title: Reform of a traditional clinical curriculum in Japan: experiences at Tokyo Medical and Dental University.
abstract: BACKGROUND
  Until recently, Japanese legislative guidelines dictated that undergraduate clinical training consisted of students' observations of clinicians' work. In 2006, Tokyo Medical and Dental University initiated a reform of their traditional undergraduate clinical curriculum. The reform integrated students into patient care teams, and included the implementation of a clinical faculty 'tutor'.
  
  
  OBJECTIVE
  This short communication describes a formative assessment of the reform work.
  
  
  METHODS
  In 2007, students, residents, and tutors were surveyed to determine their perceptions of students' integration into clinical activities, and patients' acceptance of students in their medical care. An external consultant observed students' patient care activities, and assessed the methods of and perceived barriers to clinical teaching.
  
  
  RESULTS
  Surveys indicated that students were most engaged in history-taking, procedures, and case presentations. Observations revealed students' activities and teaching to be focused on students' case presentations. Perceived barriers to teaching included insufficient time and personnel. Respondents felt that patients were accepting students in their clinical care.
  
  
  CONCLUSIONS
  This clinical reform effort includes an increase in students' interactions with patients through history-taking, and teaching through case presentations.
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. sefarrell@partners.org
authors.forename: Susan E
authors.initials: SE
authors.lastname: Farrell
authors.forename: Kazuki
authors.initials: K
authors.lastname: Takada
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Armstrong
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Tanaka
authors.forename: H Thomas
authors.initials: HT
authors.lastname: Aretz
mesh_terms: D002982:Clinical Clerkship / Q000458:organization & administration*; D003479:Curriculum; D006801:Humans; D007564:Japan; D005791:Patient Care; D012577:Schools, Medical / Q000458:organization & administration*