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2.
BMC Med Educ ; 21(1): 415, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344354

RESUMO

BACKGROUND: Patient care ownership (PCO) is an essential component in medical professionalism and is crucial for delivering high-quality care. The 15-item PCO Scale (PCOS) is a validated questionnaire for quantifying PCO in residents; however, no corresponding tool for assessing PCO in Japan exists. This study aimed to develop a Japanese version of the PCOS (J-PCOS) and validate it among Japanese medical trainees. METHODS: We performed a multicenter cross-sectional survey to test the validity and reliability of the J-PCOS. The study sample was trainees of postgraduate years 1-5 in Japan. The participants completed the J-PCOS questionnaire. Construct validity was assessed through exploratory and confirmatory factor analyses. Internal consistency reliability was examined by calculating Cronbach's alpha coefficients and inter-item correlations. RESULTS: During the survey period, 437 trainees at 48 hospitals completed the questionnaire. Exploratory factor analysis of the J-PCOS extracted four factors: assertiveness, sense of ownership, diligence, and being the "go-to" person. The second factor had not been identified in the original PCOS, which may be related to a unique cultural feature of Japan, namely, a historical code of personal conduct. Confirmatory factor analysis supported this four-factor model, revealing good model fit indices. The analysis results of Cronbach's alpha coefficients and inter-item correlations indicated adequate internal consistency reliability. CONCLUSIONS: We developed the J-PCOS and examined its validity and reliability. This tool can be used in studies on postgraduate medical education. Further studies should confirm its robustness and usefulness for improving PCO.


Assuntos
Propriedade , Tradução , Estudos Transversais , Humanos , Japão , Assistência ao Paciente , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
3.
PLoS One ; 16(2): e0246518, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33566830

RESUMO

PURPOSE: Shared decision-making (SDM) has only lately begun attaining recognition from the Japanese medical community. The purpose of this study was to create a Japanese version of the SDM-Q-Doc, which is a scale that measures SDM from the perspective of physicians, and to clarify its psychometric characteristics and identify the issues and factors that affect SDM. METHODS: The participants were 23 physicians and 130 patients who visited primary care clinics in Japan for the first time. Immediately following physician-patient interviews, the Japanese version of SDM-Q-9 and SDM-Q-Doc were administered to patients and physicians, respectively. For convergent validity, physician confidence in the medical interview (PCMI) was used. After the determination of internal consistency and validity of the SDM-Q-Doc, the relations among each item of SDM-Q-Doc, SDM-Q-9, physicians' sociodemographic attributes, and a presence or absence of nurse's attendance during outpatient consultation were assessed by a multiple regression analysis and structural equation modeling (SEM). RESULTS: A factor analysis confirmed that the Japanese version of the SDM-Q-Doc displays a one-factor structure with a high internal consistency (Cronbach's α = 0.87, ω = 0.88). The correlation between the PCMI and SDM-Q-Doc confirmed an appropriate convergent validity (r = 0.406; p < 0.001). Multiple regression analyses showed that the attendance of a nurse during consultation significantly affected one item of the SDM-Q-Doc, which in turn affected one item of the SDM-Q-9. SEM showed a good fit of model for these three items. CONCLUSION: The Japanese version of the SDM-Q-Doc's internal consistency and validity in the outpatient medical consultations in Japan were confirmed. Further, this study suggests the role of a nurse's attendance during a physician-patient consultation on facilitating the SDM. Further, using the Japanese version of the SDM-Q-Doc will promote communication skills training for medical professionals by checking the quality of SDM.


Assuntos
Tomada de Decisão Compartilhada , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Médicos/psicologia , Psicometria , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
4.
BMC Med Educ ; 21(1): 85, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33531010

