The Contribution of Citizens to Community-Based Medical Education in Japan: A Systematic Review

2021

Healthcare

Self Cite

Although the demand for general physicians has increased in Japan because of its aging population, medical universities primarily provide organ-based education; thus, medical students do not receive sufficient general medical education. The number of residents focusing on general medicine remains low; therefore, to understand the present situation regarding general medicine education, we attempted to clarify the views of medical students and the factors influencing them. In this qualitative study, semi-structured interviews were conducted in 12 medical students at Shimane University, and the results were analyzed through thematic analysis. The results indicated the emergence of three themes and 14 concepts. The three overarching themes were as follows: hopes for the field of general medicine, gaps between ideal and reality of general medicine, and factors affecting students’ motivation for specialization in general medicine. Medical students had a positive impression of general medicine and believed that it has potential for further development; however, they felt a gap between their ideals and reality (i.e., unclear expertise). Factors creating this gap included poorly developed education and medical policies. We need to restructure general medicine education based on the participants’ perceptions by establishing collaborative curricula between universities and community hospitals and by increasing students’ exposure to general medicine.

Section: Discussionmentioning

confidence: 48%

The Perception of Rural Medical Students Regarding the Future of General Medicine: A Thematic Analysis

Nishikawa

Ohta²,

2021

Healthcare

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“…The involvement of not only nurses and medical teachers but also social workers and therapists in educational processes can be effective if their specialties are respected [ 13 , 49 , 50 ]. In addition, other people in communities can be involved in education, which can be effective in rural medical education [ 51 , 52 , 53 ]. Their involvement can create opportunities to better understand the community, leading to respect for health conditions and, ultimately, to better healthcare in rural areas [ 51 , 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Nurses’ Contributions in Rural Family Medicine Education: A Mixed-Method Approach

Ohta¹,

Maejma²,

2022

IJERPH

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Family medicine residents frequently collaborate with nurses regarding clinical decisions and treatments, which contributes to their education. In rural areas, these residents experience a wider scope of practice by collaborating with nurses. However, nurses’ contributions to rural family medicine education have not been clarified. This study measured the contributions of 88 rural community hospital nurses to family medicine education using a quantitative questionnaire and interviews. The interviews were recorded, transcribed verbatim, and analyzed using the grounded theory approach. Nurses’ average clinical experience was 20.16 years. Nurses’ contributions to the roles of teacher and provider of emotional support were statistically lower among participants working in acute care wards than those working in chronic care wards (p = 0.024 and 0.047, respectively). The qualitative analysis indicated that rural nurses’ contributions to family medicine education focused on professionalism, interprofessional collaboration, and respect for nurses’ working culture and competence. Additionally, nurses struggled to educate medical residents amid their busy routine; this education should be supported by other professionals. Rural family medicine education should incorporate clinical nurses as educators for professionalism and interprofessional collaboration and as facilitators of residents’ transition to new workplaces. Subsequently, other professionals should be more actively involved in improving education quality.

“…Furthermore, improved interprofessional collaboration and the establishment of an educational culture could drive family medicine education in rural contexts [ 46 , 47 ]. Enriching educational environments and the commitment of various professionals, including citizens and patients, are critical for the continuity and improvement of family medicine education [ 48 ]. This result represents one of the exemplary processes of the implementation of family medicine education in typical rural community hospitals.…”

Section: Discussionmentioning

confidence: 99%

Family Medicine Education at a Rural Hospital in Japan: Impact on Institution and Trainees

Ohta¹,

Ryu²,

2021

IJERPH

Self Cite

Family medicine is vital in Japan as its society ages, especially in rural areas. However, the implementation of family medicine educational systems has an impact on medical institutions and requires effective communication with stakeholders. This research—based on a mixed-method study—clarifies the changes in a rural hospital and its medical trainees achieved by implementing the family medicine educational curriculum. The quantitative aspect measured the scope of practice and the change in the clinical performance of family medicine trainees through their experience of cases—categorized according to the 10th revision of the International Statistical Classification of Disease and Related Health Problems. During the one-year training program, the trainees’ scope of practice expanded significantly in both outpatient and inpatient departments. The qualitative aspect used the grounded theory approach—observations, a focus group, and one-on-one interviews. Three themes emerged during the analysis—conflicts with the past, driving unlearning, and organizational change. Implementing family medicine education in rural community hospitals can improve trainees’ experiences as family physicians. To ensure the continuity of family medicine education, and to overcome conflicts caused by system and culture changes, methods for the moderation of conflicts and effective unlearning should be promoted in community hospitals.