Kumasaka K
Department of Clinical Pathology, Nihon University School of Medicine, Tokyo.
Rinsho Byori. 1997 Aug;45(8):719-26.
We must recognize that undergraduate clinical training is insufficient in Japan and that we need to improve the role of the laboratory medicine, especially in the area of communication. Therefore, postgraduate training in clinical pathology/laboratory medicine should include; 1. Basic clinical skills (Communication skills, physical examination and common laboratory procedures such as Gram's stain, Wright-Giemsa stain, etc.), 2. Principles, instrumentation and techniques of each discipline of this broad scientific field, 3. How laboratory information is used in a medical setting, 4. The role of the clinical pathologist/laboratory physician in interacting with laboratory staff, physicians and patients. There is an increasing gap between the clinic and the laboratory. Current needs require us to make a major attempt to bridge this gap. This effort will require new and resourceful means of communication and interaction. A 24-hour on-call program was established to enrich the training of the clinical pathology residents in the USA. Each resident in the program is responsible for being on call, which entails learning the day-to-day operation of the laboratory and being available to interpret laboratory data when the need arises. Residents are expected to refer to the appropriate staff member those situations that he or she feels unable to handle. A review of all on-call problems with staff provides to be a valuable education tool, both for the residents and the staff. This learning strategy was adopted from UCSF Hospital and introduced to Nihon University Itabashi Hospital by K. Kumasaka MD in 1984. And that after 12 years of actual experience, we conclude the training program provides a readily available consultative service for the house staff, and facilitates patient care. In addition, we should make rounds with physicians and go to conferences in areas of interest and responsibilities. We could be mainly responsible for a number of problem-solving areas within the laboratory that would be directly responsive to patient problems encountered by physicians.
我们必须认识到，日本的本科临床培训并不充分，我们需要提升检验医学的作用，尤其是在沟通领域。因此，临床病理学/检验医学的研究生培训应包括：1. 基本临床技能（沟通技能、体格检查以及常见实验室操作，如革兰氏染色、瑞氏-吉姆萨染色等）；2. 这一广泛科学领域各学科的原理、仪器和技术；3. 实验室信息在医疗环境中的使用方式；4. 临床病理学家/检验医师在与实验室工作人员、医生和患者互动中的作用。临床和实验室之间的差距正在不断扩大。当前的需求要求我们做出重大努力来弥合这一差距。这项工作将需要新颖且灵活的沟通和互动方式。美国设立了一个24小时随叫随到项目，以丰富临床病理学住院医师的培训。该项目中的每位住院医师都负责随叫随到，这需要了解实验室的日常运作，并在需要时能够解读实验室数据。住院医师若遇到自己无法处理的情况，应向合适的工作人员咨询。与工作人员一起回顾所有随叫随到的问题，对住院医师和工作人员而言都是一种宝贵的教育工具。这种学习策略是从加州大学旧金山分校医院借鉴而来，并于1984年由熊坂健医学博士引入日本大学板桥医院。经过12年的实际经验，我们得出结论，该培训项目为住院医生提供了随时可用的咨询服务，并促进了患者护理。此外，我们应该与医生一起查房，并参加感兴趣和职责范围内的会议。我们可以主要负责实验室中一些解决问题的领域，这些领域将直接回应医生遇到的患者问题。
