Background Diagnostic errors are prevalent and associated with increased economic burden; however, little is known about their characteristics at the national level in Japan. This study aimed to investigate clinical outcomes and indemnity payment in cases of diagnostic errors using Japan's largest database of national claims. Methods We analyzed characteristics of diagnostic error cases closed between 1961 and 2017, accessed through the national Japanese malpractice claims database. We compared diagnostic error-related claims (DERC) with non-diagnostic error-related claims (non-DERC) in terms of indemnity, clinical outcomes, and factors underlying physicians' diagnostic errors. Results All 1,802 malpractice claims were included in the analysis. The median patient age was 33 years (interquartile range = 10-54), and 54.2% were men. Deaths were the most common outcome of claims (939/1747; 53.8%). In total, 709 (39.3%, 95% CI: 37.0%-41.6%) DERC cases were observed. The adjusted total billing amount, acceptance rate, adjusted median claims payments, and proportion of deaths were significantly higher in DERC than non-DERC cases. Departments of internal medicine and surgery were 1.42 and 1.55 times more likely, respectively, to have DERC cases than others. Claims involving the emergency room (adjusted odds ratio [OR] = 5.88) and outpatient office (adjusted OR = 2.87) were more likely to be DERC than other cases. The initial diagnoses most likely to lead to diagnostic error were upper respiratory tract infection, non-bleeding digestive tract disease, and "no abnormality." Conclusions Cases of diagnostic errors produced severe patient outcomes and were associated with high indemnity. These cases were frequently noted in general exam and emergency rooms

Increasingly popular worldwide, Japanese cuisine includes several raw preparations such as sashimi and sushi; however, limited information on food poisoning from Japanese local food is available in English literature. Without appropriate knowledge, physicians may underdiagnose traveler's diarrhea among people returning from Japan. To provide accurate information to primary care physicians worldwide, we conducted a narrative review on food poisoning research published in Japanese and English over the past four years, considering the frequency and clinical importance of various presentations.

Given scientific and technological advancements, expectations of online medical education are increasing. However, there is no way to predict the effectiveness of online clinical clerkship curricula. To develop a prediction model, we conducted cross-sectional national surveys in Japan. Social media surveys were conducted among medical students in Japan during the periods May–June 2020 and February–March 2021. We used the former for the derivation dataset and the latter for the validation dataset. We asked students questions in three areas: 1) opportunities to learn from each educational approach (lectures, medical quizzes, assignments, oral presentations, observation of physicians’ practice, clinical skills practice, participation in interprofessional meetings, and interactive discussions with physicians) in online clinical clerkships compared to face-to-face, 2) frequency of technical problems on online platforms, and 3) satisfaction and motivation as outcome measurements. We developed a scoring system based on a multivariate prediction model for satisfaction and motivation in a cross-sectional study of 1,671 medical students during the period May–June 2020. We externally validated this scoring with a cross-sectional study of 106 medical students during February–March 2021 and assessed its predictive performance. The final prediction models in the derivation dataset included eight variables (frequency of lectures, medical quizzes, oral presentations, observation of physicians’ practice, clinical skills practice, participation in interprofessional meetings, interactive discussions with physicians, and technical problems). We applied the prediction models created using the derivation dataset to a validation dataset. The prediction performance values, based on the area under the receiver operating characteristic curve, were 0.69 for satisfaction (sensitivity, 0.50; specificity, 0.89) and 0.75 for motivation (sensitivity, 0.71; specificity, 0.85). We developed a prediction model for the effectiveness of the online clinical clerkship curriculum, based on students’ satisfaction and motivation. Our model will accurately predict and improve the online clinical clerkship curriculum effectiveness.

Background To become a doctor with a high level of professionalism and ethical standards, it is important to have and maintain a high level of motivation right from medical school. However, studies in Japan have not quantitatively investigated the factors related to motivation immediately after enrollment. This study aimed to identify the demographic factors that influence the motivation of medical students immediately after admission. Methods A cross‐sectional single‐center study was conducted. First‐year medical students answered our questionnaire three weeks after the admission. The questionnaire comprised 16 demographic items and the 28‐item Academic Motivation Scale, which was used to quantify motivation. Results Our analysis showed that amotivation, representing low levels of self‐determinant motivation, was significantly higher in students whose parents were medical professionals and in students who did not talk about their problems than in those whose parents were not medical professionals and those who did talk about their problems. Intrinsic motivation, which indicates the level of self‐determinant motivation, was significantly lower in students who belonged to a sports club. Conclusions We suggest that having parents who are medical professionals may be associated with an individual's decreased motivation when entering medical school in Japan. Though this is a novel finding, further research is needed to analyze this relationship.