Simulation-based medical education in clinical skills laboratory

Clinical skills laboratories have been established in medical institutions as facilities for simulation-based medical education (SBME). SBME is believed to be superior to the traditional style of medical education from the viewpoint of the active and adult learning theories. SBME can provide a learning cycle of debriefing and feedback for learners as well as evaluation of procedures and competency. SBME offers both learners and patients a safe environment for practice and error. In a full-environment simulation, learners can obtain not only technical skills but also non-technical skills, such as leadership, team work, communication, situation awareness, decision-making, and awareness of personal limitations. SBME is also effective for integration of clinical medicine and basic medicine. In addition, technology-enhanced simulation training is associated with beneficial effects for outcomes of knowledge, skills, behaviors, and patient-related outcomes. To perform SBME, effectively, not only simulators including high-fidelity mannequin-type simulators or virtual-reality simulators but also full-time faculties and instructors as professionals of SBME are essential in a clinical skills laboratory for SBME. Clinical skills laboratory is expected to become an integrated medical education center to achieve continuing professional development, integrated learning of basic and clinical medicine, and citizens’ participation and cooperation in medical education

A Pilot Study for the Detection of Protozoa Infections of the Gut at Autopsy

In order to investigate the incidence of latent infections by parasites within the human digestive tract, we examined fresh stool samples from the colon of 31 patients (37-90 years, median age 71; 26 men and 5 women) collected within 12 hours of death. These subjects had been admitted to a university hospital in Yokohama, Japan, and died between April 2007 and December 2008 from causes other than parasitosis. Stool samples were fixed and stained for microscopic analysis, and PCR analysis for Entamoeba histolytica was performed for the parasite-positive samples. Results showed that ten out of 31 subjects were infected by E. histolytica only, one subject was infected by Giardia intestinalis only, and four subjects were infected by both E. histolytica and G. intestinalis. These findings are in contrast to conventional theories concerning general parasite infection in Japan, and indicate continuous or latent infection within the human digestive tract. The presence of pathogens such as E. histolytica and G. intestinalis in elderly or immuno-compromised patients is a serious issue and warrants further attention as a public health issue, particularly in relation to its mode of transmission