松山 泰

学び方のデザイン手法に比して,学習者評価はさほど体系化されていない.医療者教育学における学習者評価の概念は進化し続けており,2000代年前半からvan der Vleutenが提唱したProgrammatic Assessment(PA)により大きく変容した.PAの根底には,評価とは,学習者の能力の一部分を切り取り散逸的なタイミングで学習成果を判定する営み(assessment of learning)ではなく,学習者の能力を体系的に評価しその結果を学習につなげる営み(assessment for learning)だという理念がある.本稿ではPAの構造をその原則とともに概説し,導入例を紹介し,我が国への導入に際しての課題を展望した.PAの導入が,卒前卒後医学教育での学習者評価におけるパラダイムシフトを起こし,学習者評価の有用性を向上させることが期待される.(著者抄録)

2014年から正式運用されている医学教育専門家制度は、今日までに181名の専門家を輩出している。医学教育のグローバル化に対応し、国際基準に沿った教育改善に取り組むことができる実践的専門家を育成する体制が確立したように思われた。しかし、新型コロナウイルス感染症の流行によって対面型の履修コースを開催できなくなり、対面協働学習を活用していた従来の育成体制は見直しを迫られた。2021年2月、フルオンライン型で履修コースを再開した。オンライン学習に集中できる時間を考慮して事前学習コンテンツを充実させ、学習プラットフォームとしてMoodleを使用し、当日のレクチャーやグループワークをZoomで行った。大きな回線トラブルはなく、コース後のアンケートの結果、受講者の満足度、学習の有用度は高かった。本コースが新たな教育体系のgood practiceとなるよう、対面型とオンライン型の強みを取り入れて発展させていきたい。(著者抄録)

＜POINT＞(1)Learning Management Systemの活用とオンライン教育に詳しい専門家のリーダーシップが迅速なリモート教育導入の鍵であった(2)リモート教育でも体験できる学習対象を明確にした上でコンテンツ開発を進めるとよい(3)リモート教育が難しい精神運動領域と情意領域の学習は、自習教材の工夫とメンタリングの充実化で対応するとよい(4)官民協働オールジャパンで緊急時のリモート教育体制を確立していくべきである(著者抄録)

<title>Abstract</title><sec> <title>Background</title> Problem-based learning (PBL) is classified as a collaborative learning approach, wherein students learn while contributing meaning to experiences and interactions with others. An important theoretical fundament of PBL is social interdependence theory (SIT) because positive social interdependence within a group has been found to be key to better learning performance and future attitudes towards team practice. However, most previous studies in health professions education focused on cognitive outcomes, and few studies have focused on collaborative behaviors in PBL groups. The lack of this empirical insight makes implementation of PBL difficult, especially in contexts where there is limited experience with collaborative learning. Therefore, the aim of this study was to elucidate what promotes or hinders positive social interdependence and how the attributes work during PBL. </sec><sec> <title>Methods</title> We conducted four focus groups among clinical year medical students (<italic>n</italic> = 26) who participated in PBL tutorials in the formal curriculum. We asked semi-structured questions that corresponded with the overall concept of SIT. We analyzed the transcript using constructivist grounded theory and developed a model to explain contextual attributes that promote or hinder positive social interdependence in PBL. </sec><sec> <title>Results</title> Two contextual attributes of “academic inquisition” and “desire for efficiency” affect social interdependence among a student group in PBL. Academic inquisition is students’ desire to engage in their academic learning, and desire for efficiency is students’ attitude toward learning as an imposed duty and desire to complete it as quickly as possible. These attributes are initially mutually conflicting and constructing social interdependence through multiple steps including inquisition from a case, seeking efficient work, sharing interest in problem solving, expecting mutual contributions, and complementing learning objectives. </sec><sec> <title>Conclusion</title> These findings will contribute to understanding collaborative learning environments in PBL and may help explain contexts where PBL is less successful. The model can also be used as a tool to support innovation of PBL as collaborative learning. </sec>

<title>Abstract</title><sec> <title>Background</title> Developing self-regulated learning in preclinical settings is important for future lifelong learning. Previous studies indicate professional identity formation, i.e., formation of self-identity with internalized values and norms of professionalism, might promote self-regulated learning. We designed a professional identity formation-oriented reflection and learning plan format, then tested effectiveness on raising self-regulated learning in a preclinical year curriculum. </sec><sec> <title>Methods</title> A randomized controlled crossover trial was conducted using 112 students at Jichi Medical University. In six one-day problem-based learning sessions in a 7-month pre-clinical year curriculum, Groups A (<italic>n</italic> = 56, female 18, mean age 21.5y ± 0.7) and B (<italic>n</italic> = 56, female 11, mean age 21.7y ± 1.0) experienced professional identity formation-oriented format: Group A had three sessions with the intervention format in the first half, B in the second half. Between-group identity stages and self-regulated learning levels were compared using professional identity essays and the Motivated Strategies for Learning Questionnaire. </sec><sec> <title>Results</title> Two-level regression analyses showed no improvement in questionnaire categories but moderate improvement of professional identity stages over time (<italic>R</italic>² = 0.069), regardless of timing of intervention. </sec><sec> <title>Conclusions</title> Professional identity moderately forms during the pre-clinical year curriculum. However, neither identity nor self-regulated learning is raised significantly by limited intervention. </sec>

Institutional research is an essential topic in the medical education field. In this regard, curriculum mapping and competency assessments based on the model core curriculum (MCC) and diploma policies (DPs) are required topics for achieving global standards. This study investigated initial practices using a Moodle-based e-syllabus to gather and analyze curriculum information. Although some MCC elements were connected to several classes, results showed that others had no such connections. Since the MCC is defined as "a common, national, systematically organized curriculum taught in each medical faculty/university,"it should thus be improved so that each MCC element is fulfilled throughout the whole curriculum. Although the Moodle-based e-syllabus contained some problems that require improvement (especially for usability), the data integration and analytics aspects were better than those of the previous Excel-based syllabus.