1. Department of Primary Care and Medical Education Institute of Medicine, University of Tsukuba Tsukuba Japan
2. Department of Family Medicine, General Practice and Community Health Institute of Medicine, University of Tsukuba Tsukuba Japan
3. Department of General Medicine Tsukuba Central Hospital Ushiku Japan
4. Medical Education Center, School of Medicine Keio University Tokyo Japan
5. Center for General Medicine Education, School of Medicine Keio University Tokyo Japan