Impact of the Student Doctor Ceremony and Receiving a White Coat Before Clinical Clerkship Among Medical Students

The first white coat ceremony took place at a Japanese medical school in 2001 and was designed to reaffirm the responsibilities of medical students becoming student doctors（SDs）prior to their clinical clerkships. Dokkyo Medical University has been holding an SD ceremony, rather than a white coat ceremony, since March of 2014. White coats adorned with the school emblem and students’ names were distributed to students after the SD ceremony for the first time in 2018. Using an anonymous questionnaire, this study examined changes in the students’ moods before and after the SD ceremony as well as their impressions of the white coat.Of 115 responses, 106 with valid data were analyzed. The mean age was 23.44 years. The results indicated that students felt more cheerful, nervous, motivated, hopeful, steadfast, active, and restless after the ceremony than before, with 79.2％ of the students reporting a favorable opinion of the white coat adorned with the school’s emblem. Additionally, the top three meanings associated with the white coat were cleanliness, uniform, and propriety.This study revealed the impact of the SD ceremony and the meanings of the white coat among medical students. Both the SD ceremony and white coat ceremony are worthy of future examination

The Combination of Smoking and Overweight is Associated with Dyslipidemia Among Inpatients and Hypertension Among Outpatients with Schizophrenia

SUMMARYObjective:As the physical health of patients with schizophrenia is relatively poor and their risk of prematuredeath is considerably increased compared with the general population, we examined the associationbetween lifestyle-related diseases and smoking, drinking, and overweight in inpatients and outpatients withschizophrenia.Methods:The study design was cross-sectional. Subjects were 138 inpatients and 135 outpatients withschizophrenia from a psychiatric hospital in Japan. They were asked for information concerning smokingand alcohol use, and height and weight were measured to calculate body mass index. Data on hypertension,dyslipidemia, type 2 diabetes, cardiovascular diseases, and use of atypical antipsychotics were acquired frommedical records.Results:Inpatients were more likely to receive atypical antipsychotic medication and less likely to drinkalcohol. The smoking prevalence was 38.4% (53.8% in men, 17.2% in women) in inpatients and 39.3%(56.3% in men, 20.3% in women) in outpatients. Multivariate odds ratio( OR) for hypertension was significantlyhigher among outpatients than inpatients. After adjustment for age, sex, and use of atypical antipsychoticmedication, overweight smokers showed a significantly higher OR for dyslipidemia (3.17, 95% CI:1.07-9.37) among inpatients, and a significantly higher OR for hypertension (3.15, 95% CI:1.14-8.74)among outpatients. When the reference group is non-smokers with BMI below 25, smokers with BMI of 25or more had a significant higher OR( 3.38, 95% CI:1.36-8.38) for dyslipidemia among patients with schizophrenia.Conclusion:After adjustment for atypical antipsychotic medication use, the combination of smoking andoverweight was significantly associated with the prevalence of dyslipidemia among inpatients and hypertensionamong outpatients with schizophrenia

A Study of Clinical Features and the Worsening Factors Among Patients with Behget\u27s Disease in Japan

A cross-sectional survey of Beliefs disease in Japan was held to investigate the correlation of clinical-features and HLA-B51, pathergy test and the worsening factors among patients. The questionnaires were sent to 200 hospitals selected geographically at random in Japan. The diagnosis was made with Japanese Criteria for the classification and patients who did not satisfy the criteria were excluded from the study. The differences in data were analyzed by Pearson\u27s corrected chi-square test, and multiple logistic regression analyses with SPSS. A total of 180 patients (80 men and 100 women) were used as subjects. The rate of positive HLA-B51 was 57.4% (66.7% in men, 44.8% in women). HLA-B51 positivity was significantly higher in patients with eye lesions than without, and significantly lower in patients with gastrointestinal lesions than without. The rate of positive pathergy test was 53.0 % (67.3 % in men, 42.4 % in women). The pathergy test positivity was significantly higher in male patients, patients with skin lesions, and with central nerve system symptoms. The number of patients with worsening factors affecting the symptoms, such as seasonal influences, infectious states, psychological fatigue and physical fatigue was 88, with significantly more among patients with skin lesions and those with arthritis, and less among those with eye lesions. As the results of multiple regression analyses show, HLA-B51 negativity was most associated with patients with gastrointestinal lesions and the positivity was most associated with male patients. The pathergy test positivity was most associated with male patients. It was suggested that the rates of positive HLA - B51 and pathergy test were significantly higher among male patients. As the worsening factors might be concerned with the etiology of Behcet\u27s disease, this study only provided some suggestions for further examination

