Background In Japan, between 2010 and 2020, there were two post-graduate training curricula for post-graduate medical education, as follows: comprehensive rotation programmes (CRPs), which require rotation in at least seven clinical departments; and limited rotation programmes (LRPs), which require rotation in fewer clinical departments. The curriculum that should be used for standardized Japanese post-graduate training has long been debated. Multiple studies show that post-graduate trainees who trained with CRPs were more satisfied and confident and gained more clinical experience than those who trained with LRPs. However, a comparison of objective measurements of the clinical knowledge of Japanese post-graduate trainees has not been reported. The aim of this study is to objectively measure and compare the clinical knowledge of trainees in CRPs and LRPs using a component of the Professional and Linguistic Assessment Board test (PLAB test). Methods A nationwide cross-sectional study was conducted in February and March 2020. Post-graduate trainees who graduated from medical school were voluntarily recruited from general hospitals in Japan. To objectively measure the trainees’ basic clinical knowledge, the PLAB test was adapted from the UK. The cut-off point was set at 63%, as recommended by the UK General Medical Council. A statistical analysis was conducted to determine whether post-graduate programme differences contributed to the trainees’ test scores. Results Twenty-two facilities volunteered to participate after recruitment, and 97 trainees from 19 facilities participated in the study. Thirty-one participants (32%) were in a CRP, and 66 participants (68%) were in an LRP. According to multiple logistic regression, the adjusted odds ratio of CRP trainees being in the high-scoring group was 5.16 (95% CI: 1.28-20.73, p<0.05). Mean differences in the scores in paediatrics, mental health and neurology were statistically higher among CRP trainees than LRP trainees. Conclusion Post-graduate trainees who were in a CRP had better basic clinical competence knowledge (PLAB test) scores and performed better when tested in a wider range of subspecialties. Not only exam performance but also clinical performance and the longitudinal trend of trainees’ competency in post-graduate medical training should be evaluated in future studies.
Background: Patient-centred healthcare is important, and patient experiences are considered a central pillar of quality in healthcare. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS®) is an instrument used to quantitatively evaluate patient perspectives. This study's objective was to conduct the translation and adaptation of the HCAHPS® into Japanese and to determine the validity and reliability of the translated version.Methods: We translated the original English HCAPHS® into Japanese based on standardized guidelines. The content validity was assessed by an expert panel of eight members and 12 discharged patients. The discharged patients assessed the face validity. We assessed the average of all raters’ evaluations at the item level (I-CVI and I-FVI) and the scale level (S-CVI and S-FVI). We evaluated each item and the entire questionnaire, with cut-off points of 0.78 for the I-CVI and I-FVI and 0.9 for the S-CVI and S-FVI.Results: Regarding the content validity, the S-CVI was 0.99, and the I-CVIs for the individual items ranged from 0.95 to 1.0. Regarding the face validity, the I-FVIs of all items except for Q26 were 0.78 or higher. The S-FVIs were 0.96 for clarity and 0.98 for comprehension. The expert panel reviewed the translated Japanese version of the HCAHPS and modified it based on the patient raters' feedback.Conclusions: The translated HCAHPS® content is well adapted to the local context. Until now, there has been no standard instrument to measure the perspectives of hospitalized patients in Japan. The translated HCAHPS® is expected to have utility for measuring the quality of health indicators.Trial registration:No applicable.
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