Faculty Profiles - NISHIGORI Hiroshi

【医学・医療者教育学を学ぶ我が国のプログラム】京大FCME(ふくみん) 現場で働く指導医のための医学教育学プログラム基礎編 Open Access

Other Link： https://link.springer.com/article/10.1007/s10459-021-10060-z/fulltext.html

錦織宏, 及川沙耶佳, 谷昇子, 木村武司, 種村文孝

医学教育 Vol. 52 ( 6 ) page： 515 - 523 2021.12

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

2015年に文部科学省の助成を受けて開講した京都大学の「現場で働く指導医のための医学教育学プログラム-基礎編」は対面型と遠隔型を組み合わせた形で医学教育学を体系的に学ぶプログラムである。1年間で約120時間学修することになる受講生は、課題に追われながらも12名の仲間と強固な学修コミュニティを形成していき、その様は講師が羨むほどである。また、プログラムに思想・哲学を掲げていること、そして文化人類学を重視したプログラムであることが特徴である。(著者抄録)

DOI： 10.11307/mededjapan.52.6_515

Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J00050&link_issn=&doc_id=20220112190004&doc_link_id=10.11307%2Fmededjapan.52.6_515&url=https%3A%2F%2Fdoi.org%2F10.11307%2Fmededjapan.52.6_515&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

52巻3号掲載「拘束からの解放―反転授業を活用した完全オンライン型臨床研修指導医講習会―」を読んで, への応答 Reviewed Open Access

近藤猛, 錦織宏

医学教育 Vol. 52 ( 5 ) page： 450 - 451 2021.10

外科系医師はどのようにして医学教育のキャリアを形成していくのか? 臨床医から、臨床医の教育、そして医学教育学へ医学教育学を学ぶ産婦人科医として Reviewed

磯部真倫, 榎本隆之, 錦織宏

医学教育 Vol. 52 ( Suppl. ) page： 37 - 37 2021.7

Lists of potential diagnoses that final-year medical students need to consider: a modified Delphi study Reviewed Open Access

Yuka Urushibara-Miyachi, Makoto Kikukawa, Masatomi Ikusaka, Junji Otaki, Hiroshi Nishigori

BMC Medical Education Vol. 21 ( 1 ) page： 234 2021.4

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

<title>Abstract</title><sec>
<title>Background</title>
Contrastive learning is known to be effective in teaching medical students how to generate diagnostic hypotheses in clinical reasoning. However, there is no international consensus on lists of diagnostic considerations across different medical disciplines regarding the common signs and symptoms that should be learned as part of the undergraduate medical curriculum. In Japan, the national model core curriculum for undergraduate medical education was revised in 2016, and lists of potential diagnoses for 37 common signs, symptoms, and pathophysiology were introduced into the curriculum. This study aimed to validate the list of items based on expert consensus.

</sec><sec>
<title>Methods</title>
The authors used a modified Delphi method to develop consensus among a panel of 23 expert physician-teachers in clinical reasoning from across Japan. The panel evaluated the items on a 5-point Likert scale, based on whether a disease should be hypothesized by final-year medical students considering given signs, symptoms, or pathophysiology. They also added other diseases that should be hypothesized. A positive consensus was defined as both a 75% rate of panel agreement and a mean of 4 or higher with a standard deviation of less than 1 on the 5-point scale. The study was conducted between September 2017 and March 2018.

</sec><sec>
<title>Results</title>
This modified Delphi study identified 275 basic and 67 essential other than basic items corresponding to the potential diagnoses for 37 common signs, symptoms, and pathophysiology that Japanese medical students should master before graduation.

</sec><sec>
<title>Conclusions</title>
The lists developed in the study can be useful for teaching and learning how to generate initial hypotheses by encouraging students’ contrastive learning. Although they were focused on the Japanese educational context, the lists and process of validation are generalizable to other countries for building national consensus on the content of medical education curricula.

