1. Report on Program Activites of the Fiscal Year 2008
1) Implementation Framework and Plan
The GP Promotion Committee held regular meetings and confirmed that the project was properly implemented based on the plan in terms of the progresses of each team in the college and of the organization of Miyako Island training. Moreover, all instructors and administrative staffs could share information regarding significance and plan of this project through progress reports at monthly coordinating meetings among instructors and administrative staffs as well as cooperation requests as necessary. Therefore, it is expected that at the new training and education program which starts in the fiscal year 2009 on the Miyako Islands, students are provided with systematic college-wide education and able to receive efficient and high quality education.  

2) Examination of Problems Hitherto Found in Terms of On-Site Training at the Model Island (Miyako Island) and Conclusion of Training and Instruction Plans for the Next Fiscal Year
By reference to the evaluation result of the fiscal year 2008 Miyako Training which was conducted under the earlier educational method, some problems, points of improvement and measures in terms of both students and nurses were clarified. By feedback of training site, the training and instruction blueprints for the fiscal year 2009 were examined in concrete terms. It mobilized capability that the staffs and instructors on the site are able to provide students with systematic guidance. Therefore, students are able to learn efficiently and effectively; significant improvement of what students accomplish is expected. One disadvantage that we could not implement evaluation by instructors will be accommodated by holding GP Instructors meetings before the fiscal year 2009 projects start running.  

3) Establishment of the Project Promotion Framework in the Miyako Island and Implementation of Educational Ability Support for the On-Site Staff
We could secure appropriate staffs to work as training coordinator and a volunteer coordinator (one staff in each position) who will be the key personnel of Miyako Island training. As a result of coordinators’ endeavours, 3 organizations -- “the Committee for the Promotion of Miyako Island Training” “the Coordinating Council for the Guidance of Miyako Island Training” and “the Coordinating Council for Resident Volunteers Who Accommodate OPCN Trainees” – were established; and then, the structure to accept students in the Miyako Island was established. The organization of residents’ volunteers contributes to students’ understanding of residents’ cultural background; to efficient learning of community perspective; and to mitigation of economic burden. The framework of the project promotion in the Miyako Island was established as a result of cooperation among the personnel in the college and the Miyako Island. The process of making framework improved cooperative ability of college instructors, on-site training staffs and residents; it mobilized capability to provide students with training in which they learn about effective cooperation and develop cooperative ability. However, due to delay in supply of necessary equipments, training for the on-site staffs did not take place. It is expected that the training will take place at the beginning of next fiscal year.

4) Arrangement of On-Site Training Environment Based on the On-Site Training and Instruction Plans for the Next Fiscal Year
Both human and material resources of educational environment in the training facility were prepared, so that one problem of island training was ameliorated. Since students are able to utilize ICT, they are able to develop the skill to operate ICT. Therefore one disadvantage to be trained in an island turns into advantage.

5) Report Session and Evaluation Meeting for the Project of the Current Fiscal Year
The program report was presented at “Join Forum Poster Session” in Yokohama. Moreover, self assessment and evaluation of the current fiscal year were made; the report was complied; and the report is ready to be distributed to other nursing universities and colleges. It allows us to publicize significance of “learning in islands” in the field of nursing in Japan. In the fiscal year 2009, the report will be referred at the external evaluation meeting. It is expected that the meeting with reflection of the report will allow students to understand significance and value of education they have received and build confidence. It is also expected that it helps students acquire ability to cooperate in a community after their graduation and to sustain lifelong learning.

2. Report on Program Activites of the Fiscal Year 2009
1) External Evaluation of the Fiscal Year 2008 Program Outcome and FD Activities for All College Instructors and Administrative Staffs
The External Evaluation Meeting was postponed for 1 month. 2 people in the nursing field were absent. Better arrangement needs to be conducted for the next meeting. In the meeting it was suggested that the program evaluation method needs to be clarified in advance. We established an evaluation working group within the GP Instructors Team, and the working group examined a method for evaluating students’ outcomes, proposal for the evaluation method was made, and experimented survey and focus group interview to the trainees of the fiscal year 2007. However, the group could not finalize the evaluation draft. The suggestion was reflected in the third implementation plan which is for the current fiscal year. All OPCN instructors and administrative staffs are informed of and requested to participate in the program by the report section at the Coordination Meetings for the Instructors and Administrative Staffs and publicizing island training scenes for which teleconference system is utilized. However, only a certain portion of instructors and staffs are interested in the program. The fact that 2 other GP projects along with the new curriculum compilation are underway makes interest and participation in this program of some OPCN members difficult.

