Introduction to Clinical Clerkship
In the second semester of the fourth year, students acquire the skills and attitudes and integrate the knowledge necessary to finally begin clinical clerkships through diagnostics practice. Specifically, students learn medical interviewing and physical examination techniques, basic surgical procedures, and Basic Life Support (BLS) in a practical manner by dividing into small groups. What is learned here will be evaluated in the "Common Achievement Tests before Clinical Clerkship" (Objective Structured Clinical Examination (OSCE); see below).
Simulation Education
Previously, the cooperation of actual patients was sought to acquire medical skills. However, in current medical education, to ensure patient safety, students are instructed to use simulators to achieve a certain level of skill before performing procedures on patients. For example, only after it is confirmed that a student has attained a certain level of skill using a blood collection simulator is the student permitted to collect blood from a patient under the guidance of an instructor.
The Keio University School of Medicine has been providing simulation education in medical techniques for medical students and residents since 2003. Training in the simulation lab, which is staffed by a dedicated administrator (nurse), is regarded as one of the most advanced facilities in Japan, featuring numerous simulator teaching materials and comprehensive scenarios.
Simulated Patient (SP)
Similar to simulation education, in medical interviews with patients, students are first taught to have Simulated Patients (SP) play the role of the patient to improve their medical interviewing skills before interviewing actual patients.
The Keio University School of Medicine trains approximately 30 SPs, who also cooperate in practical training to improve clinical reasoning skills and medical interview practice for treatment selection and notification.
Common Achievement Tests: CBT and OSCE
The "Common Achievement Tests before Clinical Clerkship," which began in 2005, evaluate the comprehensive knowledge and basic clinical skills and attitudes that should be prepared before starting clinical clerkships, ensuring the knowledge and skills of the students.
The Common Achievement Tests consist of two parts: the Computer-Based Testing (CBT), which evaluates comprehensive understanding of basic and clinical medical sciences, and the Objective Structured Clinical Examination (OSCE), which evaluates clinical skills and attitudes. At the Keio University School of Medicine, CBT and OSCE exams are conducted in the third semester of the fourth year in preparation for clinical clerkships starting in April of the fifth year. Passing these exams allows students to participate in clinical clerkships.
Students who pass the CBT and OSCE are issued a Student Doctor card by the Association of Japanese Medical Colleges.
The purpose of the Student Doctor system is to help patients and society broadly understand the Student Doctor as a qualification intermediate between a medical student and a physician, and to create an environment where patients can feel at ease cooperating with the medical activities of medical students. Furthermore, it aims to make medical students aware of their responsibilities as Student Doctors. It is expected that students will strive to acquire the knowledge, skills, and attitudes appropriate for a Student Doctor, that the Student Doctor role will be understood by society, and that fruitful clinical clerkships can be conducted.