研究者詳細 - 錦織　宏

論文 - 錦織　宏

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連載オンラインによる医療者教育はじめに査読有り

錦織宏

医学のあゆみ 278 巻 ( 7 ) 頁： 734 - 734 2021年8月

拘束からの解放査読有り

近藤猛, 錦織宏

医学教育 52 巻 ( 3 ) 頁： 263 - 269 2021年6月

記述言語：日本語出版者・発行元：日本医学教育学会

これまで臨床研修指導医講習会は原則として2泊3日の合宿形式で行われてきたが, コロナ禍のために完全オンライン形式で実施した. 長時間の同期型オンライン学習による参加者の負担を避ける目的で, 事前課題を課してそれに基づいたディスカッションを行う反転授業形式の非同期型オンライン学習も採用した. 同期型講習実施日の5週間前から事前課題を順次提示し, 同期型講習は2020年11月13日 (金) 17時から14日 (土) 18時まで, 参加者45名に対して行った. 全参加者が課題を全て提出し修了した. 事前課題を活用した反転授業型のオンライン指導医講習会は, 多忙な臨床医を拘束する時間を大幅に削減できる可能性がある.

DOI： 10.11307/mededjapan.52.3_263

CiNii Research

5. まとめと提言 : 医学教育における行動科学・社会科学の将来査読有り

錦織宏

医学教育 52 巻 ( 2 ) 頁： 145 - 149 2021年4月

記述言語：日本語出版者・発行元：日本医学教育学会

JACMEによる医学教育分野別認証評価によって, 医学教育における行動科学・社会科学に関する議論が活発化してきている. 本特集における行動科学・社会科学・医療法学・医療倫理学に関する概念整理に加えて, 本稿では, 社会医学と社会科学の関係性を整理し, 米国や英国の医学教育における行動科学・社会科学の現況について記述する. また行動科学・社会科学において, なぜ, 心理学・人類学・社会学といった学問を基盤とするのかについて私見を述べ, 意見・異見・反論を求める.

DOI： 10.11307/mededjapan.52.2_145

CiNii Research

「医学教育研究室の抄読会から」第7回査読有り

木村峻輔, 木村武司, 錦織宏

医学教育 52 巻 ( 2 ) 頁： 161 - 163 2021年4月

「医学教育研究室の抄読会から」 (第6回) 査読有り

木村武司, 錦織宏

医学教育 52 巻 ( 1 ) 頁： 58 - 60 2021年2月

医学教育サイバーシンポジウム開催報告査読有り

医学教育サイバーシンポジウム特別委員会, 田中淳一, 門川俊明, 村岡千種, 淺田義和, 木村武司, 清水郁夫, 錦織宏

医学教育 52 巻 ( 1 ) 頁： 47 - 51 2021年2月

記述言語：日本語出版者・発行元：日本医学教育学会

新型コロナウイルス感染症 (COVID-19) は, 医学教育に大きな影響を与え, 急速に変化する不確実な状況に対応する必要が生じた. また今年度の学術大会の誌上開催の決定を受け, 情報共有・ディスカッションを行う場が必要と考えた. そこで, 医学教育サイバーシンポジウム特別委員会が編成され, 2020年5月より2週間ごとに, 「これからの臨床実習」, 「試験」「卒後教育」「With Corona時代の医学教育」の題目でシンポジウムを計4回実施した. 本稿では, その概要と今後の考察を含めて報告する.

DOI： 10.11307/mededjapan.52.1_47

CiNii Research

「医学教育研究室の抄読会から」 (第5回)

種村文孝, 木村武司, 錦織宏

医学教育 51 巻 ( 6 ) 頁： 700 - 701 2020年12月

Gestational weight gain and foetal acidosis in vaginal and caesarean deliveries: The Japan Environment and Children’s Study Open Access

Murata T., Kyozuka H., Yamaguchi A., Fukuda T., Yasuda S., Sato A., Ogata Y., Shinoki K., Hosoya M., Yasumura S., Hashimoto K., Nishigori H., Fujimori K., Kamijima M., Yamazaki S., Ohya Y., Kishi R., Yaegashi N., Mori C., Ito S., Yamagata Z., Nakayama T., Iso H., Shima M., Kurozawa Y., Suganuma N., Kusuhara K., Katoh T.

