Skip to main content
Top
Published in: Asia Pacific Family Medicine 1/2014

Open Access 01-12-2014 | Research

What primary care physician teachers need to sustain community based education in Japan

Authors: Manabu Murakami, Hidenobu Kawabata, Masaji Maezawa

Published in: Asia Pacific Family Medicine | Issue 1/2014

Login to get access

Abstract

Background

Community based education (CBE), defined as “a means of achieving educational relevance to community needs and, consequently, of implementing a community oriented educational program,” is reported to be useful for producing rural physicians in Western countries. However, why some physicians withdraw from their teaching roles is not well known, especially in Asian countries. The aim of this study was to clarify the requisites and obstacles for taking part in CBE.

Methods

We combined two steps: preliminary semi-structured interviews followed by workshop discussions. First of all, we interviewed four designated physicians (all male, mean age 48 years) working in one rural area of Japan, with less than 10,000 residents. Secondly, we held a workshop at the academic conference of the Japan Primary Care Association. Fourteen participants attending the workshop (seven male physicians, mean age 45 years, and seven medical students (one female and six male), mean age 24 years) were divided into two groups and their opinions were summarized.

Results

In the first stage, we extracted three common needs from interviewees; 1. Sustained significant human relationships; 2. Intrinsic motivation; and 3. Tangible rewards. In the second stage, we summarized three major problems from three different standpoints; A. Preceptors’ issues: more educational knowledge or skills, B. Learner issues: role models in rural areas, and C. System issues: supportive educational system for raising rural physicians.