RESUMO

CONTEXT: The Japan Residency Matching Program (JRMP) launched in 2003 and is now a significant event for graduating medical students and postgraduate residency hospitals. The environment surrounding JRMP changed due to Japanese health policy, resulting in an increase in the number of unsuccessfully-matched students in the JRMP. Beyond policy issues, we suspected there were also common characteristics among the students who do not get a match with residency hospitals. METHODS: In total 237 out of 321 students at The University of Tokyo Faculty of Medicine graduates from 2018 to 2020 participated in the study. The students answered to the questionnaire and gave written consent for using their personal information including the JRMP placement, scores of the pre-clinical clerkship (CC) Objective Structured Clinical Examinations (OSCE), the Computer-Based Test (CBT), the National Board Examination (NBE), and domestic scores for this study. The collected data were statistically analyzed. RESULTS: The JRMP placements were correlated with some of the pre-CC OSCE factors/stations and/or total scores/global scores. Above all, the result of neurological examination station had most significant correlation between the JRMP placements. On the other hand, the CBT result had no correlation with the JRMP results. The CBT results had significant correlation between the NBE results. CONCLUSIONS: Our data suggest that the pre-clinical clerkship OSCE score and the CBT score, both undertaken before the clinical clerkship, predict important outcomes including the JRMP and the NBE. These results also suggest that the educational resources should be intensively put on those who did not make good scores in the pre-clinical clerkship OSCE and the CBT to avoid the failure in the JRMP and the NBE.


Assuntos
Estágio Clínico , Internato e Residência , Competência Clínica , Computadores , Avaliação Educacional , Humanos , Japão
5.
JMA J ; 3(3): 208-215, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-33150255

RESUMO

Introduction: This study aimed to verify the internal consistency and validity of the Japanese version of the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) and investigate the association among patient factors, shared decision-making experienced by patients, and patients' decision conflict during the treatment decision process in primary outpatient settings in Japan. Methods: Patients who visited a primary care outpatient unit for the first time and completed the Japanese version of SDM-Q-9 and the Decisional Conflict Scale (DCS) immediately after consultation were included. The internal consistency of SDM-Q-9 was assessed using Cronbach's alpha coefficient. Factor analysis and structural equation modeling were used to investigate structural construct validity. The relationship among patient-perceived experiences of shared decision-making, decision conflict, and patient factors was evaluated using correlation analysis. Results: A total of 131 patients with chronic diseases (55.0% females, 28.2% aged ≥ 70 years) were included in this analysis. Cronbach's alpha for the Japanese version of SDM-Q-9 was 0.917, indicating a high degree of internal consistency. Confirmatory factor analysis indicated that the Japanese version of SDM-Q-9 had a one-factor structure. Spearman's rank correlation analysis indicated that the correlation between SDM-Q-9 and DCS was -0.577 (p < 0.05), indicating a significant inverse correlation and convergent validity. Older age was positively associated with perceived support of the physician in understanding all information. Conclusions: We confirmed that the Japanese version of SDM-Q-9 was both reliable and valid for use in Japanese primary care settings. In addition, we found a clear association between shared decision-making and decisional conflict of patients.

6.
BMJ Open ; 10(9): e034848, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973051

RESUMO

OBJECTIVES: We explored Japanese physicians' work-related stressors and identified those unique to this population, as well as clarified the influence of cultural and medical system diversity on these stressors to determine the content of future stress-reducing interventions for hospital physicians in Japan. DESIGN: We conducted a semistructured, face-to-face interview-based qualitative study between August and October 2017. The collected data were analysed using the grounded theory approach. SETTING: Hospitals around the Tokyo metropolitan area, Japan. PARTICIPANTS: Sixteen hospital physicians (mean age (SD)=33.9 (4.2) years; 11 men, 5 women). Seven worked in internal medicine and nine in surgery. RESULTS: We found unique stressors related to the Japanese medical system and culture, such as continuous all-day work after night shifts, and a hierarchical organisational system called Ikyoku. The results also indicated that Japanese physicians shared several stressors with Western physicians, such as sleep deprivation, high pressure and the limits of medicine. CONCLUSIONS: Our study clarifies some sources of work-related stressors among hospital physicians in Japan. While the key components of Western interventions might be useful in a Japanese context, the original evidence obtained from this study highlights the necessity of initiating interventions addressing the unique stressors of Japanese physicians. To reduce physicians' stress and enhance their well-being, psychological interventions for hospital physicians must be introduced in Japan.


