Osamu Fukushima

Medical student abuse during clinical clerkships in Japan

AbstractOBJECTIVE: To assess the prevalence of medical student abuse during clinical clerkships in Japan. DESIGN: A cross-sectional questionnaire survey. SETTING: Six medical schools in Japan. PARTICIPANTS: Final year (sixth-year) and fifth-year medical students in the period from September 2003 to January 2004. From a total of 559 students solicited, 304 (54.4%) returned the questionnaire, and 276 (49.4%: 178 male and 98 female) completed it. MEASUREMENTS: Prevalence of medical student abuse in 5 categories: verbal abuse, physical abuse, academic abuse, sexual harassment, and gender discrimination; differences in abusive experience between male and female students; types of alleged abusers; reporting abusive experiences to authorities; and emotional effects of abusive experiences. RESULTS: Medical student abuse was reported by 68.5% of the respondents. Verbal abuse was the most frequently experienced abuse (male students 52.8%, female students 63.3%). Sexual harassment was experienced significantly more often (P<.001) by female students (54.1%) than by male students (14.6%). Faculty members were most often reported as abusers (45.2% of cases). Abuse occurred most frequently during surgical rotations (42.0% of cases), followed by internal medicine (25.1%) and anesthesia rotations (21.8%). Very few abused students reported their abusive experiences to authorities (8.5%). The most frequent emotional response to abuse was anger (27.1% of cases). CONCLUSIONS: Although experience of abuse during clinical clerkships is common among medical students in Japan, the concept of “medical student abuse” is not yet familiar to Japanese. To improve the learning environment, medical educators need to take action to resolve this serious issue.

Experiences of alcohol-related harassment among medical students

Medical Education 2010: 44: 1213–1223

An Enzyme Histochemical Investigation on Bone Acid Phosphatases: The use of Fluoride to Distinguish the Isoenzymes

The histochemical distribution of acid phosphatase activity in chicken tibial metaphyses was investigated with the azo-dye method, using naphthol AS-BI phosphate as a substrate, and the lead-salt method, usingβ-glycerophosphate, p-nitrophenylphosphate or adenosine triphosphate as substrates. Tartrate-resistant activity was found in cartilage and bone matrices and in osteoclasts when naphthol AS-BI phosphate, p-nitrophenylphosphate or adenosine triphosphate were used. Fluoride-resistant activity was observed in the cytoplasm of osteoclasts with naphthol AS-BI phosphate or p-nitrophenylphosphate; this activity was also insensitive to tartrate. The tartrate-resistant acid adenosine triphosphatase activity, which is due to purple acid phosphatse (type V acid phosphatase isoenzyme), was significantly weaker in the cytoplasm of osteoclasts than the tartrate-resistant acid phosphatase (TRAP) activity with naphthol AS-BI phosphate or p-nitrophenylphosphate as substrates. Furthermore, the purple acid phosphatase activity was strongly inhibited by fluoride.Therefore, the TRAP activity detected with naphthol AS-BI phosphate or p-nitrophenylphosphate may be due to the combined activity of the purple acid phosphatase and another isoenzyme, which is termed fluoride-resistant acid phosphatase (FRAP).

Jikei University School of Medicine: An Interprofessional Medical Education Program

Health care is a patient-centered team approach supported not only by doctors and nurses but also by a wide range of health professionals. The teamwork approach, however, is possible only when team members understand the beliefs, attitudes, perceptions, and values of the other team members. Therefore, the Jikei University School of Medicine started an Interprofessional Education (IPE) program in 1989 wherein students learn to work in teams. Practically speaking, under the IPE program students participate in a multidisciplinary workplace, take some responsibility, assist leaders and staff, and eventually learn the beliefs, attitudes, perceptions, and values of their respective professions. This exercise enables students to acquire the ability to understand others and to work in teams. IPE is a scholastic good practice to establish collaborative thinking and behavior for effective teamwork among students and help their development as professionals. It is important in an intelligent society to prepare students who can work together with various professionals. This ability is necessary in all professions, in addition to the health professions. Thus, Jikei University advocates the importance of IPE as a model of good professional education practice.