4. Goals of Medical Education
Begin with patient/society needs
Balance between basic sciences, clinical
studies, and clinical practice
Balance of knowledge, attitude, and skills
Not only recalling information but also using
it to solve problems (deep knowledge)
5. Educational System
Elementary School 6 yrs
Junior High School 3 yrs
High School 3 yrs
University 4 yrs (Medical, Dental,
Pharmaceutical Curriculum 6 yrs)
7. Name of Medical Education for
Each Career Level in Japan
Undergraduate
Medical
Education
Preparatory
Subjects
Basic Sciences
Clinical
Medicine
Postgraduate
Medical
Education
Residency
Fellowship
Entrance Exam
CAT
License Exam
8. Major Changes in Medical
Education Curricula
1. Until 1850: Basically OJT (on-the-job training)
Basic science was not developed widely
2. 1850~1950: Discipline-based curriculum
Microbiology, Physiology, Public health…
3. 1950s~60s: Organ-system-based curriculum
Cardiology, Gastroenterology…
Basic science and clinical medicine are integrated
4. 1970s~: PBL(problem-based learning)
Faculty-resource-intensive
5. 2000~: Outcome-based education
9. Innovative Curriculum
The SPICES model
Harden, 1984
Systematic Traditional
Student-centred Teacher-centred
Problem-based Passive acquisition
Integrated Discipline-based
Community Hospital-based
Elective Standardized
Systematic Opportunistic
10. Why Outcome-based
Education?
Information explosion
Changing public expectation
Accountability
Informing curriculum decisions
Integrating teaching and assessment
Planning the continuum of education
12. Examples of OBE (1)
6 outcomes of Postgraduate training:
ACGME (Accreditation Council for
Graduate Medical Education)
ACGME Outcome Project: http://www.acgme.org/Outcome/
Patient Care
Medical Knowledge
Practice-Based Learning and Improvement
Interpersonal and Communication Skills
Professionalism
Systems-Based Practice
14. Examples of OBE (3)
IIME (Institute for
International
Medical Education):
GMER (Global
Minimum Essential
Requirements) in
medical education
Med Teach 2002, 24, 130–135
Clinical
Skills
Population
Health
Scientific
Foundations
Professional
Values,
Attitudes
Critical
Thinking
Information
Management
Communication
Skills
15. Examples of OBE (4)
The Scottish Deans’ Medical Curriculum Group’s Three
circle model (Simpson et al. Med Teach 2002, 24, 136-143)
Medical informatics
Patient management
Patient investigation
Clinical skills
Communication
Practical procedures
Health promotion and
disease prevention
Personal
development
Role of the doctor within
the health service
Attitudes, ethical
understanding and
legal responsibilities
Decision-making skills
and clinical reasoning
and judgement
Basic, social and clinical
sciences and underlying
principles
16. Points of OBE
Integrated competencies (e.g.
critical thinking and professionalism)
are more clearly targeted.
Assessment for comprehensive
performance is more emphasized
Nowadays “competency” is often used instead of
“outcome” if mentioned for curriculum
(e.g. competency-based curriculum)
17. Quality Assurance of Medical
Education in Japan
Admission policy
Combination of nationwide achievement test and schools’
own examination (most have interview)
Diploma (graduating) policy
No external examiner, schools’ own policy
Institutional systems for quality assurance
Not specific
National standards for quality assurance
Guidelines for curriculum: Nationwide core curriculum +
Common Achievement Test (for 4th year)
Quality assurance for undergraduate clinical teaching is
difficult to implement
18. Accreditation System in Japan
In 2002, the Higher Education bureau, MOE
declared the amendment of the 3rd
paragraph of Article 69 of the School
Education Act.
All the universities have to undergo self-
evaluation process and accreditation by a
certified body every 7 years.
This has become effective since 2004.
No specific accreditation system for medical
education
19. Program Accreditation in
Japan
Post-graduate professional schools (Law,
Business, Accounting, and Midwifery) must
undergo self-evaluation and take external
“program evaluation” by accreditation bodies
every 5 years according to the School
Education Act.
Program certification only to only post-
graduate professional schools.
20. Pharmaceutical Education
Accreditation in Japan
Japan Accreditation Board for Pharmaceutical
Education (JABPE) is now starting self-evaluation.
Full-scale external evaluation will start in 2012. After
2012, all pharmacy schools will take accreditation.
Program certification by JABPE is voluntary activities.
They are non-governmental bodies. These activities
aspire their educations to be fit to their global
standards.
21. Why Accreditation?
To assure the standardized medical
education
To prepare for practitioners’ mobility
to another country
In 2010 ECFMG states that all the
examinees must graduate from
internationally accredited medical schools
after 2023
22. Group Discussion
What was the model of the curriculum
you have experienced or known?
Any idea of which direction health
professional education curricula goes.