DOI： 10.11307/mededjapan.54.2_164

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Authorship：Lead author,　Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media {LLC}  

DOI： 10.1186/s12909-022-03352-4

Web of Science

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Authorship：Last author   Language：English  

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Language：Japanese  

Language：Japanese   Publisher：(一社)日本病院総合診療医学会  

【目的】総合診療医を増やす方策を検討するために,総合診療医を志望する医学生を対象にキャリア選択要因を質的に探索した。【方法】全国の10名の総合診療を志望する医学生を2グループに分け,2021年8月にオンラインでフォーカスグループを実施した。逐語録をSCAT法で分析した。【結果】参加者は地域医療,全人的医療への興味や,課外活動をきっかけに総合診療を志望し,幅広い臨床能力の獲得や,偶発的なキャリア,臨床以外のキャリアを計画していた。促進因子は,ロールモデルや指導医,地域医療との接点,分野の新しさであり,阻害因子は周囲からの評判,不明確なキャリアイメージ,卒前教育の不足であった。【結論】総合診療志望の医学生は地域医療や全人的医療への興味を背景に,課外活動や研修機会を通じた能動的な行動によりキャリアへの関心を深めていた。一方で,複雑化した専門医制度や不十分な卒前教育がその決断を思いとどまらせていた。(著者抄録)

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Informa {UK} Limited  

DOI： 10.2147/AMEP.S333958

Web of Science

PubMed

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：日本医学教育学会  

DOI： 10.11307/mededjapan.52.5_450

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Language：Japanese   Publisher：JAPAN PRIMARY CARE ASSOCIATION  

DOI： 10.14442/generalist.44.128

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Other Link： https://search.jamas.or.jp/link/ui/2022021314

Publishing type：Research paper (scientific journal)   Publisher：{BMJ}  

<sec><title>Objectives</title>Training strategies regarding entrustable professional activities (EPAs) vary from country to country; one such strategy is for residents. However, there are no reports of EPAs developed for residents who rotate to the nephrology departments. We aimed to construct such EPAs, which could be generalised to other institutions.

</sec><sec><title>Design</title>Purposive design and a modified Delphi method to build consensus.

</sec><sec><title>Setting</title>The department of nephrology in a university hospital in Aichi Prefecture, Japan.

</sec><sec><title>Participants</title>Based on the attainment goals used in our department, an initial list was developed within the research group. The expert panel included 25 nephrologists from our affiliate hospital. Responses were based on a 5-point method and agreement was reached if both (A) and (B) were met: (A) mean≥4 with a SD &lt;1; (B) more than 75% of respondents rated the item 4 or more. With agreement, the item was left for the next round. This round was repeated.

</sec><sec><title>Results</title>An initial list of 11 items was developed; after three Delphi rounds and revisions, eight items remained that were then established as the final EPAs. These items can serve as a list of goals to be reached by residents who rotate to the department of nephrology. The results indicated that most of the experts believed residents should be able to perform tasks deemed necessary or urgent for all physicians, such as those that deal with hyperkalaemia and heart failure.

</sec><sec><title>Conclusions</title>The concept of EPAs enabled us to develop goals and evaluation criteria for residents’ training in nephrology. This study can serve as a springboard for future discussions and contribute to the development of resident education in nephrology.

</sec>

DOI： 10.1136/bmjopen-2020-047923

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Language：Japanese   Publisher：(一社)日本病院総合診療医学会  

診断エラーの頻度は高く外来で5%,院内死亡の10%,医療訴訟では最大の割合を占め,医療における負のインパクトは非常に強い。もとより診療において診断エラーが存在しうることは提起されていたが2000年の「To Err is Human」から一躍注目される領域となった。診断エラーの国際学会も2008年に始まり,現在患者安全領域では最大のトピックと,まさに発展途上の領域といえる。現在,日本では2つの学会で診断プロセスに関連するワーキンググループが立ち上がっているが,半世紀も前に東京大学で行われた冲中重雄教授の最終講義「内科臨床と剖検による批判」に始まる日本における診断エラーの歴史や,エラーに対する日本人の文化的な背景を考察した文献は少ない。今後の礎とするため病院総合診療医学会診断エラーワーキンググループ設立の経緯も含め日本での診断エラーの歴史と文化に対する考察,そして我々の活動内容を報告する。(著者抄録)

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：Japan Society for Medical Education  

The faculty development for clinical supervisor teaching residents (FD) was held for two nights on site in Japan. However, corona pandemic made it difficult to conduct the FD on site, thus we conducted it completely online. To avoid participants’ burden of long hours of synchronous online learning, we adopted a flipped classroom in which assignments in asynchronous online learning was used in discussion in synchronous learning. Assignments were issued sequentially five weeks prior to the synchronous session, and the synchronous session was held from 5:00 p.m. on Friday, November 13, 2020 to Saturday, November 14, 2020 for 45 participants. All participants completed the course by submitting all the assignments. The online flipped classroom utilizing assignments has a potential to significantly reduce the time constraints on busy clinicians.

