Innovation of Undergraduate Medical Education

Classical undergraduate medical education in Japan has largely based on didactic lectures, followed by protocol-guided laboratory experiments and clinical training of history taking and physical examination. Such education strategies are efficient for cramming facts and theories, which will soon become obsolete by the time when the students go into clinical practice and are not effective for education of effective clinical skills. In the cognitive domain, what students must learn are not facts and theories alone but basic skills by which they can collect necessary updated facts and theories to solve problems encountered in clinical practice and during research activities. The problem-based experiential self-learning strategies developed by MacMaster University in Canada have been introduced to Tokyo Women's College of Medicine and Tokai University School of Medicine. In the psychomotor domain, the recent changes in the interpretation of related medical laws by the Ministries of Educaton and Health have fortunately made it possible to introduce the clinical clerkship strategy to the bedside clinical training of senior medical students. In the affective domain which had totally been neglected in Japan, a one-week session including role-playing based experiential learning of basic communication skills and nursing practice has been given to the second-year medical students before teaching anatomy in the past 10 years in Hamamatsu University School of Medicine. Students are quite sensitive to examinations. Problem solving skills rather than simple recall of facts and theories must be evaluated for encouraging students to learn problem solving skills