Kurokawa Prize in Early Career Physician

Section: Recipient’s Remarks

Kiyoshi Shikino, MD

Department of General Medicine, Chiba University Hospital

I am honored to have received the Kurokawa Prize at the ACP Chapter Annual Meeting, 2018. The “Best Abstract Award” was named as the “Kurokawa Prize” beginning in 2018, I am especially honored to be the first person to be awarded this prize.

Research particulars

What triggered this research was that I felt that there were few physicians who could perform the fundus examination confidently. Even when I observed others, few doctors were using the ophthalmoscope with confidence in actual medical practice, except for my mentor, Professor Masatomi Ikusaka. Makoto Kikugawa (Department of Medical Education, Kyushu University), one of the co-researchers, reported that approximately 90% of junior residents, senior residents, and fellows in internal medicine performed the fundus examination less than once in a few months. He also reported that the reason for the problem was mostly that they were not proficient at the fundus examination.

When I taught residents the fundus examination, I discovered why observing the fundus was difficult for them. Funduscopy is inherently difficult to teach because there is no way to verify that the learners have obtained a proper view of the fundus. The teacher cannot give students feedback on whether what they are seeing or the teacher is seeing.Furthermore, it is extremely difficult for the teachers to point out why learners cannot observe the fundus. It was such a dilemma.

Turning point

The turning point of our research was a visit to the Department of Internal Medicine, Stanford University Medical School in March 2017 where I met Dr. Errol Ozdalga and learned the educational method using the iExaminer system for fundus examination. I talked with him about implementing this educational method in Japan as well as to conduct research on its educational effect. He approved of it pleasantly.

Introduction to Clinical Clerkship at Chiba University School of Medicine

First, because of actual instruction in using this iExaminer system, student satisfaction was high, and I heard students saying that they wanted to use it actively even in future clinical training. Next, in order to confirm whether the skill really improved, I asked for the cooperation of the fundus examination simulator at the Chiba Clinical Skills Center. To evaluate the educational effects, we assessed fundus examination skills in a pre-test and a post-test. Discussions between co-researcherswere intense, raising questions such as what to make the subject matter, how many cases we must prepare, and so on. Since we were particularly interested in evaluating skills in “observing fundus,” I was keen to prevent the evaluation of skills in “interpreting fundus.” In addition,to minimize the influence of teachers’ educational skills, we developed an instructional design, led the faculty development, and randomly assigned the teachers.

Future expectations

In this study, the diagnostic accuracy of a fundus examination improved by using the iExaminer system and the time taken to identify funduscopic findingswas shortened. The iExaminer system can be implemented immediately because it can be used for free if you have the adapter and an iPhone. By spreading this teaching method, I hope that more internists can examine the fund us with confidence.

Poster_ACP Japan 2018_Shikino


ACP日本支部2018年次総会 黒川賞(若手医師部門)を受賞して

千葉大学医学部附属病院 総合診療科の鋪野 紀好先生から、ACP日本支部2018年次総会 黒川賞(若手医師部門)受賞の報告を頂きましたので、PRC委員会から広報いたします。(PRC 宮内隆政)


ACP日本支部2018年次総会 黒川賞(若手医師部門)を受賞して

千葉大学医学部附属病院 総合診療科

鋪野 紀好

この度は、ACP日本支部2018年次総会で黒川賞を頂き、大変光栄です。2018年度から”Best Abstract”は「黒川賞」に変更となり、最初に黒川賞を受賞できたことを大変名誉に思います。


今回研究を行うきっかけとなったのは、眼底鏡診察を、自信を持って実施できる内科医は少ないと感じたことである。自分の周りも見回しても、我が師匠である生坂先生を除いて、眼底鏡を実際の診療で積極的に活用している医師はほとんどいなかった。共同研究者である菊川誠先生(九州大学大学院医学研究院 医学教育学講座)が発表されているが、初期研修医、内科専攻医、内科指導医のいずれも、約90%は眼底鏡を利用していないまたは2、3ヵ月に1回の使用頻度とされる。その理由としては、眼底鏡診察が苦手というのがほとんどの理由であった。



研究の転機となったのは2017年3月のスタンフォード大学医学部内科への視察であった。そこで、エロル・オズダルガ医師と出会い、眼底鏡の教育にiExaminer systemを用いた教育手法について学んだ。彼とは、この教育手法を日本に持ち帰り実践したいこと、また教育効果についてリサーチしたいことを語りあい、快く承認してくれた。


