Clinical Reasoning
Webinar Project 2010-2015
I invite you to access seven publications of our recently
completed Monkosho-funded medical education demonstration
project, " 臨床推論能力の評価と能力向上トレーニングの開
発研究 "[研究課題番号：23590870],
freely translated 'Development and
evaluation of a prototypical clinical reasoning module.'
Publications:
1. Gerald H. Stein, MD, Ayako Shibata, BS,
Miho Bautista, MD, MS.
Webinar: Free international distant real time interactive
tutoring. Medical Teacher. 2010; 32:
619-620.
MedTeachWebinar2010Page619.pdf
[Reprint available on request]
2. Gerald H. Stein, MD, Ayako Shibata, BS, Miho Bautista,
MD, MS Yasuharu Tokuda, MD, MPH.
Webinar: An Initial Experience with Web-based Real Time
Interactive Clinical Seminars for Japanese Medical Students.
General Medicine. 2010; 11: 87-90.
https://www.jstage.jst.go.jp/article/general/11/2/11_2_87/_pdf
3. Gerald H. Stein, MD, Hironobu
Tokunaga, MD, Hirotaka Ando, MD, Mikako
Obika, MD, PhD, Tomoko Miyoshi, MD,
Yasuharu Tokuda, MD, MPH, Miho
Bautista, MD, MS, Hitomi Kataoka, MD, PhD,
and Hidekazu Terasawa, MD.
Preliminary report of a Web-based instrument to assess and
teach knowledge and clinical thinking to medical student. International
Journal of Medical Education. 2014:5:1-6.
http://www.ijme.net/archive/5/teach-knowledge-and-clinical-thinking.pdf
4. Gerald H. Stein, MD, Hironobu
Tokunaga, MD, Hirotaka Ando, MD, Mikako
Obika, MD, PhD, Tomoko Miyoshi, MD,
Yasuharu Tokuda, MD, MPH, Yoshinori
Noguchi, MD, MPH, Mitsuyo
Kinjo, MD, MPH, Shun Kohsaka, MD, Hitoshi
Honda, MD, Yuka Kitano, MD, Hidetaka
Kitazono, MD, Hitomi Kataoka, MD, PhD, Hidekazu
Terasawa, MD.
Clinical Reasoning Web-based Prototypic Module for Tutors
Teaching 5th
Grade
Medical Students : A Pilot Randomized Study. General
Medicine.
2015: 16(1): 13-25.
https://www.jstage.jst.go.jp/article/general/16/1/16_13/_pdf
5. Gerald H. Stein, Hironobu Tokunaga, Hirotaka Ando, Mikako
Obika, Tomoko Miyoshi, Yasuharu Tokuda, Yoshinori Noguchi,
Hitomi Kataoka and Hidekazu Terasawa.
Medical students’ opinion of a Web-based module to teach
clinical thinking and knowledge.
General
Medicine. 2015;16(2): 76-83.
[Pre-print available on request]
6. Takata
Yukari, Stein H Gerald, Endo Kuniyuki, Arai
Akiko, Kohsaka Shun, Kitano Yuka, Honda
Hitoshi, Kitazono Hidetaka, Tokunaga
Hironobu, Tokuda Yasuharu, Obika Mikako,
Miyoshi Tomoko, Kataoka Hitomi, Terasawa
Hidekazu.
Content analysis of medical students’ seminars: a unique
method of analyzing clinical thinking.
BMC Medical Education. 2013. 13:156.
http://www.biomedcentral.com/1472-6920/13/156
7. Gerald H. Stein, MD.
Clinical
reasoning: An unfinished journey.
General Medicine. 2015; 16(1): 5-7;
https://www.jstage.jst.go.jp/article/general/16/1/16_5/_pdf
I hope many readers and their colleagues will consider ways
to build on our documented clinical reasoning base to
improve, expand, and apply our reform-minded prototypical
clinical reasoning module to undergraduate medical
educational curriculum in Japan.
