学会誌

鈴木 昌*

要旨：
目的：新専門医制度が医師の地域偏在を助長すると懸念されている．本研究では，専攻医が多く採用された都道府県の特徴を明らかする．方法：2018年度の基本領域専攻医数（都道府県別）と各都道府県の医療や人口構成に関わる指標とを因子分析に投入した．結果：因子分析で2因子が抽出され（累積寄与度70％），第1因子は高齢化，第2因子は臨床医学教育の関与が示された．専攻医数は第2因子が強く影響し，医育機関病院医師数と強く相関した．考察：専攻医が多く採用された都道府県は医育機関病院医師数の多い都道府県であった．
キーワード：医育機関，生産年齢人口，地域偏在，都市集中，専門医

Masaru Suzuki*

Abstract:
Background: Recently launched, the system for granting a medical specialty in Japan raised has concerns about exacerbating the regional maldistribution of medical doctors. The aim of this study is to clarify the characteristics of prefectures that are gathering larger numbers of trainees under this system. Methods: We performed a factor analysis of population structure, medical care and the number of trainees in the system and studied the correlations between the number of trainees and related items. Results: The factor analysis extracted two principal components using Varimax rotation （cumulative ratio of the total variance: 70％）. The first principal component suggested an aging society, and the second suggested educational conditions. According to the analysis, the number of trainees was closely related to the educational conditions （1st principal component: -0.19, second principal component: 0.96）. In the correlation analysis, the number of trainees closely correlated with the number of doctors in medical school （r＝0.80, P＜0.001）, although it was weakly correlated with urbanization rate （r＝0.32, P＝0.03）. Discussion: This study revealed that the prefectures that are gathering a large number of the trainees are characterized as having a sufficient number of teaching doctors. The trainees might be choosing specific training hospitals to receive relevant specialty training.
Keywords: medical school, productive age population, regional maldistribution, urban concentration, board certified doctor

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*東京歯科大学市川総合病院救急科，Department of Emergency Medicine, Tokyo dental College Ichikawa General Hospital, Ichikawa Japan

Yasuhiko TOMITA*1　Tomoharu YAJIMA*1　Michio AKAGI*1　Makiko KINOSHITA*2

Abstract:
Objective: To analyze participants’ opinions regarding the content of clinical training workshops for attending physicians.
Method: A total of 225 people participants in the workshops （approximately 17 hours in 2 days） that were held between 2013 and 2016. We provided the following training sessions:（1） Kawakita Jiro Method （KJ）, （2） Process of clinical training, （3） Training program planning procedure, （4） Training objectives, （5） Classification of objectives, （6） Professionalism （PF）, （7） 6 Microskills （6MS）, （8） Significant event analysis （SEA）, （9） Training strategies, （10） Coaching, （11） Educational evaluation, （12） Clinical training systems （CTS）, and （13） Roles of attending physicians （RAP）. We only used the results of questionnaires obtained from participants who consented to the investigation, and reviewed them for （1） training proficiency, （2） session interest, and （3） course evaluation.
Results: Training sessions showing high proficiency were KJ, RAP, and CTS, and those indicating low proficiency were educational objectives, SEA, and PF. Training sessions that were of great interest were 6MS, Coaching, and KJ.
Conclusion: In the evaluation of the entire course, overall value scored the highest, followed by significance of future participation and applicability of content. Overall, the participants felt that the time for the training course was a little long and that the difficulty level was somewhat high.
Keywords: attending physician, workshop, clinical training

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*1 Department of Medical Education, Faculty of Medicine, Kyorin University Affiliated Hospital General Education Center
*2 Kofuen Hospital

日本医学教育学会　第20期　学習方略委員会
志賀 隆*1,*9　藤崎 和彦*2,*9　小松 弘幸*3,*9　前野 貴美*4,*9
阿部 恵子*5,*9　春田 淳志*6,*10　栩野 吉弘*7,*9　竹本 恭彦*7,*9
石川 和信*8,*9　首藤 太一*7,*9

要旨：
　日本のシミュレーション教育に関する大学教員研修についての全国調査を行った. シミュレーションFDを実施している大学は47校（68％）であった．OSCE関連の項目の実施率が高く，インストラクショナルデザイン，テクノロジー，プログラム評価，総括的評価，などの項目の実施率は低かった．特に，省察的実践，論文執筆の指導については15％に満たなかった．また障壁としては，学生の要因は少なく，シミュレーション教育にかかわる指導者の多忙が90％と最も多かった．
キーワード：大学教員研修，シミュレータ，シミュレーション教育，スキルスラボ，全国調査