Assuntos
Médicos , Adulto , Feminino , Hospitais , Humanos , Japão , Masculino , Pesquisa Qualitativa , Tóquio
7.
BMJ Open ; 10(8): e039944, 2020 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-32801209

RESUMO

OBJECTIVES: Globalisation has given medical university students the opportunity to pursue international electives in other countries, enhancing the long-term socialisation of medical professionals. This study identified the long-term effects of international electives on the professional identity formation of medical students. DESIGN: This is a qualitative study. SETTING: The authors interviewed Japanese medical professionals who had completed their international electives more than 10 years ago, and analysed and interpreted the data using a social constructivism paradigm. PARTICIPANTS: A total of 23 medical professionals (mean age 36.4 years; range 33-42 years) participated in face-to-face, semistructured in-depth interviews. RESULTS: During the data analysis, 36 themes related to professional identity formation were identified, and the resulting themes had five primary factors (perspective transformation, career design, self-development, diversity of values and leadership). It was concluded that international electives for medical students could promote reflective self-relativisation and contribute to medical professional identity formation. Additionally, such electives can encourage pursuing a specialisation and academic or non-academic work abroad. International electives for medical students could contribute to medical professional identity formation on the basis of cross-cultural understanding. CONCLUSIONS: This study addressed a number of issues regarding the long-term impact of international elective experiences in various countries on the professional identity formation of Japanese medical professionals. This study offers some guidance to mentors conducting international electives and provides useful information for professional identity formation development in medical professionals.


Assuntos
Internacionalidade , Identificação Social , Estudantes de Medicina , Adulto , Feminino , Saúde Global , Humanos , Masculino , Pesquisa Qualitativa
8.
BMC Health Serv Res ; 20(1): 752, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32799898

RESUMO

BACKGROUND: Japan faces the most elderly society in the world, and the Japanese government has launched an unprecedented health plan to reinforce home care medicine and increase the number of home care physicians, which means that an understanding of future needs for geriatric home care is vital. However, little is known about the future need for home care physicians. We attempted to estimate the basic need for home care physicians from 2020 to 2060. METHODS: Our estimation is based on modification of major health work force analysis methods using previously reported official data. Two models were developed to estimate the necessary number of full-time equivalent (FTE) home care physicians: one based on home care patient mortality, the other using physician-to-patient ratio, working with estimated numbers of home and nursing home deaths from 2020 to 2060. Moreover, the final process considered and adjusted for future changes in the proportion of patients dying at home. Lastly, we converted estimated FTE physicians to an estimated head count. RESULTS: Results were concordant between our two models. In every instance, there was overlap of high- and low-estimations between the mortality method and the physician-to-patient method, and the estimates show highly similar patterns. Furthermore, our estimation is supported by the current number of physicians, which was calculated using a different method. Approximately 1.7 times (1.6 by head count) the current number of FTE home care physicians will be needed in Japan in the late 2030's, peaking at 33,500 FTE (71,500 head count). However, the need for home care physicians is anticipated to begin decreasing by 2040. CONCLUSION: The results indicate that the importance of home care physicians will rise with the growing elderly population, and that improvements in home care could partially suppress future need for physicians. After the late 2030's, the supply can be reduced gradually, accounting for the decreasing total number of deaths after 2040. In order to provide sufficient home care and terminal care at home, increasing the number of home care physicians is indispensable. However, the unregulated supply of home care physicians will require careful attention in the future.


Assuntos
Necessidades e Demandas de Serviços de Saúde/tendências , Serviços de Assistência Domiciliar/organização & administração , Médicos/provisão & distribuição , Idoso , Previsões , Serviços de Assistência Domiciliar/tendências , Humanos , Japão
9.
Artigo em Inglês | MEDLINE | ID: mdl-32486372

RESUMO

The objective of this study was to assess the impact of a 2010 community-based participatory research (CBPR) reporting guideline on the quality of reporting a CBPR on smoking cessation. We searched the MEDLINE, Embase, the Cochrane Central Register for Controlled Trials (CENTRAL), PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases and included articles published up to December 2019 (PROSPERO: CRD42019111668). We assessed reporting quality using the 13-item checklist. Of the 80 articles identified, 42 (53%) were published after 2010. The overall reporting quality before and after 2010 was poor and did not differ significantly (mean difference: 0.66, 95% confidence interval [CI]: -0.21 to 1.53). The total reporting scores of the studies did not differ significantly according to the effect size of the intervention (beta coefficient: -2.86, 95% CI: -5.77 to 0.04). This study demonstrates the need to improve the quality of reporting CBPRs. We recommend that journal editors endorse the CBPR reporting guideline to encourage its use by more researchers.


