学会誌

濵田 千枝美*1，2 　川上 ちひろ*3，4　今福 輪太郎*3，4
野村 理*3，4　尾辻 健*5　西城 卓也*3，4

要旨：
背景：臨床実習は自己調整学習（SRL）が難しく，医学生がどのように調整しているかは定かでない．目的は，医学生が救急科実習でどのようにSRLを認識していたかを明らかにすることである．
方法：A大学医学部5年次28名に半構造化面接を実施し，SRL循環モデルを枠組みとした主題分析を行った．
結果：実践を通じたプロフェッショナルアイデンティティの芽生え，不確実な環境下での学習目標と学習ツールの柔軟な選択，対話を通じた適切な明日の目標立案と学習方略の選択等，8つの主題が抽出された．
考察：対話や医療への参画，SRLを駆動させる循環的な実習構造がSRLにおける医学生の認識変容に影響していることが示唆された．
キーワード：自己調整学習，共調整学習，フィードバック，診療参加型臨床実習，救急科

Chiemi Hamada*1，2　Chihiro Kawakami*3，4　Rintaro Imafuku*3，4
Osamu Nomura*3，4　Ken Otsuji*5　Takuya Saiki*3，4

Abstract:
Background: Clinical clerkship training does not always provide an ideal environment for self-regulated learning （SRL） among medical students, and how students manage their learning during this period remains unclear. This study aims to explore how medical students perceive their SRL during clinical clerkship training in the emergency medicine department.
Methods: Semi-structured interviews were conducted with 28 fifth-year medical students at University A. Thematic analysis was performed using the SRL cyclical model as a theoretical framework.
Results: Eight themes were identified, including the emergence of professional identity through clinical training, the flexible selection of learning goals and tools in uncertain environments, and the appropriate planning of next-day goals and learning strategies through dialogue.
Discussion: The findings suggest that dialogue with colleagues, participation in team-based care, and clerkship structures grounded in the cyclical SRL model positively influence the transformation of students' perceptions of SRL.
Keywords: self-regulated learning, co-regulated learning, feedback, clinical clerkship, department of emergency medicine

---

*1 産業医科大学病院救急集中治療科，Department of Emergency and Intensive Care Medicine, Hospital of the University of Occupational and Environmental Health, Japan
*2 産業医科大学医学教育改革推進センター，Center for Medical Education, University of Occupational and Environmental Health, Japan
*3 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
*4 岐阜大学医学教育開発研究センター，Medical Education Development Center, Gifu University
*5 産業医科大学医学部救急・集中治療医学講座，Department of Emergency and Intensive Care Medicine, University of Occupational and Environmental Health, Japan

宮道 亮輔*1　八木（佐伯） 街子*2，3　淺田 義和*1，3　松山 泰*3　川平 洋*1

要旨：
背景：医療シミュレーション教育（SBE）は実践的学習を可能にする教育法であり，質の向上には教育者のコンピテンシーの明確化が不可欠である．文化的背景の違いが影響するため，本研究では国内外のSBE教育者のコンピテンシーを網羅的に検討した．
方法：Arksey & O’Malleyのフレームワークに基づきスコーピングレビューを実施した．PubMed等4つのデータベースを用い，24論文を選定・分析した．
結果：9つのテーマと58のサブテーマから成るコンピテンシー記述が抽出された．日本の文献も全体の枠組みは網羅していたが，デブリーフィングや先進技術，研究に関する記述が乏しかった．他国でも態度領域や評価手法などに地域差が見られた．
結論：SBE教育者のコンピテンシーには国・地域で差異があるが，共通の枠組みも認めた．今後は各国の知見を取り入れつつ，日本の実情に即した教育者コンピテンシーの整備と活用が求められる．
キーワード：医療シミュレーション，教育者，コンピテンシー

Ryosuke Miyamichi*1　Machiko Saeki Yagi*2，3　Yoshikazu Asada*1，3
Yasushi Matsuyama*3　Hiroshi Kawahira*1