2) Promotion of On-Site Training and Education
In compliance with the academic calendar, time table, syllabi and training guideline, training which is formed by “On-Site Island Training Model” was firmly implemented. However, different understanding of the modeled training emerged among instructors, in particular, due to difference in subjects they teach. It is not because of lack of communication with on-site training instructors, but lack of effort to deepen mutual understanding among college instructors. Moreover, as for training in the first half term, different orientations (training objectives) were proposed. Reflecting this point, for the latter half term, 3 perspectives were emphasized to both groups. For improvement of the next fiscal year training, based on information compiled in the Evaluation Working Group during the current fiscal year, sufficient discussion needs to be made at the GP Instructors Team meetings. Furthermore, mutual understanding of the 3 perspectives among training instructors needs to be assured before the next training in June next year.

3) Education Support by Resident Volunteers
Educational support by resident volunteers was active. In the first half term of the training, the longest home stay period was 4 nights. For the latter half term, some students requested home stay for 11 nights. We are afraid that it may cause overwhelming burden on home stay volunteers. It needs to be evaluated by interview research as well as consultation with the volunteer coordinator. A sustainable and smooth implementation should be sought for upon agreement between OPCN and residents. We intended to promote autonomy of resident volunteers, so that we organized observation tours and lectures for volunteer leaders. Reaction of the leaders was very positive. The challenges we face for the next fiscal year includes how to recruit more resident volunteers as well as to make their cooperation regular and constant. It may be necessary to arrange some activities for volunteers.   

4) Arrangement and Utilization of Educational Environment Regarding ICT
Considering that it was still the first year, ICT environment was well utilized. However, for on-site training, the teleconference system was frequently utilized, and Skype, FCS and Joint Meeting were rarely utilized. In order to resolve this issue, an immediate action was made; an ICT training session was planned and implemented in January and February for students and instructors who were participating in the on-site training. The outcome evaluation of the session will be conducted in the next fiscal year.

5) Evaluation of On-Site Training and Education Program
The evaluation method for students was prepared in the last fiscal year and implemented properly. However, the method for evaluating college instructors and training instructors was not concluded on time. Therefore, for the current fiscal year, we could not implement the evaluation following proper schedule (immediately after the training); the evaluation for the first half term was conducted during the latter half term. The date is vital for evaluating program outcomes, so that for the training in the next fiscal year, we would like to implement evaluation of 4 groups and make the data useful for evaluation of program outcomes. Annual evaluation for volunteers was not problematic, but it is suggested that more sophisticated evaluation and improvement are necessary for establishment of a new system, so that it needs to be examined. Moreover, similarly to what is mentioned above (#2 of this section), it is suggested that we need to clarify the concept of “community perspective” by making reference to the evaluation result in order for instructors to share mutual understanding on the concept before they provide students with guidance. The evaluation result from volunteers tells that only 10 out of 17 volunteers are willing to volunteer in the next fiscal year, so that it is suggested that the college and residents need to discuss and sought for sustainable way of implementation.

6) Regular Review Meetings of the Committee for the Promotion of Miyako Island Training and the Coordinating Council for the Guidance of Miyako Island Training
During the current fiscal year, 4 joint meetings of the committee and council are planned. A joint meeting involves some advantage. However, it is concerned that on-site clinical instructors may not speak freely in front of their superiors who are members of the Committee; that is regarded as disadvantage of a joint meeting. For the next fiscal year, we would like to make revision; making 2 joint meetings and 2 independent meetings (for each organization). Joint meetings with 2 coordinators contribute to proper running of the training. However, it would be better to include volunteer directors as regular members when a meeting takes place on the Miyako Island.

7) Workshops for Improvement of Education and Guidance Ability of the Miyako Training Instructors Team
It was planned that the college holds 2 workshop sessions for ICT. As more people than we had expected applied to the sessions, we organized 3 sessions (on 15th and 29th January and 2nd Fnruary). Most participants were staffs of the prefectural hospital, so that it is necessary to invite a wide range of participants and arrange workshop schedule, contents and methods. Initially, it was planned that the college organizes the workshop for improvement of education ability. However, it was later decided that the workshop is help by multiple organizations. The arrangement of workshop was delayed since it took some time for different parties to arrive at an agreement. For the current fiscal year, it is planned that we limit ourselves just to hold a study group for “Preceptor Educational Method,” that is, only college members provide students with training guidance. 

8) Holding and Publication of Meetings
Meetings for other agendas were held as planned and satisfied their objectives. Regarding publication, several efforts are made; such as cooperation with NHK (TV) for broadcasting and with other universities for observation tour as well as frequent HP updates. Additionally, a report will be compiled by the end of March and widely distributed.

9) Preliminary Research on Applicability of the “On-Site Island Training Model” to Other Islands
Initially, research was planned on Tarama and Hateruma islands for applicability of the model. However, since it was concluded that in order to apply the model to other islands, research and investigation of those islands in the last fiscal year are too late. Therefore, during the current fiscal year, we implemented preliminary research on a half of 12 municipalities on remote islands which are located at southward from the main island and acquired relevant results. In the next fiscal year, another half of the 12 remote islands will be conducted, and we will seek for possibility of application.