Assuntos
Pesquisa Participativa Baseada na Comunidade , Publicações , Abandono do Hábito de Fumar , Envio de Mensagens de Texto , Lista de Checagem , Humanos
10.
BMJ Open ; 9(7): e027969, 2019 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-31272978

RESUMO

OBJECTIVES: Globalisation has increased the opportunities for health professionals working in developed countries to provide clinical and educational support in developing countries. However, how these experiences contribute to the leadership competency of health professionals is unclear; therefore, this study explored this with the objective of analysing the process of developing individual leadership competency. DESIGN: This is a qualitative descriptive study. Qualitative descriptive study is widely used in healthcare research, particularly to describe the nature of various healthcare phenomena. Qualitative descriptive data were collected in face-to-face, semistructured interviews. SETTING: The authors interviewed Japanese health professionals who participated in an international medical cooperation project as part of a multinational medical team between July 2017 and March 2018, and analysed and interpreted the data using a social constructivism paradigm. PARTICIPANTS: The authors interviewed 20 research participants, including 5 nurses, 5 dentists and 10 physicians with an average of 15.3 years of clinical experience. RESULTS: The interviews identified 58 emergent themes related to their leadership competency, 23 of which affected the actual medical care in their own institutions. The authors categorised the 58 emergent themes into seven competency areas: leadership concepts, teambuilding, direction setting, communication, business skills, working with others and self-development. The authors identified the relationships among each competency and identified differences between professions: nurses particularly reflected on their empathic attitudes towards patient after global clinical health experience; dentists tended to reflect on their business skills; physicians tended to reflect on their leadership concepts and teambuilding. CONCLUSIONS: This study clarified the leadership competency gained through short-term global clinical health experience and the process of individual leadership competency development. The findings provide expected learning competency for those considering medical practice in developing or other countries in the future.


Assuntos
Competência Clínica , Pessoal de Saúde , Cooperação Internacional , Liderança , Adulto , Feminino , Saúde Global , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
11.
Educ Prim Care ; 30(5): 282-288, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31185822

RESUMO

A few studies have analysed the experiences of junior residents during the initial stages of their clinical training at community-based medical institutions for gaining initial experience as doctors using an associated learning theory framework. In this study, we investigated this learning process using an experiential learning model. The survey was administered through interviews and a written questionnaire to 10 junior residents involved in the initial postgraduate clinical training at two clinics in Tokyo operated by family physicians. The interview data were analysed qualitatively, whereas the results of the questionnaire, which included an experiential learning scale, were analysed quantitatively. In the qualitative analysis, 59 themes were identified and classified into reflective observation, abstract conceptualisation, and active experimentation, as featured in the experiential learning cycle. The average scores for experiential learning before and after training at a community-based medical institution, as measured based on the experiential learning scale, exhibited a significant increase after the training. Experiential learning of junior residents was observed in various situations during their training period at a community-based medical institution, where active experimentation was the most commonly observed form of experiential learning.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Medicina de Família e Comunidade/educação , Internato e Residência/organização & administração , Centros Comunitários de Saúde , Feminino , Humanos , Internato e Residência/métodos , Japão , Aprendizagem , Masculino , Inquéritos e Questionários
12.
Patient Educ Couns ; 102(2): 301-308, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30245099

RESUMO

OBJECTIVE: Communication and interpersonal skills (CIS) are essential elements of competency-based education. We examined defensible CIS passing levels for medical students completing basic sciences (second-year students) and clinical training (fourth-year students), using five standard setting methods. METHODS: A 14-item CIS scale was used. Data from second-year (n = 190) and fourth-year (n = 170) students were analyzed using descriptive statistics and generalizability studies. Fifteen judges defined borderline CIS performance. Cut scores and fail rates from five standard setting methods (Angoff, Borderline-Group, Borderline-Regression, Contrasting-Groups, and Normative methods) were examined. RESULTS: CIS performance was similar during second-year (Mean = 74%, SD = 6%) and fourth-year (Mean = 72%, SD = 5%) students. Judges using the Angoff method expected greater competence at the fourth-year level, as reflected in the Angoff cut scores (second-year = 53% with 0% fail, fourth-year = 66% with 10% fail). Cut scores from the remaining methods did not differentiate between training levels. We found evidence of case specificity. CONCLUSION: Performance on CIS may be case specific. Passing standards for communication skills may require employing approaches such as the Angoff method that are sensitive to expectations of learner performance for different levels of training, competencies, and milestone levels. PRACTICE IMPLICATIONS: Institutions that want to encourage continued growth in CIS should apply appropriate standard setting methods.