Conclusions

Our research findings revealed that community physicians require non-monetary support or intrinsic motivation for their CBE activities, which is in accordance with previous Western studies. In addition, we found that system support, as well as personal support, is required. Complementary questionnaire surveys in other Asian countries will be needed to validate our results.
Appendix
Available only for authorised users
Literature
1.
go back to reference Community-based education of health personnel: Report of a WHO study group. World Health Organ Tech Rep Ser 1987, 746: 1–89. Community-based education of health personnel: Report of a WHO study group. World Health Organ Tech Rep Ser 1987, 746: 1–89.
2.
go back to reference Murakami M, Kawabata H, Maezawa M: What rural physicians need to engage in community based education: a qualitative interview survey. J Rural Med 2012, 7: 38–41. 10.2185/jrm.7.38PubMedCentralCrossRefPubMed Murakami M, Kawabata H, Maezawa M: What rural physicians need to engage in community based education: a qualitative interview survey. J Rural Med 2012, 7: 38–41. 10.2185/jrm.7.38PubMedCentralCrossRefPubMed
3.
go back to reference Dornan T, Littlewood S, Margolis SA, Scherpbier A, Spencer J, Ypinazar V: How can experience in clinical and community settings contribute to early medical education? A BEME systematic review. Med Teach 2006, 28: 3–18. 10.1080/01421590500410971CrossRefPubMed Dornan T, Littlewood S, Margolis SA, Scherpbier A, Spencer J, Ypinazar V: How can experience in clinical and community settings contribute to early medical education? A BEME systematic review. Med Teach 2006, 28: 3–18. 10.1080/01421590500410971CrossRefPubMed
4.
go back to reference Single PB, Jaffe A, Schwartz R: Evaluating programs for recruiting and retaining community faculty. Fam Med 1999, 31: 114–121.PubMed Single PB, Jaffe A, Schwartz R: Evaluating programs for recruiting and retaining community faculty. Fam Med 1999, 31: 114–121.PubMed
5.
go back to reference Ranmuthugala G, Humphreys J, Solarsh B, Walters L, Worley P, Wakerman J, Dunbar JA, Solarsh G: Where is the evidence that rural exposure increases uptake of rural medical practice? Aust J Rural Health 2007, 15: 285–288. 10.1111/j.1440-1584.2007.00915.xCrossRefPubMed Ranmuthugala G, Humphreys J, Solarsh B, Walters L, Worley P, Wakerman J, Dunbar JA, Solarsh G: Where is the evidence that rural exposure increases uptake of rural medical practice? Aust J Rural Health 2007, 15: 285–288. 10.1111/j.1440-1584.2007.00915.xCrossRefPubMed
6.
go back to reference Rooks L, Watson RT, Harris JO: A primary care preceptorship for first-year medical students coordinated by an Area Health Education Center program: a six-year review. Acad Med 2001, 76: 489–492. 10.1097/00001888-200105000-00024CrossRefPubMed Rooks L, Watson RT, Harris JO: A primary care preceptorship for first-year medical students coordinated by an Area Health Education Center program: a six-year review. Acad Med 2001, 76: 489–492. 10.1097/00001888-200105000-00024CrossRefPubMed
7.
go back to reference Coleman K, Murray E: Patients’ views and feelings on the community-based teaching of undergraduate medical students: a qualitative study. Fam Pract 2002, 19: 183–188. 10.1093/fampra/19.2.183CrossRefPubMed Coleman K, Murray E: Patients’ views and feelings on the community-based teaching of undergraduate medical students: a qualitative study. Fam Pract 2002, 19: 183–188. 10.1093/fampra/19.2.183CrossRefPubMed
8.
go back to reference Latessa R, Beaty N, Colvin G, Landis S, Janes C: Family medicine community preceptors: different from other physician specialties? Fam Med 2008, 40: 96–101.PubMed Latessa R, Beaty N, Colvin G, Landis S, Janes C: Family medicine community preceptors: different from other physician specialties? Fam Med 2008, 40: 96–101.PubMed
9.
go back to reference Starr S, Ferguson WJ, Haley HL, Quirk M: Community preceptors’ views of their identities as teachers. Acad Med 2003, 78: 820–825. 10.1097/00001888-200308000-00017CrossRefPubMed Starr S, Ferguson WJ, Haley HL, Quirk M: Community preceptors’ views of their identities as teachers. Acad Med 2003, 78: 820–825. 10.1097/00001888-200308000-00017CrossRefPubMed
10.
go back to reference Shannon SJ, Walker-Jeffreys M, Newbury JW, Cayetano T, Brown K, Petkov J: Rural clinician opinion on being a preceptor. Rural Remote Health 2006, 6: 490.PubMed Shannon SJ, Walker-Jeffreys M, Newbury JW, Cayetano T, Brown K, Petkov J: Rural clinician opinion on being a preceptor. Rural Remote Health 2006, 6: 490.PubMed
11.
go back to reference Lacroix TB: Meeting the need to train more doctors: The role of community-based preceptors. Paediatr Child Health 2005, 10: 591–594.PubMedCentralPubMed Lacroix TB: Meeting the need to train more doctors: The role of community-based preceptors. Paediatr Child Health 2005, 10: 591–594.PubMedCentralPubMed
12.
go back to reference Gillies RA, Jester DM, Hobbs J: Evaluating perceptions of community-based physicians from a high-retention clerkship. Fam Med 2005, 37: 639–643.PubMed Gillies RA, Jester DM, Hobbs J: Evaluating perceptions of community-based physicians from a high-retention clerkship. Fam Med 2005, 37: 639–643.PubMed
13.
go back to reference Ullian JA, Shore WB, First LR: What did we learn about the impact on community-based faculty? Recommendations for recruitment, retention, and rewards. Acad Med 2001, 76: S78-S85. 10.1097/00001888-200104001-00015CrossRefPubMed Ullian JA, Shore WB, First LR: What did we learn about the impact on community-based faculty? Recommendations for recruitment, retention, and rewards. Acad Med 2001, 76: S78-S85. 10.1097/00001888-200104001-00015CrossRefPubMed
14.
