Challenging the uncertainty of COVID-19 in rural community based medical education for family medicine: A thematic analysis

Abstract

BackgroundCommunity based medical education (CBME) enriches undergraduate and postgraduate students’ perspectives, especially in rural settings. For the continuity of rural CBME in Japan, the present disruption caused by the coronavirus must be overcome to drive CBME and educate future family physicians adequately in rural community hospitals. In this study, we examine the challenges faced by and solutions for sustainable CBME in community hospitals during the COVID-19 pandemic.MethodsA qualitative study was performed with CBME stakeholders in a community hospital. First, direct observation was performed by the first author. Through this method, field and reflection notes were taken by observing and interviewing the dean, medical teachers, nurses, medical students, a medical clerk, and rural citizens in the hospital and its surrounding rural communities from April 1 to September 30, 2020. Interviews were recorded, and their contents were transcribed verbatim. The authors analyzed the transcriptions using on a thematic analysis.ResultsOverall, 31 pages of field and reflection notes were collated through direct observation and used for analysis. Five physicians, eight nurses, one clerk, fourteen medical trainees, and three rural citizens were interviewed. Through the thematic analysis, three themes emerged: the uncertainty of COVID-19, an overwhelming fear within medical institutions, and motivation and determination to continue providing CBME.ConclusionRural CBME for family medicine should be continued for the sustainability of rural medicine, even during the COVID-19 pandemic. The end of the pandemic cannot be foreseen, and CBME in rural areas should be continued to serve its true purpose by carefully considering precautions and through continuous dialogue between stakeholders and medical educators.