Assuntos
Competência Clínica/normas , Comunicação , Educação Baseada em Competências , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/normas , Avaliação Educacional/métodos , Habilidades Sociais , Estudantes de Medicina/psicologia , Adulto , Competência Clínica/estatística & dados numéricos , Avaliação Educacional/normas , Feminino , Humanos , Masculino , Estudantes de Medicina/estatística & dados numéricos , Adulto Jovem
13.
BMC Fam Pract ; 19(1): 186, 2018 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-30497398

RESUMO

BACKGROUND: The medical practice of general practitioners/family physicians in urban areas differs from that in rural areas, accounting for the difference in specific competencies. However, variations in competencies in community healthcare required for general practitioners/family physicians in urban areas compared with those in rural areas have not yet been fully clarified. Thus, this study aimed to elucidate the competencies required for general practitioners/family physicians, especially in those characteristic to urban areas, and compare them with those in non-urban/rural areas. METHODS: A qualitative study with individual interviews and qualitative data analysis was conducted. Participants were selected by purposive sampling, and 10 general practitioners/family physicians with clinical experience of ≥7 y after graduation and ≥ 1 y in both urban and non-urban (rural) areas in Japan were recruited. Additionally, semi-structured individual interviews in a private room around the workplace of the interviewee between September 2014 and September 2016 were conducted. For data collection, interview transcripts were analyzed according to the "Steps for Coding and Theorization" method, a sequential and thematic qualitative data analysis technique and data analysis since March 2018. RESULTS: We interviewed 10 general practitioners/family physicians of Japan and extracted 10 themes as competencies characteristic to general practitioners/family physicians in urban areas. In addition to the known competencies on urban underserved care, we newly clarified the competencies of the ability to integrate divided care and ability to coordinate and collaborate with various medical care and welfare professionals in urban areas. CONCLUSION: This study was one of the few studies describing the characteristic competencies of urban general practitioners. In summary, a competency necessary for general practitioners in urban areas is to understand the urban context and provide contextual care suitable for urban areas. In the modern age, where urban population concentration is progressing and the interest in urban health is rising, our study will give certain suggestions for primary care education and practice necessary for urban areas.


Assuntos
Competência Clínica , Serviços de Saúde Comunitária/organização & administração , Clínicos Gerais/normas , Médicos de Família/normas , Pesquisa Qualitativa , População Rural , População Urbana , Adulto , Feminino , Humanos , Japão , Masculino , Atenção Primária à Saúde/normas , Estudos Retrospectivos
14.
J Rural Med ; 13(1): 11-17, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29875892

RESUMO

Objective: Community-based medical education (CBME) serves as a complement to university medical education, and it is practiced in several urban undergraduate and postgraduate curriculums. However, there are few reports on CBME learning content in rural Japanese settings. Materials and Methods: This research aimed to clarify learning content through semi-structured interviews and qualitative analysis of second-year residents who studied on a remote, rural island located 400 km from the mainland of Okinawa, Japan. Analysis was based on Steps for Coding and Theorization (SCAT). Results: Fifteen concepts were extracted, and four categories were generated: a strong connection among the islanders, the necessary abilities for rural physicians, islander-centered care, and the differences between rural and hospital medicine. In contrast to hospital medicine, various kinds of learning occurred in deep relationships with the islanders. Conclusion: Through CBME on a remote island, the residents learned not only about medical aspects, but also the importance of community health through the social and cultural aspects, whole-person medical care in a remote location, and the importance of reflection in their self-directed learning.