Scientific Reports 10 巻 ( 1 ) 2020年12月

出版者・発行元：Scientific Reports

Inappropriate gestational weight gain (GWG), either above or below the recommended values, has been associated with an increased risk of adverse obstetric outcomes. To evaluate the risks of GWG for foetal acidosis according to pre-pregnancy body mass index (BMI) and mode of delivery, we analysed women with singleton pregnancies between 2011 and 2014 in the Japan Environment and Children’s Study. Participants (n = 71,799) were categorised according to pre-pregnancy BMI. GWG was categorised into insufficient, appropriate, or excessive. Foetal acidosis was defined as umbilical artery pH (UmA-pH) < 7.20 or < 7.10. Multiple logistic regressions were performed for each BMI category to identify the risks of GWG for foetal acidosis, accounting for the mode of delivery. Excessive GWG was significantly associated with increased foetal acidosis in overweight women and in women whose pre-pregnancy BMI was 23.0–25.0 kg/m2 especially in those with vaginal deliveries. Conversely, excessive GWG was not significantly associated with increased foetal acidosis in obese women and in women whose pre-pregnancy BMI was ≥ 25.0 kg/m2.

DOI： 10.1038/s41598-020-77429-9

Open Access

Scopus

臨床研修指導医講習会における医学教育ケースカンファレンスの試み査読有り

木村武司, 種村文孝, 近藤猛, 錦織宏

医学教育 51 巻 ( 5 ) 頁： 591 - 595 2020年10月

記述言語：日本語出版者・発行元：日本医学教育学会

臨床研修指導医講習会において, 個別の教育実践ケースの発表から実際の教育現場で抱えている諸問題を議論する医学教育ケースカンファレンスを行った. 開催2カ月前から準備をし, 当日は4つのケースを扱った. 筆者らは, 教育現場の実践に医学教育学の言葉を付与し, 理論や概念的枠組みを結びつけ, 受講者に臨床研修の現場で起こっている事象の理解を深めるよう努めた. 本試みは教育実践を通じて医学教育学の知見を学ぶだけでなく, 診療科横断的な教育に関連する実践共同体の構築に寄与する可能性を示した. そこでは, 実践の背景や文脈を考慮しながら理論と適切につなぐ「通訳者」の存在が鍵となり, 今後はその人材育成も課題である.

DOI： 10.11307/mededjapan.51.5_591

CiNii Research

医学教育研究室の抄読会から　第4回査読有り

木村武司, 錦織宏

医学教育 51 巻 ( 5 ) 頁： 615 - 617 2020年10月

医学教育研究室の抄読会から　第3回査読有り

佐野樹, 木村武司, 錦織宏

医学教育 51 巻 ( 4 ) 頁： 466 - 467 2020年8月

「医学とは何か」を問う教育の実態調査 : 中川米造の医学概論の観点から査読有り

外山尚吾, 青木杏奈, 藤崎和彦, 錦織宏

医学教育 51 巻 ( 4 ) 頁： 379 - 388 2020年8月

記述言語：日本語出版者・発行元：日本医学教育学会

背景 : 中川米造が医学概論という学問で探求した「医学とは何か」という問いに関する内容が, 現在の卒前医学教育でどのように取り扱われているかを調査した.　方法 : Web上でアクセス可能なシラバスを調査対象とした. 授業内容・授業時間数・教育方法・評価方法・教員について分析した.　結果 : 69校において, 「医学哲学・医療倫理学」「医療社会学・医療人類学」「医学史」の総授業時間数はそれぞれ1066時間20分, 213時間5分, 192時間5分であり, 該当授業全体に占める割合は72%, 14%, 13%だった.　考察 : 「医学概論」という言葉ではない形で, 「医学とは何か」という問いにつながる教育が散発的に行われていることも分かった.

DOI： 10.11307/mededjapan.51.4_379

CiNii Research

反転授業を活用した臨床研修指導医講習会の実施報告査読有り

近藤猛, 錦織宏

医学教育 51 巻 ( 2 ) 頁： 168 - 170 2020年4月

「医学教育研究室の抄読会から」　第2回

木村武司, 種村文孝, 錦織宏

医学教育 51 巻 ( 2 ) 頁： 166 - 167 2020年4月

5. 学会で出会ったある高齢男性医師の語り〈なぜ医学教育研究論文を書くのか? 〉査読有り

錦織宏

医学教育 50 巻 ( 6 ) 頁： 559 - 562 2019年12月

記述言語：日本語出版者・発行元：日本医学教育学会

我々はなぜ医学教育研究の論文を書き, また学会などで発表するのだろうか? またなぜ医学教育研究の論文を読み, 学会での発表を聞くのだろうか? 医学教育の実践はしばしば講義室などの閉じられた空間で行われ, そこには, <教員・指導医>と<医学生・研修医>といった明確な権力勾配が存在する. 本稿では, 権力構造に着目した批判理論という認識論的立場に立ち, 医学教育研究における教育事例報告の意義についての論を展開する.

