学会誌

錦織 宏　名古屋大学総合医学教育センター長・教授

岡崎 史子　新潟大学医学部医学科 医学教育学分野 教授

椎橋 実智男　埼玉医科大学副学長，IRセンター 教授

小西 靖彦　順天堂大学医学研究科 医学教育学 特任教授

帝京大学 副学長　冲永 寛子

第56回日本医学教育学会大会 実行委員長
帝京大学　大久保 由美子
同　実行委員
帝京大学　髙田 真二，山本 貴嗣，堀田 晶子，紺野 久美子，三木 祐子
同　大会長
帝京大学　冲永 寛子

前田 佳孝*1　鈴木 聡*2

要旨：
背景：臨床工学技士養成校の学生にユーザビリティ（製品の使いやすさ）評価演習を行い，その妥当性を検証した．
方法：ユーザビリティの評価観点（知覚，認知，行動，フィードバック）を講義後，学生に家電製品を評価させ，自由記述で記録させた．演習の妥当性検証では 59 名の記述を評価観点で分類した．
結果：学生は平均3.2個の評価観点を用い，ユーザビリティについて平均5.6個の評価をした．評価観点のうち認知（情報の分かりやすさ等）の評価数が平均2.2個と最も多かった．
考察：学生は多様な観点で家電製品を評価できた．使い慣れた製品では発見が難しいとされる認知的問題を学生は複数発見でき，本演習は妥当だったと思われる．
キーワード：ユーザビリティ，安全教育，卒前教育，人間工学

Yoshitaka Maeda*1　Satoshi Suzuki*2

Abstract:
Introduction: We conducted usability evaluation practice among clinical engineering students, and we verified the effectiveness of the practice.
Method: After lecturing on the four evaluation perspectives of usability （perception, cognition, behavior, and feedback） , students evaluated the home appliances and recorded the results in free-text form. To verify the effectiveness of our practice, the records of 59 students were sorted according to four evaluation perspectives.
Results: Students made a mean of 5.6 usability remarks and used a mean of 3.2 evaluation perspectives. Of the evaluation perspectives, cognition （e.g., ease of understanding information） was the most frequently pointed out, with a mean of 2.2.
Discussion: Students were able to evaluate appliances from various perspectives. This practice was effective because students were able to identify a number of cognitive usability problems that are considered difficult to detect with familiar devices.
Keywords: usability, safety education, undergraduate education, ergonomics

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*1 ⾃治医科⼤学 メディカルシミュレーションセンター，Medical Simulation Center, Jichi Medical University
*2 神奈川⼯科⼤学 健康医療科学部，Faculty of Health and Medical Sciences, Kanagawa Institute of Technology

青山 稔*1　中里 陽子*2　佐野 友洋*3　比企 瑠璃子*4　上嶋 菜摘*4　金田 凌*5　大谷 桃香*1　田中 良太*2

要旨：
我々はグミを用いた結紮トレーナー（KTG）を開発し，技術評価によりノットボードとの比較実験を行った．当院に在籍する修練医（外科専攻医・初期研修医）18人，熟練医（外科専門医）18人を対象とし結紮の所要時間を計測した．結紮技術の評価は過去に報告された計算式を用いて算出した（Scott DJ. J Surg Res. 2007）．ノットボードでは修練医27.1±22.6点，熟練医37.3±18.7点で両群に有意差がなく，KTGでは修練医12.3±20.6点，熟練医36.7±18.3点で両群に有意差を認めた（p＜0.001）．KTGでは熟達度に応じた技術評価が可能で，練習により技術向上が期待される．
キーワード：結紮，外科教育，食用素材，結紮トレーナー，基本的外科手技

Minoru Aoyama*1　Yoko Nakazato*2　Tomohiro Sano*3　Ruriko Hiki*4
Natsumi Ueshima*4　Ryo Kaneda*5　Momoka Otani*1　Ryota Tanaka*2

