Reform of a traditional clinical curriculum in Japan: Experiences at Tokyo Medical and Dental University

Abstract

Background: Until recently, Japanese legislative guidelines dictated that undergraduate clinical training consisted of students’ observations of clinicians’ work. In 2006, Tokyo Medical and Dental University initiated a reform of their traditional undergraduate clinical curriculum. The reform integrated students into patient care teams, and included the implementation of a clinical faculty ‘tutor’.

Aims: This short communication describes a formative assessment of the reform work.

Method: In 2007, students, residents, and tutors were surveyed to determine their perceptions of students’ integration into clinical activities, and patients’ acceptance of students in their medical care. An external consultant observed students’ patient care activities, and assessed the methods of and perceived barriers to clinical teaching.

Results: Surveys indicated that students were most engaged in history-taking, procedures, and case presentations. Observations revealed students’ activities and teaching to be focused on students’ case presentations. Perceived barriers to teaching included insufficient time and personnel. Respondents felt that patients were accepting students in their clinical care.

Conclusions: This clinical reform effort includes an increase in students’ interactions with patients through history-taking, and teaching through case presentations.

Additional information

Notes on contributors

Susan E. Farrell

SUSAN E. FARRELL, MD, EdM, is Assistant Professor of Medicine in Harvard Medical School and consultant at Harvard Medical International.

Kazuki Takada

KAZUKI TAKADA, MD, MHS, FACP, is Assistant Professor of Medicine in Tokyo Medical and Dental University and member of the TMDU Clinical Clerkship Working Group.

Elizabeth G. Armstrong

ELIZABETH G. ARMSTRONG, PhD, is Clinical Professor of Pediatrics in Harvard Medical School and is Director of the Harvard-Macy Institute.

Yujiro Tanaka

YUJIRO TANAKA, MD, PhD, is Professor of Medicine in Tokyo Medical and Dental University and Director of the Department of Medical Education Research and Development.

H. Thomas Aretz

H. THOMAS ARETZ, MD, is Associate Professor of Pathology in Harvard Medical School and Vice President for Global Programs at Partners Harvard Medical International.