Preliminary Report of Body Mass Index Among People with and Without Schizophrenia in Japan

This cross-sectional study was designed to estimate body mass index (BMI, kg/m^2) of individuals with and without schizophrenia and to examine factors contributing to excessive weight. There were a total of 208 patients (138 men, 70 women) with schizophrenia under hospitalization in a psychiatric hospital and 1,054 controls (797 men, 257 women) without schizophrenia, who underwent overnight medical screening at another university-affiliated hospital in the same area of Japan in 1998. The mean BMI among the 208 patients with schizophrenia was 24.44±4.0 compared with a mean BMI of 23.64±2.7 in healthy controls. There were no significant differences between male patients and male controls ; however, mean BMI was higher in female patients than in female controls, especially among patients under 60 years of age. As weight gain (with increase in BMI) after initiation of medication for schizophrenia is associated more with female gender and younger age, education and support to prevent obesity is particularly important for younger female patients

シンニュウセイ オ タイショウ トシタ キツエン ボウシ キョウイク シコウ ガ タバコ ニ タイスル イシキ ニ アタエル エイキョウ ノ ケントウ

大学入学早期からの喫煙防止教育の大切さがこれまでに指摘されていたが,喫煙防止教育の効果に関してほとんど検討されていない.本研究は,大学新入学時に喫煙防止教育を施行し,その前後の喫煙に対する態度や喫煙防止教育を行う意欲や自信の変化等を検討することを目的とした.2008 年4 月に,新入生74 名(男子54 名,女子20 名)を対象に喫煙防止教育を施行し,教育の直前とその一週間後に同一アンケート調査を行い,PASW Statistics 18.0 for Windows を使用し,c 2 検定及びt 検定を行った.喫煙防止教育後の喫煙者の禁煙に対する関心度や非喫煙者の喫煙に対する関心度には,有意差は見られなかった.さらに,喫煙防止教育を受けた経験が十分あるかという質問に関しては,「タバコの害」と「タバコの依存性」では教育前と有意差は無く,「禁煙指導の方法」に関してのみ,有意に上昇した.しかし,喫煙行動に対する態度に関しては,「医療施設の全面禁煙化」以外の全項目で有意に上昇した.さらに,タバコに関する社会の動きに対する関心度が有意に高まり,喫煙防止教育に対する意欲や自信も有意に上昇した.本研究は長期的な教育効果を検討するには不十分であるが,喫煙防止教育として新入生の意識向上に良い影響を与えた.Several studies have discussed the importance of educatingstudents on smoking prevention during the initial yearsof university education. In this study we examined thechanging perceptions of smoking behavior among freshmenin university just before and after 1 week of education onthe health hazards due to smoking.In April, 2008, 74 freshmen (54 boys and 20 girls) of aparamedical university were provided health education onthe hazards caused by smoking, and the changes in the perceptionsregarding the smoking behavior were examinedby the basis of a questionnaire that was answered by thestudents before and after the education;the same questionnairewas filled both the times. For statistical examination,c 2 test and t test were performed using IBM SPSS(PASW Statistics 18.0) for Windows.Even after educating the students on smoking prevention,there was no significant difference in the attitude ofsmokers toward smoking cessation and that of non-smokerstoward smoking. Although the awareness among thestudents with regard to the health hazards of smoking wasnot significantly different before and after this education,their awareness of the methods to quit smoking had increasedsignificantly. Moreover, the mean values of the differentopinions on the smoking behavior increased significantly.However, one exception was the opinions in themedical institutions that had tobacco-free environments.The mean values that increased the highest after this education,were "Implementation of non-smoking in the entireuniversity" and "The need for effective education that assistsin quitting smoking." Further, after this education, thescore of interest in social activities against smoking increased.Education on anti-smoking is vital for freshmenafter enrollment in a university

