Clinical Clerkships in General Medicine Enable Students to Acquire Basic Medical Competencies and Experience in Community-Based Integrated Care: A Descriptive Questionnaire-Based Study

Abstract

BackgroundNo previous research has targeted educators regarding educational practice and the achievements of students in terms of the learning objectives of clinical clerkships in university general medicine departments of Japan. We aimed to clarify the characteristics of clinical clerkships in Japanese general medicine departments using a questionnaire administered to chairpersons of university general medicine departments. MethodsThis was a descriptive questionnaire-based study using Google Forms (Google, Inc., Mountain View, CA, USA). We asked the chairpersons of general medicine departments in Japanese universities the following questions, with responses given on a 5-point Likert scale: Question 1: How well are primary symptoms in the national model core curriculum for undergraduate medical education taught in clinical clerkships in university general medicine departments? Question 2: How successfully can students achieve the learning objectives of the national model core curriculum for undergraduate medical education through clinical clerkships in general medicine departments of university hospitals? Question 3: How successfully can students achieve the learning objectives of the national model core curriculum for undergraduate medical education through clinical clerkships in other community clinics or hospitals? The results of the questionnaire responses are described as mean±standard deviation. ResultsOf the 71 Japanese universities with general medicine departments, 43 were included in the analysis. For Question 1, the symptoms and pathophysiologies with a mean score of 4 points or higher were fever, general malaise, anorexia, weight loss or gain, edema, abdominal pain, lymphadenopathy, and headache. All those symptoms require basic medical competencies. For Questions 2 and 3, the intramural clinical clerkship of general medicine departments had a higher mean score than the extramural clinical clerkship for diagnostic reasoning that emphasizes medical history and physical examination and a comprehensive approach to patients with multiple health problems. In contrast, the extramural clinical clerkship, in which medical students can build experience with community-integrated care, had a mean score of 3 points or higher for all items. ConclusionsThe clinical clerkship in general medicine departments of Japanese universities provides students with chances to acquire clinical competencies regarding primary symptoms and pathophysiologies. Additionally, the extramural clinical clerkship provides experience in community-based integrated care, including home medical care, collaboration, health and welfare, and long-term care.

The Impact of an Undergraduate Community‐Based Medical Education Program in a Japanese Urban City

“…Despite most lectures and partial practical experiences completed by fifth-year students within university hospitals, the scores were remarkably low before their engagement in community-based medical training. Several previous studies have noted differences in educational content between practical experiences in university hospitals and community hospitals, suggesting the challenge of educating on community healthcare, home medical care, and patient-centered healthcare solely within university hospital settings [20,21]. It is presumed that our institution faced a similar situation.…”

Comparison of attitudes toward community-based medicine between regional-quota and general-selected medical student in Japan

“…Medical education can actively involve citizens within communities to teach comprehensive care to medical trainees. When administering comprehensive care, trainees must deal with various health problems experienced by older people 20 ) , which can lead to frailty, requiring management through multi-disciplinary community collaboration 21 ) . Citizens can modify the process of managing their health problems, and this can be learned through participation.…”

How Do We Establish the Utility and Evidence of General Medicine in Japan?

“… 26 Efforts to enhance the utility and evidence of GM in universities include multiple studies conducted by academic institutions. Research accomplishments, 27 investigations into research topics, 28 and studies on educational achievements have been undertaken, 24 , 29 , 30 yet research in this field remains relatively limited.…”