Faculty Profiles - NISHIGORI Hiroshi

Papers - NISHIGORI Hiroshi

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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 Open Access

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