DOI： 10.11307/mededjapan.50.6_559

CiNii Research

The Implications of Culture in the Education and Practice of Healthcare Professionals 査読有り Open Access

McKimm J., Nishigori H.

Asia Pacific Scholar 4 巻 ( 3 ) 頁： 1 - 2 2019年9月

Professional identity formation of female doctors in Japan - gap between the married and unmarried 査読有り Open Access

Matsui, T; Sato, M; Kato, Y; Nishigori, H

BMC MEDICAL EDUCATION 19 巻 ( 1 ) 頁： 55 2019年2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 Medical Education

Background: During professional identity formation (PIF), medical students and young doctors enter the process of socialization in medicine with their preexisting personal identities. Here, the authors focused on how gender influences both the professional and personal identities of doctors. The authors' particular research question was how the professional and personal identities of female doctors are formed in Japan, a patriarchal and highly masculinized country, especially before and after marriage and childbirth. Methods: Narrative inquiry was used as the research methodology. The authors purposively sampled 10 unmarried and 15 married Japanese female physicians with varying lengths of full-time work experience and conducted individual semi-structured face-to-face interviews between July 2013 and February 2015. The authors recorded, transcribed and anonymized the narrative data and extracted themes and representative narratives related to the formation of professional and personal identities. Based on these, the authors developed the master narrative for the whole study. Results: The PIF process by which female physicians integrate personal and professional identities was profoundly affected by gender stereotypes. Further, participant narratives revealed the existence of conflict between married and unmarried female doctors, which created a considerable gap between them. Conclusions: Female physicians lived with conflicting emotions in a chain of gender stereotype reinforcement. To overcome these issues, we propose that it is necessary to depart from a culture that determines merit based on a fixed sense of values, and instead develop a cultural system and work environment which allows the cultivation of a professional vision that accepts a wide variety of professional and personal identities, and a similarly wide variety of methods by which the two can be integrated.

DOI： 10.1186/s12909-019-1479-0

Incidence of Domestic Violence Against Pregnant Females after the Great East Japan Earthquake in Miyagi Prefecture: The Japan Environment and Children's Study

Sakurai K., Nishigori H., Nishigori T., Mizuno S., Obara T., Iwama N., Watanabe Z., Ishikuro M., Tatsuta N., Nishijima I., Sugawara J., Fujiwara I., Arima T., Kuriyama S., Metoki H., Takahashi F., Nakai K., Yaegashi N., Saito H., Kishi R., Hashimoto K., Mori C., Hirahara F., Yamagata Z., Inadera H., Kamijima M., Konishi I., Iso H., Shima M., Ogawa T., Suganuma N., Kusuhara K., Katoh T.

Disaster Medicine and Public Health Preparedness 11 巻 ( 2 ) 頁： 216 - 226 2017年4月

出版者・発行元：Disaster Medicine and Public Health Preparedness

Objective: This study aimed to clarify the correlation between the 2011 Great East Japan Earthquake and domestic violence (DV) against pregnant females after the disaster in Miyagi Prefecture, an area damaged by the earthquake and tsunami. Methods: We analyzed 7600 pregnant females from June to December 2011. The incidence of physical and mental DV and the proportions in the inland, north coastal, and south coastal areas of Miyagi Prefecture and nationwide were calculated, and a chi-square test was conducted for comparison. The risk factors for DV were estimated with multivariate logistic regression analyses on a prefecture-wide basis. Results: The incidence levels for physical DV were found to be 5.9% in the north coastal area, which was significantly higher than in the inland area (1.3%, P=0.0007) and nationwide (1.5%, P<0.0001). There were no significant differences in the incidence of mental DV between the 3 areas in Miyagi Prefecture (inland 15.2%, north coast 15.7%, and south coast 18.8%) or nationwide (13.8%). Experiencing disease or injury in someone close and changes in the family structure were significantly associated with mental DV in Miyagi Prefecture. Conclusion Continuous monitoring and support for pregnant females may be necessary to address this issue in disaster-affected areas.