go back to reference Laven G, Wilkinson D: Rural doctors and rural backgrounds: how strong is the evidence? A systematic review. Aust J Rural Health 2003, 11: 277–284. 10.1111/j.1440-1584.2003.00534.xCrossRefPubMed Laven G, Wilkinson D: Rural doctors and rural backgrounds: how strong is the evidence? A systematic review. Aust J Rural Health 2003, 11: 277–284. 10.1111/j.1440-1584.2003.00534.xCrossRefPubMed
15.
go back to reference Rabinowitz HK, Diamond JJ, Markham FW, Paynter NP: Critical factors for designing programs to increase the supply and retention of rural primary care physicians. JAMA 2001, 286: 1041–1048. 10.1001/jama.286.9.1041CrossRefPubMed Rabinowitz HK, Diamond JJ, Markham FW, Paynter NP: Critical factors for designing programs to increase the supply and retention of rural primary care physicians. JAMA 2001, 286: 1041–1048. 10.1001/jama.286.9.1041CrossRefPubMed
16.
go back to reference Gibbs T: Community-based or tertiary-based medical education: so what is the question? Med Teach 2004, 26: 589–590. 10.1080/01421590400019690CrossRefPubMed Gibbs T: Community-based or tertiary-based medical education: so what is the question? Med Teach 2004, 26: 589–590. 10.1080/01421590400019690CrossRefPubMed
17.
go back to reference Kozu T: Medical education in Japan. Acad Med 2006, 81: 1069–1075. 10.1097/01.ACM.0000246682.45610.ddCrossRefPubMed Kozu T: Medical education in Japan. Acad Med 2006, 81: 1069–1075. 10.1097/01.ACM.0000246682.45610.ddCrossRefPubMed
18.
go back to reference Tanihara S, Kobayashi Y, Une H, Kawachi I: Urbanization and physician maldistribution: a longitudinal study in Japan. BMC Health Serv Res 2011, 11: 260. 10.1186/1472-6963-11-260PubMedCentralCrossRefPubMed Tanihara S, Kobayashi Y, Une H, Kawachi I: Urbanization and physician maldistribution: a longitudinal study in Japan. BMC Health Serv Res 2011, 11: 260. 10.1186/1472-6963-11-260PubMedCentralCrossRefPubMed
19.
go back to reference Bekhet AK, Zauszniewski JA: Methodological triangulation: an approach to understanding data. Nurse Res 2012, 20: 40–43. 10.7748/nr2012.11.20.2.40.c9442CrossRefPubMed Bekhet AK, Zauszniewski JA: Methodological triangulation: an approach to understanding data. Nurse Res 2012, 20: 40–43. 10.7748/nr2012.11.20.2.40.c9442CrossRefPubMed
20.
go back to reference Ohman A: Qualitative methodology for rehabilitation research. J Rehabil Med 2005, 37: 273–280. 10.1080/16501970510040056CrossRefPubMed Ohman A: Qualitative methodology for rehabilitation research. J Rehabil Med 2005, 37: 273–280. 10.1080/16501970510040056CrossRefPubMed
21.
go back to reference Kawabata H, Murakami M, Kisa K, Maezawa M: An interview survey on factors influencing the career choice of primary care physicians in rural areas. Hokkaido J Med Sci 2010, 85: 161–165.PubMed Kawabata H, Murakami M, Kisa K, Maezawa M: An interview survey on factors influencing the career choice of primary care physicians in rural areas. Hokkaido J Med Sci 2010, 85: 161–165.PubMed
22.
go back to reference Holloway I: Basic Concepts for Qualitative Research. Malden, MA: Blackwell Science; 1997. Holloway I: Basic Concepts for Qualitative Research. Malden, MA: Blackwell Science; 1997.
23.
go back to reference Morgan DL: Focus Groups as Qualitative Research. 2nd edition. Thousand Oaks, CA: Sage; 1997. Morgan DL: Focus Groups as Qualitative Research. 2nd edition. Thousand Oaks, CA: Sage; 1997.
24.
go back to reference Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004, 24: 105–112. 10.1016/j.nedt.2003.10.001CrossRefPubMed Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004, 24: 105–112. 10.1016/j.nedt.2003.10.001CrossRefPubMed
25.
go back to reference Scupin R: The KJ, method: A technique for analyzing data derived from Japanese ethnology. Hum Organ 1997, 56: 233–237.CrossRef Scupin R: The KJ, method: A technique for analyzing data derived from Japanese ethnology. Hum Organ 1997, 56: 233–237.CrossRef
26.
go back to reference Murakami M, Kawabata H, Maezawa M: The perception of the hidden curriculum on medical education: an exploratory study. Asia Pac Fam Med 2009, 8: 9. 10.1186/1447-056X-8-9PubMedCentralCrossRefPubMed Murakami M, Kawabata H, Maezawa M: The perception of the hidden curriculum on medical education: an exploratory study. Asia Pac Fam Med 2009, 8: 9. 10.1186/1447-056X-8-9PubMedCentralCrossRefPubMed
28.
go back to reference Matsumoto M, Inoue K, Kajii E: Characteristics of medical students with rural origin: implications for selective admission policies. Health Policy 2008, 87: 194–202. 10.1016/j.healthpol.2007.12.006CrossRefPubMed Matsumoto M, Inoue K, Kajii E: Characteristics of medical students with rural origin: implications for selective admission policies. Health Policy 2008, 87: 194–202. 10.1016/j.healthpol.2007.12.006CrossRefPubMed
29.
go back to reference Inoue K, Matsumoto M, Sawada T: Evaluation of a medical school for rural doctors. J Rural Health 2007, 23: 183–187. 10.1111/j.1748-0361.2007.00088.xCrossRefPubMed Inoue K, Matsumoto M, Sawada T: Evaluation of a medical school for rural doctors. J Rural Health 2007, 23: 183–187. 10.1111/j.1748-0361.2007.00088.xCrossRefPubMed
30.
go back to reference Langlois JP, Thach SB: Bringing faculty development to community-based preceptors. Acad Med 2003, 78: 150–155. 10.1097/00001888-200302000-00009CrossRefPubMed Langlois JP, Thach SB: Bringing faculty development to community-based preceptors. Acad Med 2003, 78: 150–155. 10.1097/00001888-200302000-00009CrossRefPubMed
Metadata
Title
What primary care physician teachers need to sustain community based education in Japan
Authors
Manabu Murakami
Hidenobu Kawabata
Masaji Maezawa
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Asia Pacific Family Medicine / Issue 1/2014
Electronic ISSN: 1447-056X
DOI
https://doi.org/10.1186/1447-056X-13-6

Other articles of this Issue 1/2014

Asia Pacific Family Medicine 1/2014 Go to the issue