Creation of a Clinical Support Network to Specifically Answer the Individual Questions of International Students


1. Background and purpose
 Every year, two foreign students enter the vocational course of the school for the blind where I work. They study for 3 years and obtain an acupuncture, moxibustion and Japanese manual therapy license.  
 After returning to their countries, they become massage instructors or open clinics.
 I, a teacher in the school for the blind, and my wife, the director of the SETANI Clinic of Acupuncture, Moxibustion and Japanese Manual Therapy in Tokyo, provided continuous support to returned foreign students to improve their knowledge and skills.

2. Methods
 The following 3 methods were used.
 First, second-year foreign students in the vocational course participated in practice in the SETANI Clinic of Acupuncture, Moxibustion and Japanese Manual Therapy.
 Second, we visited home countries of returned foreign students to treat patients together with them and to teach anma therapy skills in schools for the blind in these countries.
 Third, the director of the SETANI Clinic specifically answered questions from returned foreign students using Skype, etc.

3. Results
 Eight foreign students from 7 countries have participated in practice in the SETANI Clinic of Acupuncture, Moxibustion and Japanese Manual Therapy since 2011. During the practice, foreign students received technical advice and advice on manner, while treating patients with various diseases.
 Regarding visits to home countries of returned foreign students, in 2014 we visited Mongolia and, together with a returned foreign student, treated patients with infantile paralysis. In 2015, we visited Malaysia to demonstrate anma therapy.
 Using Skype, etc., the following communication, for example, was made.
-Question: A patient complains of sensory disturbance that makes him feel like wearing socks. Please tell me how to treat this symptom.
-Instruction: The patient is likely to have multiple peripheral neuropathy. Please check whether the patient has diabetes. Massage from the ankle to the knee joint should be given for treatment. After that, electric acupuncture should be applied to the lower extremities.
-Results: Sensory disturbance improved after a few treatment sessions.

4. Discussion
 The present activities have advantages in that treatment skills can be improved in a stepwise, continuous and motivated manner.
 First, foreign students acquire knowledge from textbooks and classes and establish interpersonal relationships with teachers in the vocational course. 
 Next, they confirm textbook symptoms and treatments in actual patients and establish interpersonal relationships with therapy clinic directors in the practice outside the school.
 After returning to their countries, they learn methods of treating new patients with symptoms that they have not so far encountered by utilizing the knowledge obtained from textbooks, classes and practice and interpersonal relationships with teachers and therapy clinic directors.
 When they ask questions about new patients, they use terms that they learned from textbooks or in classes, such as "sensory disturbance that makes the patient feel like wearing socks". Teachers and therapy clinic directors speculate diseases or pathological conditions of the patients from such terms to teach them appropriate treatment.
 Thus, the presence of interpersonal relationships among teachers, therapy clinic directors and foreign students and knowledge common to the 3 parties allows the foreign students to learn treatment of new patients by just remembering, combining and applying knowledge and skills that they have learned so far, without making a new effort to learn.
 The solution of individual problems motivates foreign students to treat more new patients and to acquire new knowledge.