Abstract:
Introduction: We evaluated a trainer for improving knot-tying skills using gummy candies （KTG; knot-tying trainer using gummy）. To reveal its efficacy, the KTG was compared with a standard knot-tying board by evaluating construct and concurrent validities.
Method: The completion times for knot-tying with the both the trainers were recorded for 18 novices and 18 experts in our university hospital. The evaluation formula was published previously and comprised four items （accuracy, gap, slippage, and breakage） to calculate the total score.
Results: With the standard knot-tying board, the average score was 27.1±22.6 points in the novice group and 37.3±18.7 points in the expert group. There was no statistically significant difference between the groups. With the KTG, the average score was 12.3±20.6 points in the novice group and 36.7±18.3 points in the expert group, with a statistically significant difference （p＜0.001）.
Discussion: Using the KTG for knot-tying training, it may be possible to acquire knot-tying skills with proficiency-based training, which could improve knot-tying technique.
Keywords: knot tying, surgical education, gummy candy, knot tying trainer, fundamental surgical skills

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*1 杏林大学医学部医学科6年，Kyorin University School of Medicine, fifth-year student
*2 杏林大学医学部呼吸器・甲状腺外科学，Department of Surgery, Kyorin University School of Medicine
*3 杏林大学医学部医学科3年，Kyorin University School of Medicine, second-year student
*4 杏林大学医学部医学科4年，Kyorin University School of Medicine, third-year student
*5 杏林大学医学部医学科5年，Kyorin University School of Medicine, fourth-year student

岡田（奥村） あすか*1,2　潮谷 有二*3,4　吉田 麻衣*2,5　足立 耕平*1,2
井口 茂*6　前田 隆浩*7　永田 康浩*8

要旨：
背景：長崎大学医学部（医，保健）と長崎純心大学（福祉系）の共修授業を実施し，授業目標の学習成果と授業形態との関連を検討する．
方法：授業目標の自己評価を測定し，対面とオンラインの授業形態が異なる2年間で授業期間内の変化を検討した．
結果：医療と福祉の視点の評価は授業形態に関わらず統計的に有意に上昇したが，各学科生に対する同じ視点は対面授業の方が多くの項目でプラスの変化が見られた．
考察：オンラインでも医療と福祉のIPEに関する一定の成果が得られたと考えられた．また，授業形態で異なる変化を示した項目はグループの相互理解の違いが考えられた．今後，効果的な共修授業に向けて長期的な検証の必要性が示唆された．
キーワード：オンライン型学習，大学間連携，多職種連携教育，地域包括ケア，共修学習

Asuka（OKUMURA）Okada*1, 2　Yuji Shiotani*3, 4　Mai Yoshida*2, 5　Kohei Adachi*1, 2
Shigeru Inokuchi*6　Takahiro Maeda*7　Yasuhiro Nagata*8

Abstract:
Introduction: This study examines the relationship between learning styles and outcomes of interprofessional education （IPE） through co-curricular learning for medical and welfare students.
Method: To analyze changes over time, we utilized IPE evaluations of students from Nagasaki University School of Medicine and the Department of Comprehensive Community Care Services, Nagasaki Junshin Catholic University, who participated in either face-to-face or online classes.
Results: The learning outcomes from medical and welfare perspectives in IPE significantly increased regardless of the learning style. As for the same perspective on students from each department, the value of many outcomes in face-to-face learning showed significant increases compared to online classes.
Discussion: The learning outcomes of IPE in medical and welfare through online classes were considered to have achieved certain results. Additionally, differences in learning outcomes depending on the learning style were thought to be due to variations in understanding between the groups. It was suggested that long-term studies are necessary for effective co-curricular learning in the future.
Keywords: online learning，inter-university collaboration，interprofessional education，community comprehensive care，co-curricular learning

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*1 長崎純心大学人文学部福祉・心理学科，Department of Social Welfare and Psychology, Faculty of Humanities, Nagasaki Junshin Catholic University
*2 長崎純心大学地域連携センター医療・福祉連携部門，Department of Medical and Welfare Liaison, Community Liaison Center, Nagasaki Junshin Catholic University
*3 長崎純心大学人文学部，Faculty of Humanities, Nagasaki Junshin Catholic University
*4 慈愛園老人ホーム，Jiaien Nursing Home for the Elderly
*5 長崎純心大学人文学部こども教育保育学科，Department of Education and Care, Faculty of Humanities, Nagasaki Junshin Catholic University
*6 長崎大学大学院医歯薬学総合研究科理学療法学分野，Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences
*7 長崎大学病院 総合診療科，Department of General Medicine, Nagasaki University Hospital
*8 長崎大学大学院医歯薬学総合研究科地域医療学分野，Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences

小澤 竹俊*

要旨：
日本の社会が人口減少時代に入り，患者・社会が求めているニーズの中には，たとえ病気を治すことができなかったとしても，“人生の最期まで伴走してくれる医師の存在”がある．苦しむ人への援助には，相手が誰であったとしても関わり方として共通する点は，解決できる苦しみを解決すること，解決が難しい苦しみでも，わかってくれる誰かの存在が必要であり，穏やかになれる理由（支え）を見いだすことを支援する存在である．看取りの現場で整理され，発展した対人援助（スピリチュアルケア）の概念は，プロフェッショナリズムの実践の一つとして，医学教育で扱われるべき内容であると考えられる．
キーワード：プロフェッショナリズム，スピリチュアルケア，卒前教育，医学教育

Taketoshi Ozawa*

Abstract:
Japan has entered an era of declining population. Among the needs of patients and society is the presence of doctors who will be there for them until the end of their lives, even if they cannot cure their illness. Regardless of the target audience, support for those who are suffering shares common elements: people who are suffering appreciate having someone who they believe understands their pain, suffering that can be alleviated is addressed, and people find ways to remain calm when faced with suffering that cannot be resolved. Support for caregivers is equally important. The interpersonal support and spiritual care we have learned through our clinical practice in end-of-life care can contribute to professional education.
Keywords: professionalism, spiritual care, undergraduate education, medical education

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* めぐみ在宅クリニック，Megumi Home Clinic

髙橋 慶*1　川上 ちひろ*2,3　西城 卓也*2,3

要旨：
高度複雑化しつつもより広い視点を求められるこれからの医療のニーズに応える医療者教育には，臨床推論のような自然科学的思考に基づく実証主義重視の教育だけでは不十分であり，生物心理社会モデルなどの患者の生活世界での経験とその意味を捉えようとする現象学的な視点に基づく教育が重要となる．臨床実習前の医学部4年生を対象とした臨床推論の授業に，構造化された事例検討を通じて，臨床推論と生物心理社会モデルなどを同時に学ぶことができるオンライン授業を開発した．実証主義的視点と現象学的視点を学び，患者を生活者としてもみれるようになるため，同一事例を通じて複眼的に学習できる本授業モデルの普及が期待される．
キーワード：卒前教育，臨床推論，生物心理社会モデル，現象学，実証主義

Kei Takahashi*1　Chihiro Kawakami*2, 3　Takuya Saiki*2, 3

Abstract:
To educate medical professionals to meet the needs of future medical care, which will be highly complex and require a broader perspective, it is not enough to provide education that emphasizes positivism based on natural scientific thinking, such as clinical reasoning. It is also important to provide education based on a phenomenological perspective that seeks to understand patients’ experiences in the living world and their meaning, as seen in biopsychosocial models. We have developed an online class on clinical reasoning for fourth-year medical students prior to clinical practice, in which students can simultaneously learn clinical reasoning and biopsychosocial models through structured case studies. We expect that this teaching model will be widely adopted, as it allows students to learn both positivist and phenomenological perspectives, and to view patients as individuals in their daily lives, through a multifaceted learning experience using the same case study.
Keywords: pre-graduate education, clinical reasoning, biopsychosocial model, phenomenology, positivism

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*1 医療生協さいたま生活協同組合川口診療所，Kawaguchi Clinic, Saitama Health Cooperative, Japan
*2 岐阜大学大学院医学系研究科医療者教育学専攻，Research Field of Health Professions Education, Graduate School of Medicine Gifu University, Japan
*3 岐阜大学医学教育開発研究センター，Medical Education Development Center, Gifu University, Japan