90% of medical education evaluations were “useful” – Interview with Nobuo Nara, JACME Executive Director◆Vol.2 | m3.com

Evaluations of skills and attitudes are “partially relevant”

–In addition to participatory clinical training, there are several items that are often judged as “partially applicable” (see the figure below).

(Courtesy of Mr. Nara)

For example, in EBM education, even if students learn EBM in classrooms, it is not enough to check whether EBM is being practiced based on UpToDateR, PubMedR, guidelines, etc. in clinical practice.

Knowledge can be evaluated using paper tests, but there is also the issue that skills and attitudes are not properly evaluated. Although CBT and other methods have begun to be used for skills, assessing attitudes is particularly difficult. Students are required to be evaluated from a variety of perspectives, from their attitude during lectures, such as whether they actively ask questions, to their attitude during training, such as their appearance and the way they speak to patients.

Compared to medical schools in Europe and the United States, what is not enough in Japan is that “student participation in committees related to teaching” is not sufficient, and students are passive. When I visited universities in Europe, I was surprised to hear students explain things like, “This is how our program has improved.” To improve educational programs, it is necessary to reflect not only the education but also the opinions of students and even alumni. It is extremely useful for clinical trainees and specialist doctors to evaluate how the clinical training they have received at university is useful.

Another issue with educational competency evaluation (FD) in education is that there are few cases in which students participate in education with a thorough understanding of the entire educational program. As a result, there may be duplicate teaching, or content may be missing. There is a need to revitalize educational capacity development (FD) to improve the teaching abilities of teachers.

In addition, there are many other issues that need to be addressed in order to improve the quality of medical education, such as the use of formative evaluation to increase student motivation and the substantive evaluation of educational programs.

–On the other hand, which areas of medical school in Japan were generally highly rated?

“Mission and learning outcomes”, “Student selection and learning support”, “Faculty recruitment and selection policy”, physical aspects such as “facilities and equipment” for education, “supervision and management”, “budget”, etc. Each medical school has received good evaluations in terms of governance, etc.

“Medical education evaluation” was 90% useful

–I heard that all 82 medical schools have been accredited, but how are each university responding?

According to a survey conducted by the National Conference of Medical Directors and Hospital Directors in 2020, when asked whether “medical education evaluation” is useful for improving the quality of education, nearly 90% of respondents answered “strongly agree” or “somewhat agree.” accounted for. Even if you add in the medical schools that you applied to after that, the results are almost the same.

One of the positive comments was that interaction among teachers was encouraged. The reality is that teachers often do not know what kind of education is being provided in areas other than their own, or the overall picture of educational programs. There are many opportunities for discussions among teachers through the preparation of documents for “self-inspection and self-evaluation,” and this has led to active interaction among teachers. On the other hand, it is true that there is a heavy burden on both those receiving the examination and those making the evaluation.

(Courtesy of Mr. Nara)

–The purpose of JACME was to respond to the “2023 problem.” What do you think about whether the quality of medical education in Japan has improved through the evaluation of medical education?

It is difficult to evaluate the quality of medical education, such as from what perspective to evaluate it, but medical students are involved in creating educational programs, faculty members discuss the ideal form of education, and both students and faculty members are becoming more involved in education. I think this is leading to improved quality, such as improved understanding. Graduates are the ones who feel the fruits of education, and as I mentioned earlier, I believe that the quality of education will improve if feedback from graduates becomes effective. However, with the start of clinical training matching, graduates are leaving the university and it is becoming difficult to track their career paths, so how to provide feedback will be an issue for the future.