Continuing mind for primary care medicine as total family care mailing list (TFC-ML) group

There were historically two great doctors for primary care (PC) medicine in Japan. They are Dr. Shigeaki Hinohara and Dr. Yoshikazu Tasaka. Tasaka was always active in medical treatment, organizational management, postgraduate education, and information dissemination using the Internet, and started Total Family Care Mailing List (TFC-ML) in 1998. TFC-ML included medical information with his comments every day for long. Even after his death in 2007, TFC-ML activity has been continued by many voluntary PC physicians. His TFC mind has been transmitted to future PC physicians. His inspiration may often come to TFC members for better total family care

A study on the development of technical skills in nursing education : through the skill evaluation using simulated patients

本研究の目的は，模擬患者を導入した看護技術試験の効果の検討であった． 研究実施にあたっては，Ｂ大学倫理審査委員会の承認を得た後，被験者と模擬患者に口頭と文書による説明を行い，同意を得た． 調査は，Ａ短期大学の看護学科２年次生３０名を対象に，筆者らが作成した７段階評価の２３項目の質問紙を用いて行われた．手順としては，まず２００４年９月に質問紙を用いた看護技術試験前の調査を行った．１０月に看護技術試験のために「吸引」についての事例およびチェックリストを配布し，デモンストレーションを実施した．１１月に学生が患者役となる形式の技術試験を行った．１２月に模擬患者を導入した技術試験を実施し，その後に９月と同様の質問紙の調査を行った． 肯定的表現に７点，否定的表現に１点を配した質問紙の各項目を看護技術試験前後で比較・検討した結果，技術試験前の高得点は，「緊張感がある－緊張感がない」，「効果的－効果的でない」であり，技術試験後は「よい－よくない」，「有用な－有用でない」および「継続してほしい－継続してほしくない」であった．技術試験前の低得点は，「易しい－難しい」，「明確な－混乱した」であり，技術試験後は「易しい－難しい」，「明確な－混乱した」であった．技術試験前後で得点が上昇したのは，「易しい－難しい」，「有益－有益でない」であり，得点が低下したのは，「やる気がでる－やる気がでない」，「達成感がある－達成感がない」であった．得点が変化しなかったのは，「刺激的な－刺激のない」および「実力を発揮できる－実力を発揮できない」であった． 学生の看護技術の習得レベルを評価し看護実践力を向上させるために，模擬患者を導入した看護技術試験は効果的な方法であることが示唆されたが，学生に過度の緊張を与えず，コミュニケーションスキルが身につくような配慮の工夫が必要であると思われた．The purpose of this study was to investigate the effectiveness of a test of technical nursing skills using simulated patients. Prior to the study, we obtained the permission of the ethics committee of University B, and explained the research to the subjects and simulated patients in order to obtain their informed consent. A survey was carried out using a questionnaire constructed by the researchers comprising ２３ items with a７‐point Likert scale. The subjects were ３０ senior nursing students at Junior College A. In September ２００４, we conducted an initial survey using the questionnaire, and in October gave the subjects a paper patient and the lists for checking their nursing techniques, and a suction demonstration. In November, we gave an ordinary skills test, and in December, using the same questionnaire as before, we conducted a second survey after a test of technical nursing skills using simulated patients. Pre - and post - test analysis of the questionnaire responses（the most positive answer being awarded７ points and the most negative answer being awarded１point）, showed that pre - test high scores were obtained on the “nervous- not nervous” and “effective-not effective” items ; post-test，“good test-not a good test”, “useful-not useful” and “like to continue-not like to continue”. The pre-test low scores were “easy-difficult” and “clear-unclear” ; and post-test，“easy-difficult” and “clear-unclear”. The increased scores between pre- and post-test were “easy-difficult”, “beneficial-not beneficial” and the decreased scores were “motivation-no motivation” and “sense of achievement-no sense of achievement”. The items which were unchanged were “stimulating-not stimulating”，“developed practical ability-did not develop practical ability”. These results show that the test using simulated patients was an effective method of developing students’ nursing techniques. However, teachers need to pay attention to developing students’ communication skills and not create excessive tension for them when they have skills tests

良好な患者医師関係を築くコミュニケーションに効果的なポライトネス・ストラテジー

国立国語研究所済生会熊本病院聖路加国際病院／聖ルカ・ライフサイエンス研究所公立岩瀬病院沖縄県立中部病院国立国語研究所国立国語研究所東京外国語大学The National Institute for Japanese LanguageSaiseikai Kumamoto HospitalSt. Luke\u27s Life Science Institute, St. Luke\u27s International HospitalIwase General HospitalOkinawa Prefectural Chubu HospitalThe National Institute for JapaneseThe National Institute for JapaneseTokyo University of Foreign Studie