</sec>

DOI： 10.1186/s12909-021-02652-5

Other Link： https://link.springer.com/article/10.1186/s12909-021-02652-5/fulltext.html

A Collaborative Clinical Case Conference Model for Teaching Social and Behavioral Science in Medicine: An Action Research Study Reviewed Open Access

Junichiro Miyachi, Junko Iida, Yosuke Shimazono, Hiroshi Nishigori

2021.2

Publisher：Research Square Platform LLC

<title>Abstract</title>
<bold>Background: </bold>Effective social and behavioral sciences teaching in medical education requires integration with clinical experience, as well as collaboration with social and behavioral sciences experts and clinical faculties. However, teaching models for achieving this integration have not been adequately established, nor has the collaboration process been described. This study aims to propose a collaborative clinical case conference model to integrate social and behavioral sciences and clinical experience. Additionally, we describe how social and behavioral science experts and clinical faculties collaborate during the development of the teaching method.<bold>Methods:</bold> A team of clinical teachers and medical anthropologists planned for the development of a case conference based on action research methodology. The initial model planned for a 3-hour session, similar to the Clinicopathological Conference structure. We evaluated each session based on fieldnotes taken by medical anthropologists, and post-session questionnaires that surveyed participants’ reactions and points of improvements. Based on the evaluation, a reflective meeting was held to discuss revisions for the next trial. We incorporated the development process into undergraduate medical curricula in clinical years and in a postgraduate and continuous professional development session for residents and certified family physicians in Japan. We repeated the plan-act-observe-reflection process more than 15 times between 2015 and 2018.<bold>Results:</bold> The development of the collaborative clinical case conference model is summarized in three phases: Quasi-CPC, Interactive, and Co-constructive with unique structures and underlying paradigms. The model successfully contributed to promoting the participants’ recognition of the clinical significance of social and behavioral sciences. The case preparation entailed a unique, significant learning of how social and behavioral sciences inform clinical practice. The model development process promoted the mutual understanding between clinical faculties and anthropologists, which might function as faculty development for teachers involved in social and behavioral sciences teaching in medical education. <bold>Conclusions:</bold> The application of fitting conference models and awareness of their underlying paradigm according to educational situations could promote the integration of social and behavioral sciences with clinical medicine education. Faculty development in social and behavioral sciences in medical education should focus on collaboration with scholars with different paradigmatic orientations.

DOI： 10.21203/rs.3.rs-138564/v1

Other Link： https://www.researchsquare.com/article/rs-138564/v1.html

Correlation between the number of laparoscopy-qualified gynecologists and the proportion of laparoscopic surgeries for benign gynecological diseases in Japan: An ecological study. Reviewed International journal

Masanori Isobe, Yuki Kataoka, Kenro Chikazawa, Tomonori Hada, Hiroshi Nishigori, Toshifumi Takahashi, Takayuki Enomoto

The journal of obstetrics and gynaecology research Vol. 47 ( 1 ) page： 329 - 336 2021.1

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

AIM: We aimed to evaluate regional disparities in the proportion of the three main laparoscopic surgeries for benign gynecological diseases among 47 prefectures in Japan and their correlation with the number of laparoscopy-qualified gynecologists per population. METHODS: In this retrospective ecological study, we collected the data of patients from 47 prefectures in 2017 using "The National Database of Health Insurance Claims and Specific Health Checkups of Japan" Open Data from the Ministry of Health, Labor and Welfare in Japan. The primary outcome of the study was the proportion of laparoscopic surgeries conducted for benign gynecologic diseases (hysterectomy, myomectomy and surgery for the benign ovarian diseases). The main exposure was the number of laparoscopy-qualified gynecologists per 100 000 females. RESULTS: The average proportion of laparoscopic hysterectomies, myomectomies and surgeries for the benign ovarian disease were 38% (standard deviation (SD) 16, range 12-74), 48% (SD 18, range 9-81) and 60% (SD 11, range 36-79), respectively. Multiple regression analysis showed a significant correlation between the number of laparoscopy-qualified gynecologists per 100 000 females and the proportion of the three main laparoscopic surgeries. CONCLUSION: There are obvious regional disparities in the proportion of the three main laparoscopic procedures for benign gynecological diseases among 47 prefectures. The number of laparoscopy-qualified gynecologists correlated significantly with these regional disparities. The academic society should monitor these regional disparities and make an effort to reduce these regional disparities by increasing laparoscopy-qualified gynecologists in areas where the widespread use of laparoscopic techniques is lagging.

