Change in Japanese medical education has been accelerating over the last 10 years. Historically, clinical departments in each medical school played a crucial role, but reports in the mass media tried to refute the feudal ‘ikyoku-koza’ system with a number of malpractice cases, inappropriate patient–doctor communication, etc. At that time policies by the Ministries of Education and Health (rationalized in 2001) independently became more influential in medical education. In particular the network of governmental medical schools has been restructured, merged and privatized since 2001. In the 1990s several private medical schools developed distinctive curricula including problem-based learning (PBL), the objective structured clinical examination (OSCE) and introduction to clinical medicine (ICM). The curriculum for clinical medicine is still a critical issue and will be a major challenge for the management of each medical school. The effectiveness of the National Model Curriculum consisting of more than 1200 objectives might be questionable but the National Common Achievement Test (CAT) will make a strong impact on the preclinical curriculum. In the future each medical school should adopt an outcome-based education system to close the loop of curriculum development. An evaluation system based on the entire medical school or curriculum will be the key to successful education.

Medical education research in general is a young scientific discipline which is still finding its own position in the scientific range. It is rooted in both the biomedical sciences and the social sciences, each with their own scientific language. A more unique feature of medical education (and assessment) research is that it has to be both locally and internationally relevant. This is not always easy and sometimes leads to purely ideographic descriptions of an assessment procedure with insufficient general lessons or generalised scientific knowledge being generated or vice versa. For medical educational research, a plethora of methodologies is available to cater to many different research questions. This article contains consensus positions and suggestions on various elements of medical education (assessment) research. Overarching is the position that without a good theoretical underpinning and good knowledge of the existing literature, good research and sound conclusions are impossible to produce, and that there is no inherently superior methodology, but that the best methodology is the one most suited to answer the research question unambiguously. Although the positions should not be perceived as dogmas, they should be taken as very serious recommendations. Topics covered are: types of research, theoretical frameworks, designs and methodologies, instrument properties or psychometrics, costs/acceptability, ethics, infrastructure and support.

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.

Cross-year peer tutoring (CYPT) of medical students is recognized as an effective learning tool. The aim of this study is to investigate the non-inferiority of the objective outcome of medical interview training with CYPT compared with the results of faculty-led training (FLT), and to explore qualitatively the educational benefits of CYPT. We conducted a convergent mixed methods study including a randomized controlled non-inferiority trial and two focus groups. For the CYPT group, teaching was led by six student tutors from year 5. In the FLT group, students were taught by six physicians. Focus groups for student learners (four tutees) and student teachers (six tutors) were conducted following the training session. One hundred sixteen students agreed to participate. The OSCE scores of the CYPT group and FLT group were 91.4 and 91.2, respectively. The difference in the mean score was 0.2 with a 95% CI of −1.8 to 2.2 within the predetermined non-inferiority margin of 3.0. By analyzing the focus groups, we extracted 13 subordinate concepts and formed three categories including ‘Benefits of CYPT’, ‘Reflections of tutees and tutors’ and ‘Comparison with faculty’, which affected the interactions among tutees, tutors, and faculty. CYPT is effective for teaching communication skills to medical students and for enhancing reflective learning among both tutors and tutees.

Complex health care needs in developing countries are stimulating development and implementation of interprofessional education (IPE). To better understand IPE, it is necessary to develop and evaluate an educational program that focuses on interprofessional learning (IPL) in Indonesia. However, no instrument in the Indonesian language has been developed to measure attitudes toward IPL. The aim of this study is to describe the process of a cross-cultural adaptation of the Readiness for Interprofessional Learning Scale (RIPLS) in an Indonesian version including determining its reliability and validity. The study was conducted among students enrolled in medical, nursing, pharmacy and public health courses at the State Islamic University, Jakarta, Indonesia, in 2012. The completed responses to RIPLS were collected from 755 students. The psychometric properties were analyzed by both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA on 18-items revealed three factors accounting for 59.9% of the total variance. CFA resulted in a three-factor model over 16 items with satisfactory reliability (alpha coefficients >0.7), construct validity and acceptable indices of goodness of fit. We conclude that this Indonesian version of RIPLS with a three-factor model over 16 items is a valid tool to measure students’ attitudes toward IPL.

In most clinical teaching settings, case presentation is the most frequently used teaching and learning activity. From an educational viewpoint, the two important roles of case presentations are the presenter's reflective opportunity and the clinician educator's clues to diagnose the presenter. When a presenter prepares for a case presentation, he/she has to organize all the information collected from a patient. The presenter sometimes does not recall what to ask or to examine with relation to pertinent differential diagnoses while seeing a patient, and afterward he/she might note that more information should have been collected. He/she is able to note the processes by reflection‐on‐action and improve the processes the next time. Such a reflective process is the most important role of case conference for a presenter. When a clinician has a consultation with a patient, early problem representation determines the quality of differential diagnoses. Clinicians make a “big picture” while listening to the patient (sometimes only a glance is enough to diagnose a patient) as problem representation to narrow down clinical areas to ask questions. If the early problem representation is far from the optimal direction, the possibility of misdiagnosis will be higher. To correct the cognitive processes that lead to misdiagnosis, disclosure of uncertainty will be the key. If the teaching environment among residents or young clinicians is too competitive, some might feel reluctant to disclose incorrect reasoning processes to their peers. Or, if a clinician educator is too authoritative, students may hide key information from the educator. The educator should construct the best environment for students to be able to disclose such uncertainty. The main role of clinician educators is to facilitate and evaluate case presentations and to suggest points for improvement. Neher et al's “five microskills” are a typical example of these processes, after a short presentation of an outpatient case. Yet, for an inpatient or for formal discussion, a longer version presentation is used. To improve the clinical reasoning processes of the presenter, the short presentation has several advantages: (1) shortening the presentation requires abstraction of information, possibly leading to better problem representation; (2) it is time‐efficient; and (3) it stimulates more informal interactions with the facilitator and the audience. In clinical settings, a presenter uses his/her time for the preparation of case presentations to reflect on the information he/she has collected. The facilitator should know how to improve case presentations to diagnose and improve the presenter. The advantages of the short presentation should be emphasized.