Challenging cases of professionalism in Japan: improvement in understanding of professional behaviors among Japanese residents between 2005 and 2013

Abstract

BackgroundProfessionalism is deemed as the basis of physicians’ contract with society in Japan. Our study in 2005, using a questionnaire with scenarios to professionalism, suggested that many physicians at various levels of training in Japan encounter challenges when responding to these common scenarios related to professionalism. It is unclear how medical professionalism has changed among Japanese residents in over time.MethodsWe conducted a follow-up survey about challenges to professionalism for Japanese residents using the same Barry Questionnaire after a seven-year interval from the prior survey. The survey uses six clinical scenarios with multiple choice responses. The six cases include the following challenges: acceptance of gifts; conflict of interest; confidentiality; physician impairment; sexual harassment; and honesty in documentation. Each scenario is followed by 4 or 5 possible responses, including the “best” and the “second best” responses. The survey was conducted as a part of nationwide general medicine in-training examination.ResultsWe collected data from 1,049 participants (290 women, 28%; 431 PGY-1 and 618 PGY-2 residents). Overall, the current residents performed better than their colleagues in the earlier survey for five scenarios (gifts, conflict of interest, confidentiality, impairment, and honesty) but not for the harassment scenario. PGY-2 residents were more likely to select either the best or 2nd best choices to gifts (p = 0.002) and harassment (p = 0.031) scenarios than PGY-1 residents. Residents in the current study chose either the best or 2nd best choices to the gifts (p < 0.001) and honesty (p < 0.001) scenarios than those of the previous study conducted seven years ago, but not for the harassment scenario (p = 0.004).ConclusionsOur study suggests that there is improvement of medical professionalism with respect to some ethical challenges among the Japanese residents in the current study compared to those in our previous study.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0313-6) contains supplementary material, which is available to authorized users.

A scoping review of medical professionalism research published in the Chinese language

“…Chinese physicians could assert their own context-specific professional identity by establishing a professionalism framework that reflects cultural heritage [68], as has already been achieved at one Chinese medical school [69] and is reflected in experiences in the Middle East [17, 70]. Medical professionalism curricula can also be developed with consideration to local culture and needs, as has been demonstrated in Taiwan and Japan [71, 72]. Despite the modernization of medicine in China, traditional culture continues to influence perceptions of professionalism and societal expectations of physicians [69, 73].…”

Sexual harassment: The most challenging issue of medical professionalism in Japan

“…Our results suggested that many resident physicians in Japan encounter challenges when responding to the scenarios related to professionalism. 4,5 Compared to residents in the 2005 survey, those in the 2013 survey performed better for five scenarios (gifts, conflict of interest, confidentiality, impairment, and honesty) but not for the harassment scenario. Therefore, we proposed the implementation of a validated assessment tool and the improvement of curriculum for teaching professionalism to students and residents.…”

Comparison of professionalism between emergency medicine resident physicians and faculty physicians: A multicenter cross-sectional study

“…The Barry Questionnaire is an assessment tool for evaluating views regarding professionalism; it is widely used in the US and Japan. [12][13][14] In a previous study, participants in the US performed better than participants in Japan in scenarios that were presented involving minor confidentiality and sexual harassment, but not for three scenarios (physician impairment, conflict of interest, and acceptance of gifts). [12] A recent study of novice physicians using the Barry Questionnaire mentions improvements in medical professionalism with respect to certain ethical challenges in Japan.…”

“…In addition, Kinoshita et al reported improved responses to the Barry Questionnaire by Japanese physicians. [14] The study by Barry et al [13] indicates that satisfaction with training in professionalism is significantly related to the amount of relevant coursework. Findings of the present study are consistent with those of the prior studies and extends them by demonstrating the further need for improvement in medical professionalism education for Japanese physicians in terms of confidentiality and sexual harassment.…”

“…[12] A recent study of novice physicians using the Barry Questionnaire mentions improvements in medical professionalism with respect to certain ethical challenges in Japan. [14] To the best of our knowledge, there is no study citing a difference in medical professionalism between EM resident physicians and faculty physicians. Recognition of a gap in views regarding professionalism between EM resident physicians and faculty physicians will enable innovative curricular changes in EM postgraduate education.…”