DOI： 10.1111/jog.14528

Web of Science

Continuing medical education during pandemic waves of COVID-19: Consensus from medical faculties in Asia, Australia and Europe Reviewed

Carmen Wong, Walter van den Broek, Gillian Doody, Martin Fischer, Michelle Leech, Fabrizio De Ponti, Alexander Gerbes, Hiroshi Nishigori, Young Mee Lee, Maarten Frens, Hideki Kasuya, Franco Bazzoli, Reinhard Hickel, Hong Sik Lee, J.P.T.M van Leeuwen, Christina Mitchell, Kenji Kadomatsu, John Atherton, Francis Chan

MedEdPublish Vol. 10 ( 1 ) page： 64 2021

Development of entrustable professional activities for residents rotating nephrology department in a Japanese university hospital: a Delphi study Reviewed Open Access

Akihito Tanaka, Takeshi Kondo, Yuka Urushibara-Miyachi, Shoichi Maruyama, Hiroshi Nishigori

BMJ Open Vol. 11 ( 8 ) page： e047923 - e047923 2021

Language：English 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 <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

Problem-Based Learning in Child and Adolescent Psychiatry: A Perspective from Japan Reviewed Open Access

Junko Iwatsuki, Takeshi Kondo, Noriyuki Takahashi, Hideki Takami, Hiroshi Nishigori, Itzel Bustos-Villalobos, Branko Aleksic, Hideki Kasuya, Nobutaro Ban, Tetsuya Yagi, Norbert Skokauskas

Advances in Medical Education and Practice Vol. 12 page： 1329 - 1335 2021

Differential Diagnoses That Final-Year Medical Students Need to Consider: A Modified Delphi Study Reviewed

Yuka Urushibara-Miyachi, Makoto Kikukawa, Masatomi Ikusaka, Junji Otaki, Hiroshi Nishigori

BMC Medical Education 2020.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Research Square

<title>Abstract</title>
<bold>Background</bold>: Contrastive learning is known to be effective in teaching medical students how to generate diagnostic hypotheses in clinical reasoning. However, there is no consensus on comprehensive lists of differential diagnoses across different medical disciplines regarding the common symptoms that should be learned as part of the undergraduate medical curriculum. In Japan, the national model core curriculum for undergraduate medical education was revised in 2016, and lists of differential diagnoses for 37 common symptoms were introduced into the curriculum. This study aimed to validate the list of items based on expert consensus for use as a reference worldwide.<bold>Methods</bold>: The authors used a modified Delphi method to develop consensus among a panel of 23 expert physician-teachers in clinical reasoning from across Japan. The panel evaluated the items on a 5-point Likert scale, based on whether a disease should be hypothesized by final-year medical students considering a given symptom. They also added other diseases that should be hypothesized. A positive consensus was defined as both a 75% rate of panel agreement and a mean of 4 or higher with a standard deviation of less than 1 on the 5-point scale. The study was conducted between September 2017 and March 2018. <bold>Results</bold>: This modified Delphi study identified 275 essential and 67 supplemental items corresponding to the differential diagnoses for 37 common symptoms that Japanese medical students should master before graduation. <bold>Conclusions</bold>: The lists developed in the study can be useful for teaching and learning how to generate initial hypotheses by encouraging students’ contrastive learning. Although the lists may be specific to the Japanese context, the lists and process of validation are generalizable to other countries for building national consensus on the content of medical education curricula.

DOI： 10.21203/rs.3.rs-127514/v1

Other Link： https://www.researchsquare.com/article/rs-127514/v1.html

The number of overall hysterectomies per population with the perimenopausal status is increasing in Japan: A national representative cohort study Reviewed

Masanori Isobe, Yuki Kataoka, Kenro Chikazawa, Hiroshi Nishigori, Toshifumi Takahashi, Takayuki Enomoto

Journal of Obstetrics and Gynaecology Research Vol. 46 ( 12 ) page： 2651 - 2661 2020.12

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

Aim: This study aimed to investigate the trends in overall hysterectomy and other alternative therapies for benign uterine diseases per population aged 40–54 years in Japan. Methods: We conducted a national representative cohort study in Japan. We obtained data from ‘The National Database of Health Insurance Claims and Specific Health Checkups of Japan’ Open Data. The primary outcome was the number of overall hysterectomies for benign gynecologic diseases per population aged 40–54 years, from 2014 to 2017 in Japan. The secondary outcome was the number of alternative surgical and drug therapies to hysterectomy per population. We also analyzed the correlation between the number of laparoscopy-qualified gynecologists and the number of overall hysterectomies per population among 47 prefectures in 2017. Results: The number of overall hysterectomies for benign gynecological diseases per 100 000 females aged 40–54 years gradually increased from 320 in 2014 to 344 in 2017 (7.5% increase overall). Moreover, there was a significant increase in the use of levonorgestrel intrauterine systems. We could not explain the reason for this increase in the rate of overall hysterectomies by summarizing the increase or decrease of alternative therapies to hysterectomy. Multiple regression analysis showed a significant correlation between the number of laparoscopy-qualified gynecologists and the number of overall hysterectomies among 47 prefectures. Conclusion: Despite the spread of alternative therapies to hysterectomy, there was an increasing trend for overall hysterectomies in Japan. The reason was not clear but may be related to the spread of laparoscopic hysterectomy.