まず、このiExaminer systemを用いて実際の教育を行ったところ、学生からの満足度は高く、今後の臨床実習でも積極的に使っていきたいという声が相次いだ。次に、本当にスキルが向上するかを確認するために、本学のシミュレーションセンターである、クリニカル・スキルズ・センターへ眼底鏡シミュレータの協力を仰いだ。教育の前後で評価することで、教育効果を明確にするためだ。題材は何にするか、問題数はいくつにするかなど、共同研究者とのやり取りは白熱した。特に今回の研究は「観察力」の評価だったので、そこに「解釈力」の評価が混入しないように腐心した。また、教員による教育効果は二重盲検化がデザイン的に困難であったため、最小限にするための工夫を行った。


今回の研究では、iExaminer systemを用いることで、眼底鏡診察の診断精度が向上し、かつ観察時間が短縮されることが示された。iExaminer systemは約8000円のアダプターと、今日だれもが携帯しているiPhoneさえあれば、フリーで利用できるため明日からでも実施可能である。この教育手法が広まることで、自信を持って眼底を診察できる医師が1人でも増えることを祈ってやまない。

Poster_ACP Japan 2018_Shikino



写真:右からBA Muruganathan先生、Jack Ende先生、筆者、黒川 清先生

写真:応援に駆けつけてくださった千葉大学医学部附属病院 総合診療科 メンバーと

Chapter Business Report 2017-2018: SPC

Scientific Program Committee

Chair; Yugo Shibagaki,  MD, FACP


Agenda 1  Organization 2017-18


Chair:  Yugo Shibagaki

Vice-chair:  Teruhisa Azuma, Sugihiro Hamaguchi


Masako Utsunomiya, Shungo Yamamoto, Yasuhiro Akai, Tsuguru Hatta

Hideaki Shimizu, Mikio Hayashi, Shunpei Yoshino, Sho Fukuoka, Atsuko Uehara

and Noriaki Kurita


Agenda 2   Chapter Business Report: June 2017 – Present (June 2018)

– ACP Japan Chapter Annual Meeting 2017 (http://www.acpjapan.org/acp2017/)

Last year, we held the ACP Japan Chapter Annual Meeting 2017 at the Kyoto University Clock Tower Centennial Hall and the Kyoto University International Innovation Center on June 10th and 11th, 2017. Since we expanded the venues (rooms) for the session, we could accommodate as many as 32 sessions (didactic sessions, workshops), 8 luncheon seminars, special sessions (Plenary session, Governor’s address, Dr’s Dilemma and ACP update), a poster session with almost 100 abstracts with best poster presentation on the following day, so we kept the number of the sessions which increased significantly every year since 2013. The Doctor’s Dilemma (Medical quiz session) attracted many contestants from hospitals all over Japan which ended with a much success and the some of the winners were selected as the members representing ACP Japan Chapter and just participated and did their best in the Doctor’s Dilemma held in Internal Medicine 2018 held in May, 2018 in New Orleans. The poster discussion was a very lively session with many participants with full of discussions. Three presenters with each representative of students, residents and young physicians were awarded and had a chance to give a presentation in the main hall the next day, applied to the Internal Medicine Meeting 2018 and seemed to get motivated by this wonderful experience. We had the immediate past president, Dr. Nitin Damle, who provided the educational talk at the plenary session and ACP update.

Agenda 3     Chapter Business Plan:

– Organizing the Annual Meeting 2018 of the ACP Japan Chapter (http://www.acp2018.org/)

On June 2nd and 3rd, 2018, we will organize the Annual Meeting 2018 of the ACP JC in Kyoto. Beginning last year, Kyoto University International Innovation Center was added to the venue of the Meeting as well as Kyoto University Clock Tower Centennial Hall to accommodate more attractive sessions and lectures. In fact, this year we accommodate 45 sessions with special sessions

The theme of the Meeting this year is “Mind & Arts as Essentials for Internists: Beyond Evidence and Technology”. We will address this very important issue in the plenary session, following the keynote lecture from the immediate past president of ACP, Dr. Jack Ende, with experienced physicians who practice medicine with mindfulness as guest speakers, discussing how we can raise the mindful care as well as technical part of medicine in the era of super-aging society with the frail elderly. In addition, we will offer sessions like Dr’s Dilemma (an inter-institutional Quiz tournament by teams of residents), the poster-discussion session, as well as the special talk by Dr. Jack Ende. This time, we also invite Dr. Muruganathan from India chapter of ACP to enhance the partnership with Asian chapters.


