Faculty Profiles - NISHIGORI Hiroshi

Papers - NISHIGORI Hiroshi

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第48回医学教育セミナーとワークショップ in 京都大学

鈴木康之, 錦織宏

医学教育 Vol. 44 ( 5 ) page： 368 - 369 2013

Reformation of Medical Education for an Aging Society in Japan. Invited Reviewed

Hiroshi Nishigori

Journal of Medical Research and Education. Vol. 1 ( 2 ) page： 8 - 9 2012.12

Minimum Requirementの身体診察法を網羅したHDPEモデル授業用シナリオの開発

小林智子, 錦織宏, 菊川誠, 大滝純司

医学教育 Vol. 43 ( Suppl. ) page： 184 - 184 2012.7

東京大学医学部医学科における女性学士入学者のアイデンティティの変遷 Reviewed

佐々木那津, 錦織宏, 大西弘高, 北村聖

医学教育 Vol. 43 ( Suppl. ) page： 56 - 56 2012.7

A global template for reforming residency without work-hours restrictions: decrease caseloads, increase education. Findings of the Japan Resident Workload Study Group. Reviewed International journal

Gautam A Deshpande, Kumiko Soejima, Yasushi Ishida, Osamu Takahashi, Joshua L Jacobs, Brian S Heist, Haruo Obara, Hiroshi Nishigori, Tsuguya Fukui

Medical teacher Vol. 34 ( 3 ) page： 232 - 9 2012

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

BACKGROUND: Japanese physician training programs are currently not subject to rigorous national standardization. Despite residency restructuring in 2004, little is known about the current work allocation of residents in Japan. AIMS: We quantified the amount of time that Japanese junior residents spend in service versus education in the context of caseload, fatigue, and low-value administrative work. METHODS: In this prospective, time-and-motion study, the activity of 1st- and 2nd-year residents at three Japanese community hospitals was observed at 5-min intervals over 1 week, and categorized as patient care, academic, non-patient care, and personal. Self-reported sleep data and caseload information were simultaneously collected. Data were subanalyzed by gender, training level, hospital, and shift. RESULTS: A total of 64 participating residents spent substantially more time in patient care activities than education (59.5% vs. 6.8%), and little time on low-value, non-patient work (5.1%). Residents reported a median 5 h of sleep before shifts and excessive sleepiness (median Epworth score, 12). Large variations in caseload were reported (median 10 patients, range 0-60). CONCLUSIONS: New physicians in Japan deliver a large volume of high-value patient care, while receiving little structured education and enduring substantial sleep deprivation. In programs without work-hour restrictions, caseload limits may improve safety and quality.

DOI： 10.3109/0142159X.2012.652489

Web of Science

PubMed

A national survey of international electives for medical students in Japan: 2009-2010. Reviewed International journal

Hiroshi Nishigori, Osamu Takahashi, Naomi Sugimoto, Kiyoshi Kitamura, Graham T McMahon

Medical teacher Vol. 34 ( 1 ) page： 71 - 3 2012

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

BACKGROUND AND OBJECTIVES: International electives can provide experiences for medical students to learn about health systems and foster critical self-reflection. So far, little is known about the status of Japanese students' engagement in international electives. We sought to provide information about the internationalization of Japanese medical education by clarifying the current situations of international electives. METHOD: We undertook a cross-sectional national 17-item questionnaire survey of program officers in all medical schools in Japan in February 2010. RESULTS: Sixty-five (81.3%) of 80 Japanese medical schools responded to the questionnaire. 462 Japanese medical students (3% of all students in their clinical years) travelled to North America (45.5%), Asia (25.0%), or Western Europe (24.4%) to study abroad. The number of students who participated in international electives was significantly increased when academic credit was available (median 6 vs. 1, p < 0.001) and institutional affiliations were present (median 7 vs. 2 students, p < 0.001). Most students were evaluated by means of written assignment on return. DISCUSSION AND CONCLUSION: About 3% of Japanese medical students participate in international clinical exchanges. Academic credit and institutional affiliations appear to promote greater utilization of international exchange opportunities.

DOI： 10.3109/0142159X.2012.638014

Web of Science

PubMed

東京大学医学部医学科学士入学制度の実態 Reviewed

佐々木那津, 錦織宏, 大西弘高, 北村聖

医学教育 Vol. 42 ( Suppl. ) page： 74 - 74 2011.7

A model teaching session for the hypothesis-driven physical examination. Reviewed International journal

Hiroshi Nishigori, Kozo Masuda, Makoto Kikukawa, Atsushi Kawashima, Rachel Yudkowsky, Georges Bordage, Junji Otaki

Medical teacher Vol. 33 ( 5 ) page： 410 - 7 2011

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

INTRODUCTION: The physical examination is an essential clinical competence for all physicians. Most medical schools have students who learn the physical examination maneuvers using a head-to-toe approach. However, this promotes a rote approach to the physical exam, and it is not uncommon for students later on to fail to appreciate the meaning of abnormal findings and their contribution to the diagnostic reasoning process. The purpose of the project was to develop a model teaching session for the hypothesis-driven physical examination (HDPE) approach in which students could practice the physical examination in the context of diagnostic reasoning. METHODS: We used an action research methodology to create this HDPE model by developing a teaching session, implementing it over 100 times with approximately 700 students, conducting internal reflection and external evaluations, and making adjustments as needed. RESULTS: A model nine-step HDPE teaching session was developed, including: (1) orientation, (2) anticipation, (3) preparation, (4) role play, (5) discussion-1, (6) answers, (7) discussion-2, (8) demonstration and (9) reflection. DISCUSSIONS AND CONCLUSIONS: A structured model HDPE teaching session and tutor guide were developed into a workable instructional intervention. Faculty members are invited to teach the physical examination using this model.