DOI： 10.1111/jog.14517

Web of Science

Failure or adaptation? - Redefining PBL from the perspective of the Safety II paradigm. Reviewed International journal

Ikuo Shimizu, Hiroshi Nishigori

Medical teacher Vol. 42 ( 9 ) page： 1076 - 1077 2020.9

Admission policies and methods at crossroads: a review of medical school admission policies and methods in seven Asian countries. Reviewed International journal Open Access

Diantha Soemantri, Indika Karunathilake, Jen-Hung Yang, Shan-Chwen Chang, Chyi-Her Lin, Vishna D Nadarajah, Hiroshi Nishigori, Dujeepa D Samarasekera, Shuh Shing Lee, Lilybeth R Tanchoco, Gominda Ponnamperuma

Korean journal of medical education Vol. 32 ( 3 ) page： 243 - 256 2020.9

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

Selecting the right applicants is an important part of medical student admission. While one universally accepted selection criterion is academic capacity, there are other criteria such as communication skills and local criteria (e.g., socio-cultural values) that are no less important. This article reviews the policies and methods of selection to medical schools in seven countries with varying socio-economic conditions and healthcare systems. Senior academics involved in medical education in Indonesia, Japan, Malaysia, the Philippines, Singapore, Sri Lanka, and Taiwan completed a pre-agreed pro-forma per each country to describe the country's admission policies and methods. The details were then compared and contrasted. This review identifies tension between many of the policies and methods used in medical school admissions, such as between the need to assess non-cognitive abilities and widen access, and between the need for more medical professionals and the requirement to set high entry standards. Finding the right balance requires careful consideration of all variables, including the country's human resource needs; socio-economic status; graduates' expected competencies; and the school's vision, mission, and availability of resources.

DOI： 10.3946/kjme.2020.169

EPAを用いた老年医学分野における初期臨床研修到達目標の開発 Reviewed

Entrustable professional activity(EPA)を用いた、腎臓内科を研修する初期臨床研修医の到達目標と評価基準の作成 Reviewed

田中章仁, 近藤猛, 宮地由佳, 丸山彰一, 錦織宏

日本腎臓学会誌 Vol. 62 ( 4 ) page： 375 - 375 2020.7

渡邊一久, 近藤猛, 葛谷雅文, 錦織宏

医学教育 Vol. 51 ( Suppl. ) page： 207 - 207 2020.7

目標・方略・評価を基盤とした卒後・専門教育のあり方〜現状とあるべき姿〜産婦人科領域における臨床研修医教育、専攻医教育、サブスペシャリティ教育における現状と問題点 Reviewed

磯部真倫, 錦織宏, 榎本隆之

医学教育 Vol. 51 ( Suppl. ) page： 42 - 42 2020.7

Faculty development in medical education: an environmental scan in countries within the Asia pacific region. Reviewed International journal Open Access

Dujeepa D Samarasekera, Shuh Shing Lee, Ardi Findyartini, Rita Mustika, Hiroshi Nishigori, Shunsuke Kimura, Young-Mee Lee

Korean journal of medical education Vol. 32 ( 2 ) page： 119 - 130 2020.6

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

PURPOSE: In recent years, faculty development (FD) research is more noticeable within an inter-professional context and in allied health education. However, there is a paucity of published literature on FD medical education programs in Asia. With the formation of the Asia Pacific Medical Education Network (APME-Net) in 2015, a scoping review of an environmental scan of FD medical education programs in main institutions in South East Asia and Australia in 2018 was conducted. METHODS: A survey was developed to collect data on FD in medical education after several rounds of discussion with APME-Net members. The representatives from nine countries in Asia and Australia were invited to partner in this research project. They sent the questionnaire to the Dean of all different medical schools after ethical clearance. The data collected was analyzed using descriptive statistics. RESULTS: Only institutions in four countries responded to the questionnaire. The medical/health professions education center/department/unit has been established in most educational institutions in these countries. These centers/departments/units mostly carry out FD programs to improve the teaching and learning skills of trained participants, particularly clinical teachers via workshops and seminars. Staffing issues and participant buy-in are the current key priorities of the center/department/unit in terms of FD. Lastly, research related FD program has not been well-supported in these countries, hence, the lack of publication in this area. CONCLUSION: Collaboration between countries to address key areas of interest and develop more standardized and productive FD medical education is required especially in research.

DOI： 10.3946/kjme.2020.160