チイキ ホウカツ イリョウ ジッシュウ ノ ジュコウセイ ノ トクセイ ト ソノ キョウイク コウカ ニ カンスル ケンキュウ

全国的に地域枠入学者による医学部定員増加が行われている.それに伴い医学部では,より良い地域医療教育の導入が求められている.そこで本研究は,地域医療を目指す学生の特性を知るとともに地域医療教育の効果を学生の自己評価点とSOC (Sense of Coherence) 得点の地域教育導入前後比較により検討することを目的とした.調査対象は,獨協医科大学医学部第1学年おける地域包括医療実習受講生の16名( 男子9名,女子7名:平均年齢18.9±1.0歳) と非受講生の1年生98名( 男子66名,女子32名:平均年齢19.9±1.7歳) である.平成22 年7 月15 日に対象者全員に対して研究の説明を行い,文書による研究参加への同意を得た後,行動規範26項目の自己評価 (7 点満点) とSense of Coherence (SOC) 29 項目及び生活習慣に関する質問12 項目に回答する自記式アンケート調査を行った.さらに,平成22 年12 月11 日に,受講生のみを対象に7 月15 日に施行したものと同一のアンケート調査を行った.地域包括医療実習I 受講生は,非受講生に比較して,家族と同居しているもの,現在運動をしていないものが多かった.また,学習態度の自己評価点とSOC 処理可能感の得点が有意に高かった.地域包括医療実習I の実習前後の変化を検討したところ,生活態度の自己評価が終了時には有意に上昇していた.しかしSOC 把握可能感の得点が有意に低下していた.地域医療教育導入前後でほとんどの項目で大きな変化はなかったが,生活態度の行動変容に良い効果が得られた.また,把握可能感が低下していたため,面接などで適切な支援が必要である.The quotas of students who wish to be involved in communitymedicine have increased in medical schools in Japan.Accordingly, programs focused on community medicineare required in medical education. In this study weaimed to identify the characteristics of medical studentswho pursue community medicine. We also aimed to evaluatethe effects of the local community medical educationcourse for medical students by examining changes in thescores of self-evaluation of standards of conduct and in thescores of sense of coherence (SOC) before and after thecourse.Participants were 16 first-year students (9 men, 7 women;mean age, 18.9±1.0 years) at Dokkyo Medical Universitywho took the comprehensive community medicinepractice course( community medicine course students) and98 students (66 men, 32 women;mean age, 19.9±1.7years) who did not take the course( non-community medicinecourse students).Information on the study was provided on July 15, 2010,and written informed consent was obtained from all participants.A self-evaluation questionnaire comprising 26 itemsregarding standards of conduct, each to be rated on a seven-point scale, and a questionnaire comprising 29 items ofSOC and 12 items of lifestyle were used. Both questionnaireswere completed by all participants on July 15, 2010and by the community medicine course students on DecemberThe percentage of students who lived with their familiesand the percentage of students who did not regularly exerciseat the time of the questionnaire survey were higher inthe community medicine course students than in the noncommunitymedicine course students. In addition, the selfevaluationscore for attitude toward leaning and the SOCscore for sense of manageability were significantly higher inthe community medicine course students than in the noncommunitymedicine course students. In the communitymedicine course students, the self-evaluation score for attitudetoward life was significantly increased, while the SOCscore for sense of comprehensibility significantly decreasedby the end of the course.The comprehensive community medicine practice coursehad a positive effect on student attitude toward life, andpreferable behavioral modifications were observed, althoughscores for most items remained unchanged by the end ofthe course. Our findings revealed a decrease in sense ofcomprehensibility, indicating that appropriate student support,such as consultation, is necessary

イガクセイ トシテ テキセツ ナ コウドウ ヤ タイド オ ジコ ヒョウカ スル トキニ エイキョウ スル セイカツ シュウカン カンレン インシ ノ ケントウ : ダイ1ガクネン カラ ダイ2ガクネン エノ ジコ ヒョウカ テン ノ ヘンカ オ チュウシン ニ

