学会誌

今村 啓太*1　杉本 明子*2

要旨：
目的：達成目標と職業価値観との関係性および職業価値観が達成目標に与える影響を検討した．
方法：対象は理学療法士養成専門学校4校の学生とした．質問紙調査で達成目標と職業価値観を測定し，Pearsonの積率相関係数と重回帰分析を実施した．
結果：達成目標と職業価値観には有意な正の相関が認められた．熟達目標には自己価値や社会的評価が正の影響を，労働条件が負の影響を与えていた．遂行接近目標や遂行回避目標には社会的評価や労働条件が正の影響を，自己価値や組織からの独立が負の影響を与えていた．
結論：達成目標と職業価値観は関連し，職業価値観は達成目標に影響を与えることが示唆された．
キーワード：学習動機，達成目標理論，職業価値観，理学療法士教育，専門学校学生

Keita Imamura*1　Akiko Sugimoto*2

Abstract:
Purpose: This study examined the relationship between achievement goals and work values, and the influence of work values on achievement goals．
Methods: The subjects were 538 students from four Physical Therapist Vocational Schools．Achievement goals and work values were measured with a questionnaire survey, and Pearson's product-moment correlation coefficient and multiple regression analysis were performed．
Results: There was a positive significant correlation between achievement goals and work values． Mastery goals were positively influenced by self-worth and social evaluation, and negatively influenced by the comfortable working environments．Performance approach goals and performance avoidance goals were positively influenced by social evaluation and comfortable working environments, and negatively influenced by self-worth and independence from the organization．
Conclusion: Achievement goals and work values were related, and work values were suggested to influence achievement goals．
Keywords: learning motivation, achievement goal theory, work values, physical therapist education, vocational school students

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*1 九州医療スポーツ専門学校，Kyushu Medical Sports Vocational School
*2 明星大学，Meisei University

鈴木 康之*1　恒川 幸司*2　武田 裕子*3　川上 ちひろ*1　早川 佳穂*1　今福 輪太郎*1　西城 卓也*1

要旨：
目的：我が国の医学生選抜の課題を解明するために，医学生の社会経済的背景に対する市民と医療系教育者の認識を対比的に明らかにする．
方法：市民と医療系教育者に医学生の社会経済的背景に関する情報を提示し，フォーカスグループでの逐語を主題分析法により帰納的に分析した．
結果：家族の経済力など家庭背景に関する6主題，教育格差など社会背景に関する5主題，多様な学生選抜など医学教育への期待に関する4主題が抽出された．
考察：市民，医療系教育者ともに，医学生の社会経済的背景に問題意識を持ち，医学生の多様性を広げる必要性を認識していた．本知見は今後の医学生選抜規準の再考に資するものである．
キーワード：医学生，社会経済的背景，格差社会，市民，医療系教育者，フォーカスグループ，認識

Yasuyuki Suzuki*1　Koji Tsunekawa*2　Yuko Takeda*3　Chihiro Kawakami*1
Kaho Hayakawa*1　Rintaro Imafuku*1　Takuya Saiki*1

Abstract:
Objective: Perceptions of citizens and health professions educators towards the socioeconomic backgrounds of medical students were investigated to elucidate the challenges of selecting medical students who will be responsible for the future of healthcare in Japan.
Methods: Ten focus groups, comprising 14 citizens and 26 health professions educators, were conducted regarding the presented information on the socioeconomic backgrounds of Japanese medical students. Data were analyzed using an inductive thematic analysis approach.
Results: Six themes related to family backgrounds, such as higher economic status, five themes related to social backgrounds, such as social and educational disparity, and four themes related to expectations for medical education, such as selection of medical students with diverse backgrounds were extracted.
Discussion: Both citizens and health professions educators were aware of the problem of the skewed socioeconomic backgrounds of medical students and the need to expand diversity. This finding will contribute to the reconsideration of future medical school admission criteria.
Keywords: medical students, socioeconomic background, social disparity, citizen, health professions educator, focus group, perception