– Organizing the Annual Meeting 2019 of the ACP Japan Chapter

We are planning to hold ACP JC 2019 on June 1st and 2nd in Kyoto with the same venue as this year.

In the Clinic Japnese translation project. How to incorporate In the Clinic in daily practice: 5 minutes bedside teaching

Dr. Kitano : St. Marianna University Yokohama City Seibu Hospital, Emergency and Critical Care Medicine

5-minutes teaching held on 3rd Jun 2018 at Kyoto

In the Clinic Japanese Translation Project has been in progress which is one of the leading project of PRC (public relations committee). There have been more applicants than the actual slots for the translation teams. The first translated article of In the Clinic, which is HCV, has been posted on the ACP main chapter’s webpage this April. Through this project, our goal is to have the members of ACP Japan Chapter to be able to utilize the excellent ACP resources including In the Clinic.
At this year’s annual meeting, we have presented a practical workshop with the collaboration of ‘In the Clinic Translation Project’ and ‘Bedside 5-minute Teaching’ We prepared the 12 general rules = Bedside 5-munite Teaching, which are based on 6 articles of In the Clinic.
In this practical workshop, participants have output the Bedside 5-munites Teaching and at the end of the seminar, they appeared to find themselves be able to use the rules as part of their active knowledge in the clinical setting. We hope this workshop served as an eye-opener to get one out of a lifelong sense of insufficiency where one feel he/she is not acquiring active knowledge even with a lot of literature reading.





Home Pageは http://acp2018.org/index.html となります。



その場合、京都大学国際科学イノベーション棟1階 「ACPJC2018総合受付」(6月2日(土)、3日(日)9時~)までお越しください。




ACP日本支部年次総会セッション2-C2-1「FACPへの道 - なぜ,そしてどのようにそれを目指すのか – 」に関する事前アンケートのお願い

Health and Public Policy Committee委員長の小山雄太先生より、ACP日本支部年次総会セッション2-C2-1「FACPへの道 - なぜ,そしてどのようにそれを目指すのか – 」に関する事前アンケートのお願いです。(PRC 小尾 佳嗣)



今年6月のACP日本支部年次総会において,Health and Public Policy CommitteeとCredential/Membership Committeeとの共同企画セッションを開催することになりましたので,セッションの紹介と皆さんへお願いがありメールを投稿いたしました.

6月3日 9:15〜10:35 2階 C-2会場
「FACPへの道 - なぜ,そしてどのようにそれを目指すのか – 」

・ 将来FACPを取得しようと思っているかいないのか,またその理由
・ (FACPの方には)なぜFACPになろうと思ったのか
・ FACPを取得して日常業務に変化があったか
・ 資格を取得したうえでの将来の展望は?





・ セッションの準備のため,締め切りは5月26日 18時まで といたします.
・ お寄せいただいたご意見は集約して,セッション当日に(必要に応じ個人の特定ができない形にして)一部をご紹介して参加された皆さんでの討論の参考にさせていただきます.
・ アンケートの集計結果は,年次総会終了後にご紹介できるように何らかの形式で(まだ詳細を決めていませんが)準備したいと考えています.



2017年7月1日現在,日本支部においてACP本部が認定するMasterは6名,Fellowは320名,Honorary Fellowは1名ですが,このセッションは

・ MACP,FACPの方々がどうしてFACPを目指したのか
・ FACPを目指す道のりがいかなるものであったのか
・ FACPを取得することによって診療・教育・研究など日常業務におけるpracticeがどのように変化したのか(あるいはしなかったのか)
・ FACPとしての将来の展望をどのように描いているのか





小山 雄太
日本海総合病院 腎臓膠原病内科
Yuhta Oyama, MD, FJSIM, FACP
〒998-8501 山形県酒田市あきほ町30
Phone: 0234-26-2001
Fax: 0234-26-5114
e-mail: yuhta217@sweet.ocn.ne.jp







(文責:PRC 小尾)






(文責:PRC 小尾佳嗣)


6月2~3日に京都で開催されるACP日本支部年次総会2018では、貴院・医療機関様のご活躍を広く総会参加者に紹介していただくため、 病院紹介プログラムブースを設けています。



ACP日本支部事務局 担当:文野

(文責:PRC 小尾佳嗣)