目的:プロフェッショナリズムの育成を医学教育に導入することを前提に医学生の低学年時の行動に対する自己評価の変化とそれに影響する因子を検討した.調査対象:2010 年の獨協医科大学医学部第1 学年の学生92 名(男子57 名,女子35 名)調査方法:2010 年7 月の1 年次と2011 年8 月に2 年次の2 回にわたって行動規範に関する自己評価表および国民健康・栄養調査に基づき作成した生活習慣調査アンケート調査を施行したその得点に影響する生活習慣関連因子を検討した.結果:1 年次から2 年次で自己評価が有意に向上したのは,「他者の人権や人格を尊重し,積極的かつ友好的にコミュニケーションをとり,分かりやすく説明する技術や態度の習得」「常に予習・復習を欠かさないなど学習習慣」「積極的に新しい知識や技能を吸収しようとする能動的な学習態度」であった.一方,2 年次で有意に自己評価が低下していたのは「講義や実習を欠席しない」「他人のものを盗用したり,データをねつ造したりしてレポートを作成しない」「与えられた課題や宿題等の提出期限を守っている」などであった.1 年次の低い自己評価に影響した項目は,男子,喫煙経験,朝食欠食,睡眠で休養がとれていないこと,睡眠補助剤の使用であった.さらに,1 年次の喫煙経験は2 年次の低い自己評価にも影響した.結論:不健康なライフスタイルが行動や態度の自己評価に影響することが判明したことより,生活習慣の変容は,行動の自己評価を向上させる可能性が示唆された.ObjectiveThe purpose of this study was to investigate factors associatedwith the professionalism of medical students, andspecifically their fitness to practice.SubjectsSubjects were 92 first-year students (57 men, 35 women)at Dokkyo Medical University School of Medicine.MethodsA 26-item self-report questionnaire on fitness to practiceand a 12-item self-report questionnaire on lifestyle werecompleted by the medical students at Dokkyo Medical University,once in their first year in July 2010 and again intheir second year in August 2011.ResultsFitness to practice scores were significantly higheramong second-year than first-year students regarding"friendly and positive communication with others while respectingtheir individual differences and human rights","learning earnestly through preparation and review beforeand after lectures", and "willingness to learn". Conversely,fitness to practice scores were significantly lower amongthe second-year than first-year students regarding "unexcusedabsence from lectures or clinical practice"," submissionof plagiarized or falsified reports", and" missed submissiondeadlines". The factors associated with lower selfassessmentscores among first-year students were beingmale, smoking experience, skipping breakfast, poor qualityof sleeping and sleeping pill usage. Furthermore, smokingexperience among first-year students was associated withlower self-assessment scores of fitness to practice in thesecond year.ConclusionThe results suggest that the early adoption of healthybehaviors had a positive influence on fostering educationalprofessionalism among medical student

ホンガク ドウソウ カイイン ノ キンム ジョウキョウ : ジョセイ イシ シエン オ メザス ヨビテキ ケンキュウ トシテ

雇用の分野における男女の均等な機会及び待遇の確保のために,「男女雇用機会均等法」が成立し,妊娠や出産を理由として職場で不利益な取り扱いをすることは禁じられている1).さらに,「男女共同参画社会基本法」が施行され,2006 年には日本医師会に男女共同参画委員会が設立している2).しかし,我が国の女性医師の就労に影響を与える因子を検討した先行研究によると,性差による就労上の不利益を経験した女性医師が多く,就労格差を女性医師は強く認識しているという結論となっている3).このことは日本ばかりではなく,海外でも同様に報告されている4,5).特に,女性医師は男性医師に比較して,非常勤パートタイムで勤務することが多いと報告されている3,4).パートタイムで働く主たる理由は,出産と子育てである5).多くの女性医師が子育てを優先するために仕方なくパートタイム勤務を選択していることは事実である.また,母性を優先させる選択は職場での昇進・キャリアアップを閉ざすという結果につながる 3).しかし,一方で女性にとって出産や育児は非常に大切な母性の獲得であり,出産を経験した女性医師は医師を職業として選択したことにより満足していると報告されている6).これが女性医師にとってのワーク・ライフ・バランスのジレンマになっている.さらに,現在,医師を養成する大学医学部では,男女は平等に入学できるが,過酷な労働を強いられる大学病院では,女性医師は常勤勤務から離職せざるを得なくなるというアンバランスが生じている.本研究は,本学の女性医師支援のあり方を考える予備的研究として,本学同窓会会員の現況報告を検討し,さらに女性医師支援に関する先行文献を考察することを目的とした