Abstract:
Background: Simulation-based education（SBE） is a practical learning strategy in healthcare education. To ensure its quality, clarifying the competencies required of simulation educators is essential. Given the influence of cultural contexts, this study aimed to comprehensively examine the competencies of simulation educators in Japan and other countries.
Methods: A scoping review was conducted using the framework by Arksey and O’Malley. Literature searches were performed in four databases, including PubMed, to identify studies describing competencies for healthcare simulation educators. A total of 24 articles were selected and analyzed.
Results: The analysis identified nine major themes and 58 subthemes related to educator competencies. While literature from Japan and other countries covered the overall framework, variations were found at the subtheme level. Japanese literature lacked detailed descriptions on debriefing, advanced technologies, and research competencies.
Conclusions: While core competencies for simulation educators show similarities across countries, notable regional differences exist. Incorporating global insights while tailoring competencies to Japan’s specific educational and cultural context is essential for developing effective educator training programs.
Keywords: simulation-based education, educator, competency

---

*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 自治医科大学看護師特定行為研修センター，Training Center for Nurses Pertaining to Specified Medical Acts, Jichi Medical University
*3 自治医科大学医学教育センター，Medical Education Center, Jichi Medical University

鈴木 康之*1　野村 理*1　恒川 幸司*2　西城 卓也*1　武田 裕子*3

要旨：
目的：医学部入学者選抜の改善に資することを目的に，大学第一世代（FGCs）の医学生の社会経済的・教育的背景を明らかにする．
方法： 全国横断的・量的オンライン質問紙調査．医学生1,849名と看護学生295名を分析対象とした．
結果：医学生で両親ともに大卒でないFGCsは12.1%で，看護学生の39.4%より少なかった．医学生のFGCsと親大卒群を比較したところ，FGCsは小都市・関東関西以外の出身者が多く，家族年収が少なく，親族に医師・歯科医師がいる割合が少なかった．またFGCsは通塾頻度が少なく，国公立高校卒，成績上位者が多かった．大学受験は国公立単願，地域枠・推薦AO入試，現役合格，第一志望校，国公立医学部在籍者が多く，人口20万人未満の地域で勤務を希望する割合が多かった．
考察： FGCsの背景と勤務地志向は親大卒群と異なっていた．FGCsが有する可能性と諸課題を更に研究する必要がある．
キーワード：医学生；大学第一世代；first-generation college students （FGCs）；社会経済的背景

Yasuyuki Suzuki*1　Osamu Nomura*1　Koji Tsunekawa*2
Takuya Saiki*1　Yuko Takeda*3

Abstract:
Objective: To determine the socio-economic and educational backgrounds of first-generation college students （FGCs） among Japanese medical students, with the aim of contributing to the improvement of medical school admissions.
Methods: A nationwide cross-sectional online questionnaire survey was conducted. A total of 1,849 medical students and 295 nursing students participated.
Results: The proportion of FGCs among medical students was 12.1%, lower than that among nursing students （39.4%）. The backgrounds of FGCs were compared with those of non-FGCs （students whose parents were university graduates）. FGCs were more likely to come from small cities and from outside the Kanto/Kansai regions. They reported lower annual family incomes and had fewer doctors or dentists among their relatives. FGCs attended cram schools less frequently, were more likely to have graduated from national or public high schools, and had higher academic grades. They applied exclusively to national or public medical schools, were more likely to take regional quota or recommended AO entrance examinations, passed these exams immediately after high school graduation, and were more often enrolled in their first-choice and national or public medical schools. FGCs also expressed a stronger intention to work in less-populated areas in the future.
Discussion: The backgrounds of FGCs differ significantly from those of non-FGCs. Further investigation into the challenges and potential of FGCs in medicine is warranted.
Keywords: medical students；first-generation college students （FGCs）； socio-economic background

---

*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 名古屋市立大学医療人育成学，Department of Medical Career and Professional Development, Nagoya City University School of Medical Sciences
*3 順天堂大学医学教育学，Department of Medical Education, Juntendo University, Faculty of Medicine