The 20th Learning Strategies Development Committee, Japan Society for Medical Education
Takashi SHIGA*1,*9　Kazsuhiko FUJISAKI*2,*9　Hiroyuki KOMATSU*3,*9
Takami MAENO*4,*9　Keiko ABE*5,*9　Junji HARUTA*6,*10
Yoshihiro TOCHINO*7,*9　Yasuhiko TAKEMOTO*7,*9
Kazunobu ISHIKAWA*8,*9　 Taichi SHUTO*7,*9

Abstract:
　We have conducted a nationwide survey on faculty development for simulation-based medical education in Japan. The response rate was 90％. Forty-seven （68％） schools have implemented faculty development programs for simulation-based education. The most commonly implemented contents were standardized patient development, task trainer, high fidelity manikin operation, and student evaluation, which were related to objective structured clinical examination objective clinical skill assessment. Only 15 percent of medical schools implemented topics on reflective practice, and scientific writing. A constraint on faculty time was the most commonly perceived barrier to simulation use （mentioned by 62 schools; 90％）.
Keywords: faculty development, simulator, simulation based medical education, clinical skills laboratory, nationwide survey

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*1国際医療福祉大学医学部救急医学,　Department of Emergency Medicine, School of Medicine, International University of Health and Welfare
*2 岐阜大学医学教育開発研究センター, Medical Education Development Center, Gifu University
*3 宮崎大学医学部医療人育成支援センター, Center for Medical Education and Career Development, Faculty of Medicine, University of MIyazaki, Miyazaki, Japan
*4 筑波大学医学医療系, Faculty of Medicine, University of Tsukuba
*5愛知医科大学大学院看護学研究科高度実践看護学分野臨床実践看護学, Aichi Medical University Graduate school of Nursing, Advanced Practice Nursing, Clinical nursing 
*6 筑波大学医学医療系地域医療教育学, Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Japan  
*7 国際医療福祉大学医学部医学教育統括センター・シミュレーションセンター，Office of Medical Education & Simulation Center, School of Medicine, International University of Health and Welfare
*8 大阪市立大学大学院医学研究科総合医学教育学, Department of Medical Education, Graduate School of Medicine, Osaka City University, Osaka, Japan
*9 委員，Committee member
*10 協力者，Collaborator

要旨：
　プロフェッショナリズムとは，「特定の専門職集団professionの一員professionalとしての（正しい）あり方-ism」である．自他の行為が「正しい」と認識することは道徳的判断であるから，プロフェッショナリズムとは，特定の専門職に相応しいとされる道徳的特徴である．したがってプロフェッショナリズム教育とは，第1に学修者に対してこの専門職に求められる道徳的特徴に沿った行動の修得を促すことであり，第2に異なる道徳的特徴を有する他者（非医療職を含む）との間に生じる摩擦を解決する方法を学ぶことであると言える．本稿では，発展著しいヒトの道徳性に関する科学的知見に基づいて，これらの学修を促進する方略をご紹介する．
キーワード：プロフェッショナリズム，道徳性の科学，スローシンキング

Abstract:
　Professionalism is the （right） way of being/doing things as a member of a particular profession. Evaluating legitimacy （right/wrong） of one’s behavior or the behavior of others is a moral judgement. Thus, professionalism is a set of desirable moral characteristics of a particular profession. The education of professionalism firstly promotes learning a set of desirable moral characteristics required in a profession. Secondly, it promotes the resolution of conflict with someone who has different moral characteristics. In this article, a possible learning strategy to promote these learning objectives will be explained based on the emerging knowledge of the science of human morality.
Keywords: medical professionalism, science of morality, slow thinking

野村 英樹*

Hideki NOMURA*

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*金沢大学附属病院総合診療部，General Medical Department, Kanazawa University Hospital

松岡 英仁*

Hidehito MATSUOKA*

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*兵庫県立淡路医療センター呼吸器外科，Respiratory Surgery, Hyogo Prefectural Awaji Medical Center

高村 昭輝*

キーワード：地域基盤型医療者教育，地域参加型医療者教育，日本

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*金沢医科大学医学部医学教育学講座

―鈴木淳一先生のもとでの医学教育と私の歩み――――――――――――――― ―富士研の由来とJ/S先生――――――――――――――――――――――――― ―鈴木淳一先生に送る言葉――――――――――――――――――――――――― ―鈴木淳一　編集委員長との出会い――――――――――――――――――――― ―鈴木淳一先生，本当にお世話になりました―――――――――――――――――

駒澤 伸泰*　瀧谷 公隆*　河田 了*　寺﨑 文生*

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*大阪医科大学医学教育センター，Medical Education Center, Osaka Medical College