15.
Perspect Med Educ ; 7(4): 264-271, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29671134

RESUMO

INTRODUCTION: Medical and healthcare professionals' empathy for patients is crucially important for patient care. Some studies have suggested that a significant decline in empathy occurs during clinical training years in medical school as documented by self-assessed empathy scales. Moreover, a recent study provided qualitative evidence that communication skills training in an examination context, such as in an objective structured clinical examination, might stimulate perspective taking but inhibit the development of compassionate care. Therefore, the current study examined how perspective taking and compassionate care relate to medical students' willingness to show empathic behaviour and how these relations may change with communication skills training. METHODS: A total of 295 fourth-year Japanese medical students from three universities completed the Jefferson Empathy Scale and a newly developed set of items on willingness to show empathic behaviour twice after communication skills training, pertaining to post-training and retrospectively for pre-training. RESULTS: The findings indicate that students' willingness to show empathic behaviour is much more correlated with perspective taking than with compassionate care. Qualitative descriptive analysis of open-ended question responses revealed a difficulty of feeling compassion despite showing empathic behaviour. DISCUSSION: These findings shed light on the conceptual structure of empathy among medical students and generate a number of hypotheses for future intervention and longitudinal studies on the relation between communication skills training and empathy.


Assuntos
Comunicação , Empatia , Estudantes de Medicina/psicologia , Ensino/psicologia , Educação de Graduação em Medicina/métodos , Humanos , Japão , Relações Médico-Paciente , Pesquisa Qualitativa , Inquéritos e Questionários , Ensino/normas , Universidades/organização & administração
16.
BMC Med Educ ; 18(1): 20, 2018 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-29370796

RESUMO

BACKGROUND: Patient-centered care has been one of the most frequently discussed principles in medical practice. However, there is a serious concern that the patient-centered attitudes of physicians diminish over the course of their medical education. This longitudinal study examined changes in resident physicians' patient-centered attitudes and their confidence in communicating with patients, and explored the relationship between the two traits. METHODS: The study participants were resident physicians at a university hospital in Tokyo. Participants' patient-centered attitudes (as measured by the Patient-Practitioner Orientation Scale [PPOS]), and their confidence in communicating with patients (as per the Physician Confidence in the Medical Interview scale: [PCMI]) were assessed through self-reported questionnaires completed at the beginning of residency (n = 204) and again at the end of the first year (n = 95). RESULTS: PPOS scores declined significantly during the year, both in terms of attitude toward sharing information and decision-making with patients, and attitude of caring for patients' expectations and emotions. The shift in caring attitude differed significantly by gender. The increase in PCMI score was greater for those with a smaller decrease in PPOS score. CONCLUSIONS: As seen in previous studies of medical students, resident physicians' patient-centered attitudes declined during their first year of residency, while there may be a gender-based difference within the shift. The increase in physicians' confidence in communicating with patients was greater for those who showed a smaller decline in patient-centered attitude. Additional studies are needed to detail the changes in physicians' attitudes, confidence, and communication skills over the course of their medical training, and to develop systematic assessment and training programs.


Assuntos
Assistência Centrada no Paciente , Médicos , Estudantes de Medicina , Adulto , Atitude do Pessoal de Saúde , Empatia , Feminino , Humanos , Internato e Residência , Estudos Longitudinais , Masculino , Relações Médico-Paciente , Médicos/psicologia , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Fatores de Tempo , Tóquio , Adulto Jovem
17.
Am J Med Sci ; 354(6): 597-602, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29208257

RESUMO

BACKGROUND: Faculty development programs, studied both home and abroad, have been shown to be helpful for enhancing the scholarly and academic work of nonacademic clinicians. Interprofessional education and faculty development efforts have been less well studied. This project investigated the effect of a well-studied faculty development program applied in an interprofessional fashion across health profession educators in medicine and nursing. METHODS: A faculty cohort of nurse and physician educators at The University of Tokyo underwent training in the Stanford Faculty Development Center (SFDC) model of clinical teaching through a sequence of 7 workshops. The workshops were performed in English with all materials translated into Japanese. A validated, retrospective pretest and posttest instrument was used to measure study outcomes on global assessment of teaching abilities and specific teaching behaviors (STBs) at 1 and 12 months after intervention. Successful completion of Commitment to Change statements were also assessed at 12 months. RESULTS: In total, 19 faculty participants completed the study. All participants found the workshops valuable. For global assessment, significant improvement in self-reported teaching abilities was seen comparing the mean pretest scores of 27.26 (maximum score = 55, standard deviation [SD] = 8.61) with mean scores at both 1 month (36.81, SD = 7.48, P < 0.001) and at 1 year (34.67, SD = 7.32, P < 0.001). For STBs, significant improvement was also seen comparing the mean group pretest score of 82.11 (maximum score = 145, SD = 15.72), to the posttest mean score of 111.11 (SD = 14.48, P < 0.001) and the 1-year mean score of 103.76 (SD = 12.87, P < 0.001). In total, 27/42 Commitment to Change statements were successfully completed at 1 year. CONCLUSIONS: Faculty development for improving clinical teaching can be performed across the cultures of medicine and nursing, as well as across the cultures of the United States and Japan.


