module for tutors to teach clinical reasoning to medical students. The students' opinion supported the modular components of the web-based seminar format, Sequential Question and Answer test, and the tutoring syllabus as an effective way to improve learning clinical reasoning, case presentation, and medical information. Students also suggested refinements of the prototypic module.

Clinical Reasoning Web-based Prototypic Module for Tutors Teaching 5th Grade Medical Students : A Pilot Randomized Study

Gerald H. Stein, Hironobu Tokunaga, Hirotaka Ando, Mikako Obika, Tomoko Miyoshi, Yasuharu Tokuda, Yoshinori Noguchi, Mitsuyo Kinjo, Shun Kohsaka, Hitoshi Honda, Yuka Kitano, Hidetaka Kitazono, Hitomi Kataoka, Hidekazu Terasawa

JOURNAL OF GENERAL AND FAMILY MEDICINE 16 ( 1 ) 13 - 25 2015年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY

Background: At present clinical reasoning skills are not systematically taught in Japanese medical universities. We developed a prototypic preliminary module for clinical tutors to introduce clinical reasoning to Japanese medical students. We hypothesized that tutored medical students would outperform self-study students.Method: Using the web-based Sequential Question and Answer test that rewarded history and differential diagnosis as proxies for clinical reasoning, we compared the pre and posttest scores of 12 randomized fifth grade tutored students at two universities during four tutor-led 1.5-hour web-based seminars using a structured syllabus to 12 randomized self-study students.Results: The tutored and self-study groups' pretest scores were statistically similar at about 40 out of 100 weighted correct points. The tutored students' posttest scores were 62 points, significantly greater (p = 0.007) than the pretest mean 42 points, compared to the self-study students' posttest scores of 52 points, significantly greater (p = 0.012) than pretest mean 40 points. The difference between the two posttest groups was of borderline statistical significance (p = 0.08).Conclusions: We successfully assessed a prototypic module for tutors to introduce clinical reasoning to Japanese medical students. The tutored students achieved higher scores than the self-study students. Further research is needed to exploit the potential of our modular clinical reasoning system.

DOI： 10.14442/general.16.13

Factors Associated with Remission and/or Regression of Microalbuminuria in Type 2 Diabetes Mellitus 査読

Tetsuichiro Ono, Kenichi Shikata, Mikako Obika, Nobuyuki Miyatake, Ryo Kodera, Daisyo Hirota, Jun Wada, Hitomi Kataoka, Daisuke Ogawa, Hirofumi Makino

Acta Med. Okayama 68 ( 4 ) 235 - 241 2014年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

The aim of this study was to clarify the factors associated with the remission and/or regression of microalbuminuria in Japanese patients with type 2 diabetes mellitus. We retrospectively analyzed the data of 130 patients with type 2 diabetes mellitus with microalbuminuria for 2-6 years (3.39 +/- 1.31 years). Remission was defined as improving from microalbuminuria to normoalbuminuria using the albumin/creatinine ratio (ACR), and regression of microalbuminuria was defined as a decrease in ACR of 50% or more from baseline. Progression of microalbuminuria was defined as progressing from microalbuminuria to overt proteinuria during the follow-up period. Among 130 patients with type 2 diabetes mellitus with microalbuminuria, 57 and 13 patients were defined as having remission and regression, respectively, while 26 patients progressed to overt proteinuria. Sex (female), higher HDL cholesterol and lower HbAlc were determinant factors associated with remission/regression of microalbuminuria by logistic regression analysis. Lower systolic blood pressure (SBP) was also correlated with remission/regression, but not at a significant level. These results suggest that proper control of blood glucose, BP and lipid profiles may be associated with remission and/or regression of type 2 diabetes mellitus with microalbuminuria in clinical practice.

Preliminary report of a Web-based instrument to assess and teach knowledge and clinical thinking to medical student. 国際誌

Gerald H Stein, Hironobu Tokunaga, Hirotaka Ando, Mikako Obika, Tomoko Miyoshi, Yasuharu Tokuda, Miho Bautista, Hitomi Kataoka, Hidekazu Terasawa

International journal of medical education 5 1 - 6 2014年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：INT JOURNAL MEDICAL EDUCATION-IJML