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*1 岐阜大学医学教育開発研究センター，Medical Education Development Center, Gifu University School of Medicine
*2 岐阜大学大学院医学系研究科医学教育学，Division of Medical Education, Gifu University Graduate School of Medicine
*3 順天堂大学医学教育学，Department of Medical Education, Juntendo University, Faculty of Medicine

堀田 亮*1　瀬戸山 陽子*2　川上 ちひろ*1

要旨：
　医療者教育に携わる者が教育，支援上でどのような事項を習得することが望ましいか明らかにするために，大学教員および臨床現場の指導者92名に無記名，個別記入形式のWeb調査を行った．障害学生支援に関する14項目について，それぞれ認知度と必要度を尋ねたところ，認知度が平均値以下で，必要度が平均値以上の項目は「合理的配慮」，「教育的配慮」，「自己理解」，「臨床実習における支援方法」，「プライバシーと守秘義務」であった．本研究結果を基に，オンデマンドで学習できる動画教材等を作成し理解啓発を促すことが望ましい．そうすることで，学習を支援する者の資質や技能が向上し，医療者教育の水準の向上，発展に寄与できる．
キーワード：障害学生支援，学習者支援，認知度，必要度

Ryo Horita*1　Yoko Setoyama*2　Chihiro Kawakami*1

Abstract:
The purpose of this study was to identify keywords medical educators should learn for their teaching and support. An anonymous web-based survey was conducted with 92 university faculty members and clinical supervisors. The participants were asked about their awareness and need for the 14 items related to support for students with disabilities. The items with below-average awareness and above-average need were “reasonable accommodation,” “educational considerations,” “self-understanding,” “support methods in clinical practice,” and “privacy and confidentiality”. Based on the results of this study, it is desirable to create video materials that can be studied on demand to promote understanding and awareness. This would contribute to the improvement of the qualities and skills of those who support learning and to the development of the standard of medical education.
Keywords: support for students with disabilities, support for learners, awareness, needs

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*1 岐阜大学医学教育開発研究センター，Medical Education Development Center, Gifu University School of Medicine
*2 東京医科大学教育IRセンター，Tokyo Medical University, Institutional Research Center

山田 陽平*1　安藤 友一*1　佐藤 元紀*1　木村 卓二*2　伴 信太郎*3　佐藤 寿一*1

要旨：
中津川市は，小学校6年生を対象に医療・介護に関心を持ち，将来医療・介護従事者になる志を持って貰うための医療・介護職体験イベント「メディカルキッズ」を 2013年度より開催している．イベント参加者の7～9年後の現在の進路状況を調査し，当該イベントが医療・介護職志向に及ぼす影響を評価した．2013～2015年度のイベント参加者43名に 2022 年度に現在の進路を尋ねるアンケート調査を行った．回答率81％で，医療・介護関係へ就職または進学している者は40％，その中で当該イベント参加が進路選択の契機となったと答えた者は64%だった．当該イベントは将来医療・介護職を選択する契機になっていることが示唆された．
キーワード：職業体験，小学生，医療人志向

Yohei Yamada*1　Yuichi Ando*1　Motoki Sato*1　Takuji Kimura*2　Nobutaro Ban*3　Juichi Sato*1

Abstract:
Since 2013, Nakatsugawa City has been holding a medical/nursing care work experience event called“Medical Kids,” aimed primarily at sixth-grade elementary school students to develop an interest in medical and nursing care and aspire to become medical/nursing care workers in the future. We investigated the current career paths of participants in this event 7 to 9 years after the event, and evaluated the impact of the event on their intentions to work in the medical and nursing care professions.
A questionnaire survey was conducted in 2022 asking 43 participants of the event from 2013 to 2015 about their current career paths. The response rate was 81.4%, with 40% employed or pursuing higher education in the medical/nursing care field, and 64% of them stated that participating in the event was an opportunity for them to choose a career path. It turned out that this event was an opportunity for them to choose a future medical or nursing career.
Keywords: work experience, elementary school students, medical professional aspirations

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*1 名古屋大学医学部附属病院総合診療科，Department of General Medicine, Nagoya University Hospital
*2 オリーブ在宅クリニック，Olive Homecare Clinic
*3 中津川市地域総合医療センター，Nakatsugawa Community Medical Center