青木 浩樹*1　菊川 誠*2

要旨：
医師に求められる臨床能力を9項目に分類し，久留米大学医学部心臓・血管内科同門医師132名を対象に定量的自己評価調査を実施した．相関分析と階層的クラスタリング分析により，各能力項目は相互に関連づけて認識され，個人として発揮される能力群と，他者との関係性で発揮される能力群の2つの大きな構造として捉えられていることが示唆された．本結果は，臨床能力育成の体系的設計に資する基礎的知見を提供すると思われる．
キーワード：臨床能力；能力構造；医師の自己認識

Hiroki Aoki*1　Makoto Kikukawa*2

Abstract:
Clinical competence in physicians comprises multiple interrelated components. We conducted a quantitative self-assessment survey of 132 physicians affiliated with the Division of Cardiovascular Medicine at Kurume University School of Medicine to investigate how these competencies are perceived. Nine competencies were defined based on national and international guidelines. Correlation analysis revealed significant positive associations among all competencies, indicating that physicians perceive them as interrelated. Hierarchical cluster analysis identified two major clusters: one related to individual traits and another associated with social interaction. These findings suggest that clinical competencies are perceived not in isolation but as structured domains. This provides foundational insight for the development of systematic training programs that align with how physicians experience and develop clinical competence.
Keywords: clinical competence, competency structure, physicians’self-perception

---

*1 久留米大学循環器病研究所，Cardiovascular Research Institute, Kurume University
*2 九州大学大学院医学研究院医学教育学講座，Department of Medical Education, Faculty of Medical Sciences, Kyushu University

太田 雄馬*1　淺田 義和*2　松山 泰*2

要旨：
医療分野における人工知能の急速な進歩に伴い，更新され続ける法的・倫理的基準に順じた人工知能の活用を医学部のカリキュラムで教育することが求められている．我々は，先行研究の結果に基づいて，臨床実習前の医学科4年生を対象に，人工知能活用における法的・倫理的課題を問題解決型学習形式で教育実践した．「臨床実習医学生が医療問診AIアプリの診断を過信する患者に対応する」問題解決型学習事例は新規的であり，ARCSモデルに基づいた省察においても，その有用性が示唆された．
キーワード：臨床実習前教育，人工知能，倫理，問題解決型学習，ARCSモデル

Yuma Ota*1　Yoshikazu Asada*2　Yasushi Matsuyama*2

Abstract:
With the rapid advancement of artificial intelligence technology in medicine, there is a growing demand for medical school curricula to educate students on its use in accordance with evolving legal and ethical standards. Based on previous research findings, we implemented a problem-based learning (PBL) program for fourth-year medical students—prior to their clinical clerkships—to address legal and ethical issues related to AI utilization. A novel PBL case, featuring a medical student responding to a patient who over-relies on a diagnosis from an AI-powered medical consultation app, demonstrated potential educational value, as reflected in student feedback analyzed using the ARCS model.
Keywords: pre-clinical medical education, artificial intelligence, ethics, problem-based learning, ARCS model

---

*1 自治医科大学大学院医学研究科，Graduate School of Medicine, Jichi Medical University
*2 自治医科大学医学教育センター，Medical Education Center, Jichi Medical University

髙橋 美裕希*1　野村 理*2　鷹羽 律紀*1　高田 惟登*3
浅野 文哉*3　川尻 宏昭*4　西城 卓也*2

要旨：
21世紀の医療者教育では，医療と社会システムの変革を志向する第3世代型の教育実践への移行が求められている．しかしそのような教育モデルの開発事例はまだ多くは報告されていない．今回，大学・行政・地域の医療機関により新しい医療者教育の共創を実現しようと試みている地域医療教育の文脈において，我々は課題探究や学際性など第3世代の医療者教育のエッセンスを基盤とした実習モデルを開発した．それは医学科2年生が，地域の課題探究・調査・提言のプロセスに主体的に関与しながら小さくも社会変革に寄与する可能性が示唆される課題探究型学習モデルである．第3世代の医療者教育の理念を具現化した本モデルの今後の普及や検証が期待される．
キーワード：プロジェクト型・探究型学習，第3世代医療者教育

Miyuki Takahashi*1　Osamu Nomura*2　Ritsuki Takaha*1　Yuito Takada*3
Fumiya Asano*3　Hiroaki Kawashiri*4　Takuya Saiki*2