DOI： 10.11307/mededjapan.52.3_263

CiNii Books

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Other Link： https://search.jamas.or.jp/link/ui/2021305352

Language：Japanese   Publisher：Japan Society for Medical Education  

In career education, devising ways to elicit proactive participation is vital, thus we conducted face-to-face workshops to drive learners’ participation. However, the COVID-19 pandemic forced us to teach classes online. Therefore, to motivate more than 100 students to participate actively in the online format, we conducted career education using Active Book Dialogue® where several students read a book together in a short period of time. Each student read a specific part of the book they were assigned and summarized it in collaboration with their group members. This enabled them to learn career theory. Additionally, the online format allowed several lectures to be held within a remote and interactive environment. We will reflect on this experience and report on how this can be applied in other schools.

DOI： 10.11307/mededjapan.52.3_235

CiNii Books

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Other Link： https://search.jamas.or.jp/link/ui/2021305347

Language：English   Publisher：The Japanese Society of Internal Medicine  

DOI： 10.2169/naika.110.1193

CiNii Books

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Other Link： https://search.jamas.or.jp/link/ui/2021261630

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

Corynebacterium simulans was first reported in 2000. Its characteristics such as isolation frequency, specimen types, and antimicrobial susceptibilities are poorly understood, because identification is difficult using conventional methods. We performed a retrospective observational study of 13 and 317 strains of C. simulans and C. striatum, respectively, isolated from consecutive patients at Nagoya University Hospital from January 2017 to December 2018. We analyzed patients' backgrounds, types of specimens, and antimicrobial susceptibilities. Antimicrobial susceptibilities were compared with those of C. striatum. The frequencies of isolation of C. simulans and C. striatum were 3.9% and 96%, respectively. C. simulans was not detected in specimens associated with mucous membranes, such as sputum and secretions from the craniocervical region, which were frequent for C. striatum. C. simulans was mainly detected in the skin (61.5%). All C. simulans isolates were susceptible to anti-MRSA drugs, as well as to numerous other antibiotics, including those that are orally administered. For example, C. simulans was significantly more susceptible to penicillin G, ceftriaxone, and ciprofloxacin than C. striatum (respective susceptibilities: 66.7% vs 5.4%, 50.0% vs 4.0%, 66.7% vs 5.9%). There was no significant difference between meropenem and erythromycin, although susceptibility to each was relatively high (100.0% vs 31.7%, 50.0% vs 11.9%). C. simulans was susceptible to numerous orally administered antibiotics and more susceptible to antimicrobial drugs than C. striatum. C. simulans was detected less frequently than C. striatum and was infrequently detected in specimens associated with mucous membranes. These characteristics will aid the selection of optimal antimicrobial therapies.

DOI： 10.18999/nagjms.83.2.269

PubMed

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Language：Japanese   Publisher：日本医学教育学会  

DOI： 10.11307/mededjapan.52.1_61

CiNii Books

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Other Link： https://search.jamas.or.jp/link/ui/2021150033

Language：Japanese  

Authorship：Last author   Language：English  

Language：Japanese   Publisher：日本医学教育学会  

DOI： 10.11307/mededjapan.51.6_707

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Language：Japanese   Publisher：Japan Society for Medical Education  

We conducted a case conference to solve problems in teaching practices and for clinician teachers to discuss various issues occurring in the field. The conference was based on the presentation of individual educational practice cases from faculty development workshops approved by the Ministry of Health, Labor and Welfare. We prepared two months before the event and dealt with four cases on the day of the event. During the discussion, we tried to link educational problems with a theory or a conceptual framework in medical education so that participants, including case presenters, would have a better understanding of clinical training settings. In addition, communication across disciplines was facilitated through discussions. This attempt has the potential to contribute to the development of a community of practice related to cross-disciplinary education. The key to success for this case conference was the "interpreter" role. The person in that role considers the background and context of practice and links practice with theory appropriately. In addition, faculty development for educators who can play the role will also be an issue in the future.

