Summary: In the latest edition of Harden’s Blog, Professor Harden informs us of the lessons he took away from attending the recent 47th Conference of the Japan Society for Medical Education in Niigata, Japan. Description: Pat Lilley and I participated last week in the 47th Annual Conference of the Japan Society for Medical Education.  The conference was in Niigata where the best Saki comes from, made from local rice and water.  At the opening reception we had 100 different Saki choices.  The AMEE stand at the meeting was an opportunity to meet with some old friends and make new ones.  We have a large delegation from Japan coming to Glasgow for AMEE 2015.  In my opening presentation I had been invited to speak on the OSCE, outcome-based education and the spiral curriculum.  At first sight these seemed somewhat different topics, but on reflection they are closely related and indeed are the required ingredients if we want to move to a more authentic curriculum where doctors qualify with the abilities necessary to meet the needs of the community which they will serve.  We were looked after magnificently during our visit by Toshiya Suzuki who was responsible for the organisation of the meeting.  

There was much of interest at the meeting, although the majority was in Japanese.  The first of my three take home messages related to a great interest in the behavioural sciences in the medical curriculum.  In a symposium on the subject I had been asked to give a thirty minute presentation on the position in the UK, Dan Hunt talked about the position in the US and Osamu Fukushima and Hiroshi Nishigori talked about the position in Japan.  The room was packed for the symposium with more than 300 present and standing room only.  It is an area where in the past not much attention has been paid to it in Japan.  AMEE is working with BESST in the UK to promote behavioural sciences in the curriculum and BESST have a workshop at AMEE 2015 in Glasgow on the proposed new core curriculum for behavioural sciences in medical education.  In preparing for my presentation I was hugely helped by my daughter, Jennifer, who is Senior Lecturer in Social Sciences at Edinburgh Medical School and is responsible for a far sighted programme which has been allocated about 25% of the time in the first year.  She gave me a recorded interview with a student who talked very persuasively about the huge impact the course has had on his own thinking and reorientation away from the bio-medical sciences to the social sciences in medicine.  Very impressive.  In the symposium one interesting question was asked as to whether, in additional to including the behavioural sciences in the curriculum, more attention should be paid in selection to selecting students with the appropriate characteristics expected of a doctor.

My second take home message was from the presentation by Jong Hoon Kim on the Clinical Skill Assessment in the Korean National Medical License examination.  Jong Hoon had looked after us during our visit last month to Korea.  He reported a detailed analysis of the performance of the OSCE in the licensing exam.  One interesting fact which was questioned at the meeting was that students who took the examination which was offered over a week, later in the week were not at an advantage compared to students who took it earlier.  This is a question that is often raised when an OSCE is run over several days.  His evidence was quite clear, however, about this.  There is no advantage.  Not everyone agreed with the concept of a national examination and Nobutaro Ban, who is currently President of the Japanese Society for Medical Education, questioned the desirability of having a national examination and argued that this should be left to the individual schools with, as in the UK, some accountability to a national body.  

My third take home message related to students.  Some students had asked to meet with me during the conference and for me this was one of the highlights.  Traditionally students have not been very engaged with the curriculum organisation in Japan, but this may be changing.  They wanted to question me about the GMC recommendations in Tomorrow’s Doctors, particularly the recommendations from the 1993 first version.  I think this was very appropriate as it did set the scene for many of the changes in medical education in the UK and elsewhere.  Two of the students have now joined AMEE as student members and intend to come to an AMEE conference.

There is no doubt that attending such meetings broadens my perspective of medical education and lets me see that while many of the basic problems and principles are the same, there are certainly cultural differences.

I saw this week in the Journal of Chiropr Educ. (2013, Vol 27 No. 1 pp 48-49), a very positive review of my book with Jennifer Laidlaw, Essential Skills for a Medical Teacher.  It was encouraging to read that our aims in writing the book have been achieved.  The review concludes that ‘Essential Skills for a Medical Teacher: An introduction to Teaching and Learning in Medicine fulfils its mission to provide an excellent introduction as well as a resource for advanced study.  Harden and Laidlaw provide a common language and set of principles that should be as useful within chiropractic education as it is for education in other health professions.  Read it to expand your own skills, or even better, read it with your colleagues to magnify the positive impact on chiropractic education.’  A copy of the complete review is on MedEdWorld.  I hope our next book, a Definitive Guide to the OSCE, to be launched in Glasgow, has a similar positive reception.