An Educational Intervention of Interprofessional Learning in Community Based Health Care in Indonesia: What did We Learn from the Pilot Study?

Interprofessional learning (IPL) in community based health care (CBHC) was a pilot model to promote interprofessional education and collaborative practice in Indonesia and to offer the opportunity for medicine, nursing, pharmacy, and public health students to have hands-on experiences in IPL in community settings. The purpose of this article is to describe the IPL program and its implementation in CBHC and to present the students’ reaction towards the program. The study was conducted at the State Islamic University in Jakarta, Indonesia in 2012. Sixty two third-year students, 20 faculty members as tutors, 20 people as standardized patients (SPs) and 15 real patients volunteered and completed this program. Students attended a four-day workshop, a two-day simulation and practiced IPL for two months. The evaluation program applied a mixed-method design and showed that the success of the program was due to designing the program based on theoretical grounds in learning and social domains, applying various teaching methods (small group learning techniques, practice-based learning, and reflective practice) and providing a supportive environment for informal activities. The usefulness of this program was evident from a significant quantifiable improvement in student satisfaction. However, the high rate of student withdrawal from the program was the main issue as the program was not integrated into the curriculum.  It needs support from university structures to handle the complexity of professional curricula and the boundaries between faculty/disciplines. Keywords: evaluation program, educational intervention, interprofessional learning, community settin

Psychometric Item Analysis and Validation of Indonesian Version of Intragroup Conflict and Group Atmosphere Scale

Interprofessional education (IPE) is a learning model that brings together a variety of professions. This learning has the potential for the emergence of group conflict. It was needed the tools to evaluate the dynamics of conflict that arose within the group in IPE. The objective of this study was to validate the scales of intragroup conflict (IC) and group atmosphere (GA) in Indonesian version. A survey was conducted at the State Islamic University, Jakarta, Indonesia, in 2011 and we collected 302 valid questionnaires from medical, nursing, pharmacy and public health students. The IC and GA scale were adapted in Indonesian language through the cross-cultural adaptation process. The psychometric properties were analyzed by both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA of IC scale on 11-items and GA scale on 8-items accounted for 65.1% and 62.0%, respectively, of the total variance. The final model of IC scale is 10 items three-factors and GA scale is of 8-items three-factors. Both scales demonstrated the satisfactory reliability, adequate convergent validity and acceptable indices of goodness of fit. The study suggested that the Indonesian version of IC and GA scale are valid to assess the attitudes to manage intragroup conflict during IPE

The tertiary structure of the human Xkr8–Basigin complex that scrambles phospholipids at plasma membranes

Xkr8–Basigin is a plasma membrane phospholipid scramblase activated by kinases or caspases. We combined cryo-EM and X-ray crystallography to investigate its structure at an overall resolution of 3.8 Å. Its membrane-spanning region carrying 22 charged amino acids adopts a cuboid-like structure stabilized by salt bridges between hydrophilic residues in transmembrane helices. Phosphatidylcholine binding was observed in a hydrophobic cleft on the surface exposed to the outer leaflet of the plasma membrane. Six charged residues placed from top to bottom inside the molecule were essential for scrambling phospholipids in inward and outward directions, apparently providing a pathway for their translocation. A tryptophan residue was present between the head group of phosphatidylcholine and the extracellular end of the path. Its mutation to alanine made the Xkr8–Basigin complex constitutively active, indicating that it plays a vital role in regulating its scramblase activity. The structure of Xkr8–Basigin provides insights into the molecular mechanisms underlying phospholipid scrambling

Risk perception and risk attitudes in Tokyo: A report of the first administration of DOSPERT+M in Japan