DOI： 10.3109/0142159X.2010.540269

Web of Science

PubMed

Asian perspectives for reflection. Reviewed International journal

Hiroshi Nishigori, Kanokwan Sriruksa

Medical teacher Vol. 33 ( 7 ) page： 580 - 1 2011

医学部学士編入学試験受験者の受験準備の現状 Reviewed

佐々木那津, 錦織宏, 大西弘高, 北村聖

医学教育 Vol. 41 ( Suppl. ) page： 97 - 97 2010.7

What are portfolios and showcase portfolios? Reviewed

The Japanese journal of family practice Vol. 15 ( 2 ) page： 32 - 44 2010

A hypothesis-driven physical examination learning and assessment procedure for medical students: initial validity evidence. Reviewed International journal

Rachel Yudkowsky, Junji Otaki, Tali Lowenstein, Janet Riddle, Hiroshi Nishigori, Georges Bordage

Medical education Vol. 43 ( 8 ) page： 729 - 40 2009.8

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL PUBLISHING, INC

CONTEXT: Diagnostic accuracy is maximised by having clinical signs and diagnostic hypotheses in mind during the physical examination (PE). This diagnostic reasoning approach contrasts with the rote, hypothesis-free screening PE learned by many medical students. A hypothesis-driven PE (HDPE) learning and assessment procedure was developed to provide targeted practice and assessment in anticipating, eliciting and interpreting critical aspects of the PE in the context of diagnostic challenges. OBJECTIVES: This study was designed to obtain initial content validity evidence, performance and reliability estimates, and impact data for the HDPE procedure. METHODS: Nineteen clinical scenarios were developed, covering 160 PE manoeuvres. A total of 66 Year 3 medical students prepared for and encountered three clinical scenarios during required formative assessments. For each case, students listed anticipated positive PE findings for two plausible diagnoses before examining the patient; examined a standardised patient (SP) simulating one of the diagnoses; received immediate feedback from the SP, and documented their findings and working diagnosis. The same students later encountered some of the scenarios during their Year 4 clinical skills examination. RESULTS: On average, Year 3 students anticipated 65% of the positive findings, correctly performed 88% of the PE manoeuvres and documented 61% of the findings. Year 4 students anticipated and elicited fewer findings overall, but achieved proportionally more discriminating findings, thereby more efficiently achieving a diagnostic accuracy equivalent to that of students in Year 3. Year 4 students performed better on cases on which they had received feedback as Year 3 students. Twelve cases would provide a reliability of 0.80, based on discriminating checklist items only. CONCLUSIONS: The HDPE provided medical students with a thoughtful, deliberate approach to learning and assessing PE skills in a valid and reliable manner.

DOI： 10.1111/j.1365-2923.2009.03379.x

Web of Science

PubMed

鑑別診断を考えながら行う身体診察(HDPE)の指導方法に関する教材開発の試み

大滝純司, 錦織宏, 増田浩三, 菊川誠, 川島篤志

医学教育 Vol. 40 ( Suppl. ) page： 145 - 145 2009.7

DREEM, PHEEM, ATEEM and STEEM in Japanese. Reviewed International journal

Hiroshi Nishigori, Makiko Nishigori, Hiroshi Yoshimura

Medical teacher Vol. 31 ( 6 ) page： 560 - 560 2009.6

I came, I saw, I reflected: a qualitative study into learning outcomes of international electives for Japanese and British medical students. Reviewed International journal Open Access

Hiroshi Nishigori, Takashi Otani, Simon Plint, Minako Uchino, Nobutaro Ban

Medical teacher Vol. 31 ( 5 ) page： e196-201 - e201 2009.5

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

BACKGROUND AND AIM: Although medical students have increasingly more opportunities to participate in international electives, their experiences are usually unstructured and the literature referring to their learning outcomes, educational environment, and assessment is scanty. This study was undertaken to clarify qualitatively what students learn from their international electives. METHODS: We carried out semi-structured individual interviews with 15 Japanese students studying clinical medicine in British medical schools and six British students studying in Japanese medical schools. The thematic synthesis method was used in analysing the transcribed data and triangulation by multiple researchers was used to achieve higher reliability. RESULTS: The main learning outcomes identified were skills in history taking and physical examination with clinical reasoning and in management of diseases rarely seen in the students' own countries; awareness of clinical ethics and merits and demerits of different systems of healthcare and medical education; sensitivity to issues in doctor-patient relationships and work ethics; enhancement of cultural competence; and personal development. CONCLUSIONS: Most learning outcomes of international electives are culture- or system-dependent. Students achieved outcomes related closely to medical professionalism, mainly through reflection. International electives may give students opportunities to learn both professionalism and cultural competence.

DOI： 10.1080/01421590802516764

Scopus

PubMed

IPEに求められるReflection Reviewed

錦織宏

保健医療福祉連携．1(1): 67-69 2009

序章．次世代の医学教育者の育成に向けて－医学教育マスターコース検討委員会報告 Invited Reviewed

鈴木康之, 吉岡俊正, 吉田素文, 田川まさみ, 錦織宏, 西城卓也, 守屋利佳, 大谷尚, 渡邊洋子

医学教育．40(4): 235-236 2009

Advanced OSCEの開発臨床診断の思考過程を組み込んだ身体診察学習と評価の開発研究(第3報)

菰田孝行, 大滝純司, 阿部幸恵, 山科章, 平山陽示, 原田芳巳, 錦織宏, 増田浩三, 川島篤志, 菊川誠

医学教育 Vol. 39 ( Suppl. ) page： 24 - 25 2008.7