OBJECTIVE: We report the preliminary development of a unique Web-based instrument for assessing and teaching knowledge and developing clinical thinking called the "Sequential Questions and Answers" (SQA) test. Included in this feasibility report are physicians' answers to the Sequential Questions and Answers pre- and posttests and their brief questionnaire replies. METHODS: The authors refined the SQA test case scenario for content, ease of modifications of case scenarios, test uploading and answer retrieval. Eleven geographically distant physicians evaluated the SQA test, taking the pretest and posttest within two weeks. These physicians completed a brief questionnaire about the SQA test. RESULTS: Eleven physicians completed the SQA pre- and posttest; all answers were downloaded for analysis. They reported the ease of website login and navigating within the test module together with many helpful suggestions. Their average posttest score gain was 53% (p=0.012). CONCLUSIONS: We report the successful launch of a unique Web-based instrument referred to as the Sequential Questions and Answers test. This distinctive test combines teaching organization of the clinical narrative into an assessment tool that promotes acquiring medical knowledge and clinical thinking. We successfully demonstrated the feasibility of geographically distant physicians to access the SQA instrument. The physicians' helpful suggestions will be added to future SQA test versions. Medical schools might explore the integration of this multi-language-capable SQA assessment and teaching instrument into their undergraduate medical curriculum.

DOI： 10.5116/ijme.52a7.7280

Factors associated with remission and/or regression of microalbuminuria in type 2 diabetes mellitus.

Tetsuichiro Ono, Kenichi Shikata, Mikako Obika, Nobuyuki Miyatake, Ryo Kodera, Daisyo Hirota, Jun Wada, Hitomi Kataoka, Daisuke Ogawa, Hirofumi Makino

Acta medica Okayama 68 ( 4 ) 235 - 41 2014年

記述言語：英語掲載種別：研究論文（学術雑誌）

The aim of this study was to clarify the factors associated with the remission and/or regression of microalbuminuria in Japanese patients with type 2 diabetes mellitus. We retrospectively analyzed the data of 130 patients with type 2 diabetes mellitus with microalbuminuria for 2-6 years (3.39±1.31 years). Remission was defined as improving from microalbuminuria to normoalbuminuria using the albumin/creatinine ratio (ACR), and regression of microalbuminuria was defined as a decrease in ACR of 50% or more from baseline. Progression of microalbuminuria was defined as progressing from microalbuminuria to overt proteinuria during the follow-up period. Among 130 patients with type 2 diabetes mellitus with microalbuminuria, 57 and 13 patients were defined as having remission and regression, respectively, while 26 patients progressed to overt proteinuria. Sex (female), higher HDL cholesterol and lower HbA1c were determinant factors associated with remission/regression of microalbuminuria by logistic regression analysis. Lower systolic blood pressure (SBP) was also correlated with remission/regression, but not at a significant level. These results suggest that proper control of blood glucose, BP and lipid profiles may be associated with remission and/or regression of type 2 diabetes mellitus with microalbuminuria in clinical practice.

Content analysis of medical students' seminars: a unique method of analyzing clinical thinking. 国際誌

Yukari Takata, Gerald H Stein, Kuniyuki Endo, Akiko Arai, Shun Kohsaka, Yuka Kitano, Hitoshi Honda, Hidetaka Kitazono, Hironobu Tokunaga, Yasuharu Tokuda, Mikako Obika, Tomoko Miyoshi, Hitomi Kataoka, Hidekazu Terasawa

BMC medical education 13 156 - 156 2013年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC

BACKGROUND: The study of communication skills of Asian medical students during structured Problem-based Learning (PBL) seminars represented a unique opportunity to assess their critical thinking development. This study reports the first application of the health education technology, content analysis (CA), to a Japanese web-based seminar (webinar). METHODS: The authors assigned twelve randomly selected medical students from two universities and two clinical instructors to two virtual classrooms for four PBL structured tutoring sessions that were audio-video captured for CA. Both of the instructors were US-trained physicians. This analysis consisted of coding the students' verbal comments into seven types, ranging from trivial to advanced knowledge integration comments that served as a proxy for clinical thinking. RESULTS: The most basic level of verbal simple responses accounted for a majority (85%) of the total students' verbal comments. Only 15% of the students' comments represented more advanced types of critical thinking. The male students responded more than the female students; male students attending University 2 responded more than male students from University 1. The total mean students' verbal response time for the four sessions with the male instructor was 6.9%; total mean students' verbal response time for the four sessions with the female instructor was 19% (p < 0.05). CONCLUSIONS: This report is the first to describe the application of CA to a multi-university real time audio and video PBL medical student clinical training webinar in two Japanese medical schools. These results are preliminary, mostly limited by a small sample size (n = 12) and limited time frame (four sessions). CA technology has the potential to improve clinical thinking for medical students. This report may stimulate improvements for implementation.

DOI： 10.1186/1472-6920-13-156

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