Abstract Background: The Domain-Specific Risk Taking scale (DOSPERT) has been used to measure risk perceptions and attitudes in several nations and cultures. Takahashi translated DOSPERT to Japanese but DOSPERT responses from Japan have never been reported. Butler et al. (2012) developed an additional medical risk domain subscale to be added to DOSPERT to form DOSPERT+M. Objective: To describe the translation of the medical risk domain subscale to Japanese and to characterize domain-specific risk attitudes in Tokyo. Methods: Members of a probability-weighted online panel representative of the Tokyo metro area were randomized to complete pairs of DOSPERT+M tasks (risk attitude, risk perception, benefit perception). We explored relationships among domains through correlational and factor analysis; we tested the hypothesis that the medical risk domain and DOSPERT’s health/safety domains were uncorrelated. Participants: One hundred eighty panelists. Results: Six of the original DOSPERT items (two each in the ethics, health/safety, and financial domains) are not useable in Japan according to the Japanese Marketing Research Association code because they ask about participation in illegal activities; we thus used abbreviated versions of those domains leaving out these items. The DOSPERT+M items generally did not cluster cleanly into the expected domains, although items within the same domain usually were intercorrelated. Participants demonstrated domain-specific conventional risk attitudes, although nearly half of those assessed were perceived-risk neutral in all domains. Unlike our recently reported findings in the U.S. population, DOSPERT+M medical domain scores were associated with health/safety domain scores, although they were often more strongly associated with scores in other domains, such as recreational activities. Conclusion: The DOSPERT (and DOSPERT+M) instruments are problematic in Japan but Japanese citizens may also differ from those of other nations in their risk attitudes and perceptions

Assessment of Clinical Reasoning by Listening to Case Presentations: VSOP Method for Better Feedback

Case presentation is used as a teaching and learning tool in almost all clinical education, and it is also associated with clinical reasoning ability. Despite this, no specific assessment tool utilizing case presentations has yet been established. SNAPPS (summarize, narrow, analyze, probe, plan, and select) and the One-minute Preceptor are well-known educational tools for teaching how to improve consultations. However, these tools do not include a specific rating scale to determine the diagnostic reasoning level. Mini clinical evaluation exercise (Mini-CEX) and RIME (reporter, interpreter, manager, and educator) are comprehensive assessment tools with appropriate reliability and validity. The vague, structured, organized and pertinent (VSOP) model, previously proposed in Japan and derived from RIME model, is a tool for formative assessment and teaching of trainees through case presentations. Uses of the VSOP model in real settings are also discussed

History of Japanese medical education

Since medical education programs in Korea and Japan seem to mutually influence each other, this review article provides a history of Japanese medical education, focusing on the way in which it influenced and was influenced by Korean medical education. In the late 19th century, the University of Tokyo established the core medical school, disseminating its scholarship and system to other medical schools. In the early 20th century, the balance between the quality and quantity of medical education became a new issue; in response, Japan developed different levels of medical school, ranging from imperial universities to medical colleges and medical vocational schools. After World War II, all of Japan’s medical schools became part of the university system, which was heavily regulated by the Ministry of Education (MOE) Standard for the Establishment of Universities. In 1991, MOE deregulated the Standard; since 2000, several new systems have been established to regulate medical schools. These new approaches have included the Model Core Curriculum, 2-year mandatory postgraduate training, and a medical education accreditation system. Currently, most medical schools are nervous, as a result of tighter regulatory systems that include an accreditation system for undergraduate education and a specialty training system for postgraduate education

Comparison of the currents measured by electromagnetic current meter and bottom mounted ADCP in Otsuchi bay

Near-surface current data obtained by bottom-mounted Acoustic Doppler Current Profilers (ADCP) are compared with those by electromagnetic current meter (ACM) in Otsuchi bay, Sanriku ria coast in northern Japan during the two periods from October 2003 to March 2004 and from April to October 2004. Although near-surface data obtained by upward looking ADCP is affected by the acoustic beam reflected from the sea surface, the results show that those data have significant correlation with each other. This means that bottom-mounted ADCP is useful for estimating the transport from the sea-surface to bottom