木村 知*

要旨：
　当院は，東京医科歯科大学の臨床研修協力医療機関として，初期研修医を毎年度複数名受け入れ，在宅医療を中心とした地域医療研修を行っている．研修医は末期がん患者を最低1名担当し，終末期医療および緩和ケアを実践する．昨今，終末期の意思決定支援の一環としてアドバンス・ケア・プランニング（ACP）の有用性が叫ばれ，初期研修でも必修とされているが，必ずしも医師の認知度は高いと言えず十分実践されていない．今回筆者は初期研修医と共にACPを実践し，意義と課題を検討した．また，教育理論を踏まえれば，ACP研修は，研修医の患者とのコミュニケーションスキルの習熟に加え，患者本位の医療に関する学習動機に資すると考えられた．
キーワード：臨床研修，アドバンス・ケア・プランニング（ACP），終末期の意思決定，患者とのコミュニケーションスキル

Tomo Kimura*

Abstract:
As a clinical training partner medical institution of Tokyo Medical and Dental University, our hospital accepts several residents each year and conducts regional medical training centered on home medical care. Each resident will be in charge of at least one terminally ill cancer patient and will practice end-of-life care and palliative care. Recently, the usefulness of Advance Care Planning (ACP) as part of end-of-life decision-making support has been emphasized. It is required to be included in initial training, but it is not necessarily well-recognized by doctors and is not fully practiced. This time, the author practiced ACP with residents and examined its significance and problems. Furthermore, based on educational theory, ACP training was thought to contribute not only to helping residents acquire communication skills with patients but also to motivating them to learn about patient-centered medical care.
Keywords: clinical training, Advance Care Planning (ACP), end-of-life decision-making, communication skill

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* 医療法人社団実幸会いらはら診療所，Irahara Primary Care Hospital

Cara Kim*1　Elanur Colak*2

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*1 Faculty of Medicine, Technical University of Munich, Germany
*2 Faculty of Medicine, University of Cologne, Germany

Elizabeth Schueth*1, 2

Abstract:

The United States population is growing, along with 40% of active physicians approaching 65 years of age, creating a significant physician shortage which is predicted to be a gap of nearly 124,000 physicians by 2034. Additionally, although over half the graduating medical school classes are now female, women physicians are working part-time or considering going part-time at drastic rates (representing 3/4ths of women physicians by 6 years immediately following training). There have been great strides in women’s rights in the workplace and in acceptance rates into the medical field; however, these steps forward have been stifled by the lack of institutional and social support of women physician mothers. In the United States, we lack policies and a culture that adequately supports physician mothers. Here I offer a perspective after observing our Japanese colleagues in the Anesthesiology Department at Juntendo University Hospital. Juntendo University’s Anesthesiology Department has a female chair and many policies to support physician mothers at a societal, institutional, and department level. The US healthcare system could learn from our Japanese colleagues by adjusting at a minimum our institutional expectations and policies to better support physician mothers in the workplace. With improved support, we may retain more US women physicians partially helping to resolve the impending physician shortage facing the country.

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*1 Brigham & Women’s Hospital
*2 Harvard Medical School

プロフェッショナリズム部会
宮田 靖志*1　朝比奈 真由美*2　高宮 有介*3　髙田 真二*4　笠井 大*5　横尾 英孝*6

要旨：
　学修者のアンプロフェッショナルな行動への対応は単純な解決策がなく，体系的な再教育の方法も提示されておらず，非常に困難なものである．医学教育者はその対応に非常に苦慮し，心身ともに疲労困憊することが稀ではない．本セミナー&ワークショップでは，学修者のアンプロフェショナルな行動への対応の基本的知識を提供したうえで，先進的な取り組みをしている3つの大学から卒前教育における対応の具体的方法を提示した．その後，これらをもとにして，参加者各自が対応している事例を小グループ討論にて共有し，教育現場での実践的な対応を学んだ．各講演の要点と小グループ討論の概要を報告する．
キーワード：アンプロフェッショナルな行動，教育・評価ガイドライン，プロフェッショナリズム評価委員会，懲罰，形成的評価，総括的評価，逸脱行動報告書制度，教育的介入，イエローカード制度，レッドカード