Abstract:
In health professions education in the 21st century, there is a need to move toward a third-generation educational practice oriented toward the transformation of healthcare and social systems. However, few examples of the development of such an educational model have been reported. In the context of community-based health professions education-where universities, governments, and hospitals are attempting to co-create a new type of health professions education, we have developed an educational model grounded in the principles of third-generation health professions education, including problem inquiry and interdisciplinarity. It is a project- and inquiry-based learning model that suggests the possibility for second-year medical students to contribute to social change, however small, through their proactive involvement in the inquiring, investigating, and proposing solutions to local problems. Further dissemination and validation of this model, which embodies the philosophy of third-generation health professions education, are anticipated.
Keywords: project-and inquiry-based learning, third-generation health professions education

---

*1 岐阜大学大学院医学系研究科地域共創型飛騨高山医療者教育学講座，Department of Community-Based Co-Creative Hida-Takayama Health Professions Education, Graduate School of Medicine, Gifu University
*2 岐阜大学医学教育開発研究センター，Medical Education Development Center, Gifu University
*3 岐阜大学医学部，School of Medicine, Gifu University
*4 高山市役所医療保健部，Department of Medical and Health Care, Takayama City Hall

山本 幸近*1，2　小杉 俊介*2，3　徳増 一樹*1　菊川 誠*3　大塚 文男*1

Yukichika Yamamoto*1，2　Shunsuke Kosugi*2，3　Kazuki Tokumasu*1
Makoto Kikukawa*3　Fumio Otsuka*1

---

*1 岡山大学大学院医歯薬学総合研究科総合内科学，Okayama University Graduate School of Medicine，Dentistry and Pharmaceutical Sciences，Department of General Medicine
*2 飯塚病院総合診療科，Iizuka Hospital，Department of General Medicine
*3 九州大学大学院医学研究院医学教育学講座，Kyusyu University School of Medicine，Department of Medical Education，Faculty of Medical Science

徳増 一樹*1　宮地 由佳*2　森下 真理子*3

Kazuki Tokumasu*1　Yuka Urushibara-Miyachi*2　Mariko Morishita*3

---

*1 岡山大学病院総合内科・総合診療科，Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
*2 岐阜大学医学部医学教育開発研究センター，Medical Education Development Center, Gifu University
*3 京都大学医学部附属病院医療安全管理部，Department of Patient Safety, Kyoto University Hospital

木村 武司*

Takeshi Kimura*

---

*名古屋大学医学部附属病院卒後臨床研修・キャリア形成支援センター，Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital

淺田 義和*1　八木（佐 伯） 街子*1，2

Yoshikazu Asada*1　Machiko Saeki Yagi*1，2

---

*1 自治医科大学医学教育センター，Medical Education Center, Jichi Medical University
*2 自治医科大学特定行為研修センター，Training Center for Nurses Pertaining to Specified Medical Acts, Jichi Medical University

今福 輪太郎*1　川上 ちひろ*2，3　松井 真弓*4　山内 恒生*5　小島 悠揮*6　西城 卓也*2，3

Rintaro Imafuku*1　Chihiro Kawakami*2，3　Mayumi Matsui*4
Kosei Yamauchi*5　Yuki Kojima*6　Takuya Saiki*2，3

---

*1 名古屋市立大学大学院看護学研究科，Graduate School of Nursing, Nagoya City University
*2 岐阜大学医学教育開発研究センター，Medical Education Development Center, Gifu University
*3 岐阜大学大学院医学系研究科医科学専攻医学教育学，Division of Medical Education, Graduate School of Medicine, Gifu University
*4 岐阜大学グローカル推進機構，Organization for Promotion of Glocalization, Gifu University
*5 岐阜大学応用生物科学部，Faculty of Applied Biological Sciences, Gifu University
*6 岐阜大学工学部，Faculty of Engineering, Gifu University, Gifu, Japan

永井 精一郎*

Seiichiro Nagai*

---

*京都大学医学部医学科6年生，Faculty of Medicine, Kyoto University

Abrahim N. Razzak*

---

*School of Medicine, Medical College of Wisconsin, Milwaukee, United States of America