3. Report on Program Activites of for the Fiscal Year 2010
1) Planning, Implementation and Evaluation of the Study Program for Island Training Instructors under Collaborative Supervision of the College and the Miyako Prefectural Hospital
Based on the organized framework for development of the Study Program for Island Training Instructors, regular meetings of the “Program Steering Committee” and “Working Group Council” have taken place. The meetings have examined how to improve ability of training instructors. A volume of an information magazine “A MA TSU KI” has been published after every meeting of the Working Group Council; 16 volumes have been published. The magazine has been distributed to all OPCN instructors and posted on hospital wards; intentional information sharing has been conducted.
              For improvement of training instruction ability, it has been recognized that both systematization of training instruction and development of instruction ability are necessary. Consequently, we organized 3 types of workshops: “On Sanctity (Ethics)” for 3 times, “Review of Infection Control” for 3 times, and “Learning How to Let Students Learn” for 4 times. All workshops are completed, and reports of all workshops are being compiled.
              We are compiling the “Guideline for Instruction of Training at the Miyako Prefectural Hospital” and project report which summarize the program accomplishment. Moreover, it is decided that the cooperative project between the college and the Miyako Prefectural Hospital will be developed and implemented in the following years.

2) Mobilization of Resident Volunteer Autonomy for Students’ Learning Support
The resident volunteers (Myaaku Association) autonomously organized regular team leaders’ meetings for supporting students by the home stay, conveyance and lecture volunteer teams, and then contributed to refinement of learning environment. All 73 students who participated the Miyako Island training were supported by resident volunteers.
              We were told by the volunteers that it is significant to participate in the training because “It is fun to interact with students; it was nice meeting with them” “The new roles helped our self development; it was worthwhile” “The training made us realize good aspects of our community; the college and we create the community.” As one of expected outcomes, the project initially expected that the new roles for the residents contribute to their happiness and they are able to be proud of their community. Although the residents’ ways of expression were different from our agenda, it is clear that our expectation was satisfied.

3) Holding and Publication of GP Related Meetings, Meetings of the Committee for the Promotion of Miyako Island Training, Meetings of the Coordinating Council for the Guidance of Miyako Island Training, Coordinators’ Meetings, Evaluation Meetings and Repost Sessions
As for GP related meetings, the meetings of the GP Promotion Committee, the Committee for the Promotion of Miyako Island Training, the Coordinating Council for the Guidance of Miyako Island Training, joint meetings of coordinators and undergraduate GP instructors teams and meetings of the Training Evaluation Working Group were hold almost as they had been planned.
              The Undergraduate GP Report Session – which examines the 3 year project activities – was hold in the Miyako Island (8th January 2011), and 153 people participated in the session. According to the survey result of the participant, it was concluded that the Miyako Island is an excellent training site, the 3 year project activities have contributed to human resource development and also contributed to the Miyako Islands community.
              As for our publicizing activities, our reports were presented at the 5th conference of the Japan Society of Rural and Remote Area Nursing titled “Significance of Residents’ Participation in On-Site Training for Geriatric Health Nursing (first report): in the Case of Elderly ‘Residents’ Volunteers’ in the Miyako Island” “Programme for Nursing Practice Skill Development by Cooperation between the College and the Island Training Site (third report): Cooperative Training Instruction by College Instructors and Training Instructors.” Moreover, the scenes of students’ Miyako training, home stay and the undergraduate GP report session were introduced in a local news paper and “Okinawa Journal Hana (flower) View 2010.8.15.”

4) Promotion of On-Site Training and Education Program
6 subjects are allocated for the “On-Site Island Training Model” training in the Miyako Island. The total of 72 students in the second, third and last year of the college received the training at 8 facilities of public health, medical care and welfare. The Training Evaluation Working Group is conducting evaluation of the students, college instructors (who were in charge of the training), training instructors, leaders of the training facilities and residents’ volunteers.

5) Research and Examination of Applicability of the Model to Other Islands
Research on applicability of the model to other islands was conducted in the last fiscal year. Some issues remain in terms of finding facilities which are willing to accept trainees, but some facilities in small remote islands showed interests in accepting student trainees. For the following years’ revised curriculum (starting in the fiscal year 2011), geriatric health nursing training programmes are planned in the Ishigaki Island (which are similar size to the Miyako Island) as well as the Irabu and Ikema islands (which are smaller than the Miyako Island).

6) Compilation of Overall Evaluation and Final Report of the Program
In terms of the overall evaluation of the project, a draft of final report including a component of self evaluation will be submitted to the External Evaluation Committee meeting, scheduled on the 26th February. The draft will be evaluated by the Committee, and the final report will be compiled by the end of March.