Assuntos
Competência Cultural/educação , Educação/métodos , Docentes de Medicina/educação , Docentes de Enfermagem/educação , Adulto , Avaliação Educacional , Feminino , Humanos , Relações Interprofissionais , Japão , Masculino , Ensino
18.
BMC Med Educ ; 17(1): 34, 2017 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-28178986

RESUMO

BACKGROUND: Sharing information is crucial for discussion of problems and treatment decision making by patients and physicians. However, the focus of communication skills training in undergraduate medical education has been on building the relationship and gathering information; thus, resident physicians tend to be less confident about sharing information and planning treatment. This study evaluated the medical interviews conducted by resident physicians with a focus on information giving, and investigated its relationships with their confidence in communication and simulated patient (SP) satisfaction. METHODS: Among 137 junior resident physicians at a university hospital in Japan who participated in a survey of communication skills, 25 volunteered to conduct simulated medical interviews. The medical interviews were video-recorded and analyzed using the Roter Interaction Analysis System, together with additional coding to explore specific features of information giving. The SPs evaluated their satisfaction with the medical interview. RESULTS: Resident physicians who were more confident in their communication skills provided more information to the patients, while SP satisfaction was associated only with patient-prompted information giving. SPs were more satisfied when the physicians explained the rationales for their opinions and recommendations. CONCLUSION: Our findings underscore the importance of providing relevant information in response to the patient requests, and explaining the rationales for the opinions and recommendations. Further investigation is needed to clinically confirm our findings and develop an appropriate communication skills training program.


Assuntos
Educação de Pós-Graduação em Medicina/normas , Disseminação de Informação , Internato e Residência/normas , Corpo Clínico Hospitalar/psicologia , Satisfação do Paciente , Assistência Centrada no Paciente/normas , Relações Médico-Paciente , Adulto , Comunicação , Educação de Pós-Graduação em Medicina/métodos , Feminino , Hospitais Universitários , Humanos , Internato e Residência/métodos , Japão , Masculino , Anamnese/métodos , Anamnese/normas , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/normas , Simulação de Paciente , Assistência Centrada no Paciente/métodos , Autoimagem , Adulto Jovem
20.
Yakugaku Zasshi ; 135(1): 109-15, 2015.
Artigo em Japonês | MEDLINE | ID: mdl-25743907

RESUMO

Interprofessional work (IPW) is increasingly important in various settings including primary care, in which the role of pharmacists is particularly important. Many studies have shown that in cases of hypertension, diabetes, dyslipidemia, and metabolic syndrome, physician-pharmacist collaboration can improve medication adherence and help to identify drug-related problems. Some surveys and qualitative studies revealed barriers and key factors for effective physician-pharmacist collaboration, including trustworthiness and role clarification. In Japan, some cases of good collaborative work between pharmacists and physicians in hospitals and primary care settings have been reported. Still, community pharmacists in particular have difficulties collaborating with primary care doctors because they have insufficient medical information about patients, they feel hesitant about contacting physicians, and they usually communicate by phone or fax rather than face to face. Essential competencies for good interprofessional collaboration have been proposed by the Canadian Interprofessional Health Collaborative (CIHC): interprofessional communication; patient/client/family/community-centered care; role clarification; team functioning; collaborative leadership; and interprofessional conflict resolution. Our interprofessional education (IPE) team regularly offers educational programs to help health professionals learn interprofessional collaboration skills. We expect many pharmacists to learn those skills and actively to facilitate interprofessional collaboration.


Assuntos
Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Serviços Comunitários de Farmácia , Papel Profissional
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