I offer my deepest appreciation and thanks to the many
contributors that permitted the successful completion of the
clinical reasoning WP.
Invited
Lectures:
“Clinical thinking Web-based prototypic
module for Japanese medical students.”
1. Division of General Internal Medicine, Department of
Medicine, University of Florida, Gainesville Florida, USA;
April 24, 2014.
2. Nagoya 2nd Red Cross Hospital, Nagoya, Japan; June 9.
2014.
3. Department of Emergency Medicine, General Internal
Medicine and Community Medicine, Fukui Faculty of Medicine,
Fukui, Japan; June 20, 2014.
Preliminary Announcement
2012-2013
The Webinar
Project team at FukuiDai( Professor Terasawa Hidekazu),
OkayamaDai(Professor Kataoka Hitomi) and
TsukubaDai(Professor Tokuda Yasuharu) is please to release
preliminary information about the demonstration project
Aims
1. Tutor Japanese
5th grade medical students in clinical thinking skills.
2. Assess the
effectiveness of this tutoring
3. Develop and
implement a test to measure basic clinical thinking
4. Perform
"Content Analysis" of students and tutors speaking.
Methods
1. Randomly
selected 24 5th grade Japanese medical students, 12 tutored,
12 self-studied
2. Two volunteer
tutors who completed Japanese and North American general
medicine residencies
3. Tutoring
conducted on the Internet, in real time interactive audio
and video communication. Each of 2 'classrooms' has 6
students with one tutor.
4. Tutors taught
from a uniform interactive syllabus
5. Assessment was
by answering questions of a clinical case in which narrative
data was presented, a question ask, students wrote answers
in text, correct answers appeared, more clinical data
presented leading to differential diagnosis. This test is
called Sequential Question Answer(SQA). The test was
accessed by any standard Internet browser.
Results
1. All 12 tutored
students attended the 4 tutored sessions
2. Each class met
weekly 4 times, each session lasted 1.5 hours
3. All 24
students completed the pre and post tutoring SQA assessment
4. SQA results
pending
5. "Content
Analysis" of medical students' and tutors' speaking pending
Funding in part
from Monkasho:
臨床推論能力の評価と能力向上トレーニン
グの開発研究
http://kaken.nii.ac.jp/ja/p/23590870
[
Developmental research project for medical student clinical
thinking training and evaluation]
Selected comments
from tutored students' questionnaire
・I think that increased
knowledge was worth enough. But the actual idea further, and
learned the process of thinking that has been used in
clinical teacher, very helpful I think.
・知識が増えたという意味だけでも十分勉
強になりました。でもそれ以上に、「臨床医の先生が実際に現場で使っている思考の過程を学ぶことが出来た」ということが、大変意
味がありました。
・I think a very good system.
Lectures in small groups is also easy to go to my head. Also
be done in conjunction with the other students are better
able to compare their knowledge, etc.. Including teachers,
can be met off-campus, I could help in the future.
・（Webinarという遠隔授業は）とても良いシステムだと思います。少人数での
講義というのも頭に入りやすかったです。また、他大学の学生と同じクラスで受講できたために、自分の知識等を比較したりすること
も出来ました。講師の先生を含めて学外に知り合いができることも、今後役立つかもしれないと感じました。
Selected comments
from tutors' questionnaire[English only]:
It was a great
experience for me to have 4 sessions of Webinar to teach
clinical thinking process. I myself am doing that clinical
reasoning on daily work my hospital, but it takes longer and
more energy to let students/residents fully understand and
acquire that thinking process. This Webinar project helped
me to know how to do it.
For information
please contact FukuiDai’s Dr. Hironobu Tokunaga ( Chief
Coordinator): marutoku@mx2.fctv.ne.jp
or
University of
Florida’s Dr. Gerald Stein (Project Director)
jerrydoc@ufl.edu