Professionalism Subommittee
Yasushi Miyata*1　Mayumi Asahina*2　Yusuke Takamiya *3
Shinji Takada*4　Hajime Kasai*5　Hidetaka Yokoh*6

Abstract:
Addressing unprofessional behavior among medical students and residents presents a formidable challenge, characterized by the absence of straightforward solutions and a lack of established methodologies for remediation. Medical educators grapple with this issue, often experiencing physical and psychological strain. This seminar and workshop aimed to equip educators with fundamental strategies for managing students’ misconduct, featuring presentations from three universities pioneering innovative approaches within undergraduate education. Drawing from these insights, participants engaged in small group discussions, exchanging personal anecdotes and insights to glean actionable measures for immediate implementation in educational contexts. Below are the key highlights from each lecture and ensuing group deliberations.
Keywords: unprofessional conduct, education and evaluation guidelines, professionalism evaluation committee, discipline, formative evaluation, summative evaluation, deviant behavior report system, educational intervention, yellow card system, red card

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*1 愛知医科大学医学部地域総合診療医学寄附講座，Department of Primary Care and Community Health, Aichi Medical University School of Medicine
*2 千葉大学医学部附属病院総合医療教育研修センター，Health Professional Development Center, Chiba University Hospital
*3 昭和大学医学部医学教育学講座，Department of Medical Education, Showa University School of Medicine
*4 帝京大学医学部医学教育センター・麻酔科学講座，Center for Medical Education, and Department of Anesthesiology, Teikyo University School of Medicine
*5 千葉大学大学院医学研究院医学教育研究，Department of Medical Education, Graduate School of Medicine, Chiba University
*6 鹿児島大学大学院医歯学総合研究科医歯学教育開発センター，Center for Innovation in Medical and Dental Education, Kagoshima University, Graduate School of Medical and Dental Sciences

賀來 敦*

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* 医療法人寿尚会洛陽病院，Rakuyo Hospital

石川 和信*1,2

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*1 山形大学医学部， Yamagata University School of Medicine
*2 特定医療法人舟山病院総合内科，Department of General Internal Medicine, Funayama Hospital

柿坂 庸介*1,2　多田 寛*3　森下 葵*3,4　浮城 一司*1　大田 千晴*5

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*1 東北大学大学院医学系研究科てんかん学，
Department of Epileptology, Graduate School of Medicine, Tohoku University
*2 東北大学医学教育推進センター，Office of Medical Education, School of Medicine, Tohoku University
*3 東北大学大学院医学系研究科乳腺・内分泌外科学，
Department of Breast and Endocrine Surgical Oncology, Graduate School of Medicine, Tohoku University
*4 平鹿総合病院乳腺外科，Department of Breast Surgery, Hiraka General Hospital
*5 東北大学大学院医学系研究科小児病態学，Department of Pediatrics, Graduate School of Medicine, Tohoku University

鈴木 康之*1　武田 裕子*2

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*1 岐阜大学医学教育開発研究センター，Medical Education Development Center, Gifu University
*2 順天堂大学医学教育学，Department of Medical Education, Juntendo University

大西 友紀*

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* 横田空軍基地病院，Yokota Air Base Hospital

柿坂 庸介*1,2　佐々木 拓也*3　浮城 一司*1

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*1 東北大学大学院医学系研究科てんかん学，
Department of Epileptology, Graduate School of Medicine, Tohoku University
*2 東北大学医学教育推進センター，Office of Medical Education, School of Medicine, Tohoku University
*3 東北医科薬科大学医学部医学科，Tohoku Medical Pharmaceutical University, School of Medicine

Marc R. Schneider*　Anna B. Zidek*

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* Medical Student, Faculty of Medicine, Medical University-Varna “Prof. Dr. Paraskev Stoyanov”, 9000 Varna, Bulgaria

林 幹雄*

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* 関西医科大学教育センター，Kansai Medical University Center for Health Professions Education