DOI： 10.11307/mededjapan.51.5_591

CiNii Books

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Other Link： https://search.jamas.or.jp/link/ui/2021052258

Language：Japanese   Publisher：Japan Society for Medical Education  

We developed a virtual career thinking game and provided third-year medical students with workshop-type career instruction to identify "transition" in a career and their own values. The game is a group work activity based on the assumption that the virtual character will respond to a turning point during undergraduate school and after graduation, and experience the story of a doctor's life. After playing the game and sharing the story of each group, participants were asked to think about what they would do at a possible turning point. Although favorable response were observed in the first year, problems were found, and improvements were made in the second year, and further effects were observed. The results show that career education using games increases students' ability to respond to turning points and is an effective technique in career education.

DOI： 10.11307/mededjapan.51.4_417

CiNii Books

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Other Link： https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17K17586/

Language：Japanese   Publisher：(一社)日本腎臓学会  

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

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：Japan Society for Medical Education  

DOI： 10.11307/mededjapan.51.3_276

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Other Link： https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-18H00782/

Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：Japan Society for Medical Education  

DOI： 10.11307/mededjapan.51.2_168

CiNii Books

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Language：English  

Corynebacterium simulans was first reported in 2000. Although it is a member of the normal skin flora, some cases of C. simulans infection have been reported. Other Corynebacterium spp. rarely cause chronic pyogenic spondylitis, and pyogenic spondylitis caused by C. simulans has not been reported at all. Here we report a case of acute pyogenic spondylitis due to C. simulans. A 78-year-old man with diabetes mellitus visited our hospital with a 3-day history of lower back pain and fever. Blood culture revealed C. simulans and magnetic resonance images of lumbar vertebrae showed pyogenic spondylitis. He recovered after treatment by vancomycin for 9 weeks and was discharged home. No recurrence has been observed for half a year. This is likely the first reported case of pyogenic spondylitis by C. simulans. In general, Corynebacterium spp. cause chronic pyogenic spondylitis, but this case showed an acute course.

DOI： 10.1016/j.jiac.2019.10.012

PubMed

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Language：Japanese  

DOI： 10.2169/internalmedicine.3309-19

Web of Science

PubMed

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

TAFRO syndrome is a novel disease concept characterized by Thrombocytopenia, Anasarca, myeloFibrosis, Renal dysfunction, Organomegaly, multiple lymphadenopathy and a histopathological pattern of atypical Castleman's disease. A 58-year-old man was diagnosed as TAFRO syndrome by clinical and histopathological findings. After receiving intensive immunosuppressive therapy, his thrombocytopenia and anasarca had not improved. He developed complications such as methicillin-resistant Staphylococcus aureus sepsis, gastrointestinal bleeding, peritonitis caused by Stenotrophomonas maltophilia, gastrointestinal perforation, and disseminated candidiasis resulting in death. Autopsy revealed disseminated candidiasis and hemophagocytic lymphohistiocytosis, with no evidence of TAFRO syndrome. During treatment, we regarded his lasting thrombocytopenia and anasarca as insufficient control of TAFRO syndrome. However, the autopsy revealed that thrombocytopenia was caused by secondary hemophagocytic lymphohistiocytosis caused by over-immunosuppression. We reviewed the published literature to identify indicators of adequate treatment, which suggested improvement of platelet count and anasarca several weeks after initial therapy. This indicated that we could not depend on the platelet count and anasarca in acute medical care after initial treatment. We should treat TAFRO syndrome based on patients' clinical status and obviate the risk of treatment-related complications caused by over-immunosuppression.

DOI： 10.18999/nagjms.81.3.519

PubMed

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

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Language：Japanese   Publisher：日本医学教育学会  

DOI： 10.11307/mededjapan.50.1_086

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Language：Japanese   Publisher：(株)日本医事新報社  

慢性疾患を抱える患者のケアは一面的な介入だけでは不十分である。多面的な介入のための考察や計画のために有用なのが、6つのコンポーネントからなる慢性疾患ケアモデルである。(著者抄録)

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Language：Japanese   Publisher：(株)日本医事新報社  

地域に根付く「住民同士のお節介」が認知症になった女性の独居生活を支えていた。これを地域独自のケアシステムとして考察する。(著者抄録)

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Language：Japanese   Publisher：(株)日本医事新報社  

慢性疾患ケアモデルを用いて外来診療を多職種で見直すことで、多忙な診療業務の負担を軽減し、患者ケアの質を高めることができるかもしれない。(著者抄録)

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DOI： 10.11477/mf.3103900657

CiNii Books

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

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Language：Japanese  

CiNii Books

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Other Link： https://search.jamas.or.jp/link/ui/2017283663

Language：Japanese   Publisher：(一社)米国内科学会日本支部  

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Event date： 2022.8

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2022.2

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Language：Japanese  

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