DOI： 10.1017/dmp.2016.109

Scopus

Determinants of polyunsaturated fatty acid concentrations in erythrocytes of pregnant Japanese women from a birth cohort study: Study protocol and baseline findings of an adjunct study of the Japan environment & Children's study Open Access

Saito S., Kawabata T., Tatsuta N., Kimura F., Miyazawa T., Mizuno S., Nishigori H., Arima T., Kagawa Y., Yoshimasu K., Tsuno K., Ito Y., Kamijima M., Nakai K., Yaegashi N.

Environmental Health and Preventive Medicine 22 巻 ( 1 ) 2017年

出版者・発行元：Environmental Health and Preventive Medicine

Background: N-3 polyunsaturated fatty acids (n-3 PUFA) may have multiple beneficial effects on the outcome of pregnancy, maternal health and child development. The present study introduced the protocol of a birth cohort study to examine the beneficial effects of n-3 PUFA status in pregnant Japanese women as an adjunct study of the Japan Environment and Children's Study (JECS). Methods: The JECS participants in the coastal areas of Miyagi Prefecture were further invited to participate in this adjunct study, and 1,878 pregnant women were enrolled prior to delivery. Their n-3 PUFA status was evaluated with fatty acid profiles in erythrocytes of maternal blood collected from 1,623 mothers at 24-30 weeks of gestation and cord blood from 1,505 deliveries. Results: The baseline results, including comprehensive data on the fatty acid status and determinants affecting the PUFA status, were analyzed. In stepwise multivariate analyses, the cord blood docosahexaenoic acid (DHA) level was found to be significantly influenced by the DHA level in maternal blood, the child's sex, and the gestational period. The maternal DHA level was influenced by fish intake, maternal age, and the prepregnancy body mass index. While cord blood eicosapentaenoic acid (EPA) was influenced by maternal EPA, fish intake, and season at birth, additional factors such as maternal education, household income, and smoking habits affected the maternal EPA content. Conclusion: Further studies are warranted to clarify the nutritional impacts of n-3 PUFA in pregnant Japanese women of the cohort study.

DOI： 10.1186/s12199-017-0636-5

Open Access

Scopus

Fermented food consumption and psychological distress in pregnant women: A nationwide birth cohort study of the Japan environment and children’s study Open Access

Takahashi F., Nishigori H., Nishigori T., Mizuno S., Obara T., Metoki H., Sakurai K., Ishikuro M., Iwama N., Tatsuta N., Nishijima I., Fujiwara I., Arima T., Nakai K., Sugiyama T., Kuriyama S., Yaegashi N., Saito H., Kishi R., Hashimoto K., Mori C., Hirahara F., Yamagata Z., Inadera H., Kamijima M., Konishi I., Iso H., Shima M., Ogawa T., Suganuma N., Kusuhara K., Katoh T.

Tohoku Journal of Experimental Medicine 240 巻 ( 4 ) 頁： 309 - 321 2016年12月

出版者・発行元：Tohoku Journal of Experimental Medicine

Health benefits of fermented foods are attracting attention worldwide, and they have been traditionally eaten in Japan. Moreover, a recent study showed the association between the higher intake of yogurt and lower prevalence of depressive symptoms during pregnancy. Psychological problems, such as anxiety and depression, during pregnancy are serious health concerns and may increase the risk of adverse outcomes in children. In this study, we explored the association between fermented food consumption and psychological distress in 10,129 pregnant Japanese women, using the fixed data of the Japan Environment and Children’s Study (JECS), an ongoing nation-wide birth cohort study. Food consumption was assessed with a semi-quantitative food frequency questionnaire (FFQ), and the Kessler 6-item psychological distress scale (K6) was administered to eligible women during their second or third trimester to eliminate overlap with the period of hyperemesis gravidarum. The mean median gestation in the subjects was 24.8 weeks. In total, 9,030 subjects completed the K6 questionnaire and FFQ. Importantly, the prevalence of the K6 score of ≥ 13 was 3.1% (280 subjects). This value was lower compared to precedent studies, which may reflect that cooperative and health conscious subject participated in the survey. The multivariate logistic regression analysis indicates that the intake of yogurt, lactic acid beverages, cheese, Japanese pickles, miso soup, or fermented soybeans was not significantly associated with a K6 score of ≥ 13. In conclusion, the present cohort study shows no association between fermented food consumption and psychological distress symptoms during the second or third trimester of pregnancy.

DOI： 10.1620/tjem.240.309

Open Access

Scopus

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