Impact of COVID‐19 on the analytical diagnosing ability of family medicine residents

2021

IJERPH

Self Cite

Community-based medical education (CBME) offers vital support to healthcare professionals in aging societies, which need medical trainees who understand comprehensive care. In teaching comprehensive care practices, CBME can involve citizens from the relevant community. This research synthesizes the impact of the involvement of communities on the learning of medical trainees in CBME. We conducted a systematic review, in which we searched ten databases from April 1990 to August 2020 for original articles in Japan regarding CBME involving citizens and descriptively analyzed them. The Kirkpatrick model was used to categorize the outcomes. Our search for studies following the protocol returned 1240 results; 21 articles were included in this systematic review. Medical trainees reported satisfaction with the content, teaching processes, and teachers’ qualities. Medical trainees’ attitudes toward community and rural medicine improved; they were motivated to become family physicians and work in communities and remote areas. This review clarified that citizen involvement in CBME had an effective impact on medical trainees, positively affecting perceptions of this type of education, as well as improving trainees’ knowledge about and attitude toward community and rural medicine.

Section: Discussionmentioning

confidence: 99%

The Contribution of Citizens to Community-Based Medical Education in Japan: A Systematic Review

Ohta¹,

Ryu²,

2021

IJERPH

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“…Referring to the previous article related to our context of the pandemic of COVID-19, medical trainees and medical teachers struggled to learn clinical reasoning due to the corruption of pretest probabilities of diseases because of the fear of the COVID-19. 16 As the participants stated, rural nurses also struggled with constructing the system of infection control for COVID-19 because they were not used to performing infection control while accepting medical trainees. Each stakeholder in rural CBME had to focus on different issues in this pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…14 However, presently, rural CBME stands the risk of interference because of social fear of the spread of infections in urban areas, on one hand, and rural citizens' mental stress from self-quarantine, which can complicate the rural education of family medicine trainees, on the other. 10,16 The presently adverse situation must be overcome to drive CBME and educate future family physicians adequately in rural community hospitals. 17 To continue delivering rural CBME, the perceptions on limitations and drivers of education should be inquired from stakeholders involved in rural CBME.…”

mentioning

confidence: 99%

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

Ohta¹,

Ryu²,

2020

Preprint

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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.

“…The participants were rural CBME stakeholders at Unnan City Hospital, which educates more than 40 trainees in family medicine every year [ 20 ]. Participants included physicians (the dean, the director of the hospital, and medical educators), nurses (the director of nursing, deputy directors, and head nurses), clerks, and citizens collaborating in the CBME.…”

Section: Methodsmentioning

confidence: 99%

“…The severity of the pandemic varies depending on population density and the distance of cities from local points of origin [ 18 , 19 ]. In rural areas, there are few patients with COVID-19 and the standard precautions and protocols have been effective in controlling the infection [ 12 , 18 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Uncertainty of COVID-19 Inducing Social Fear and Pressure on the Continuity of Rural, Community-Based Medical Education: A Thematic Analysis

Ohta¹,

Ryu²,

2021

Healthcare

Self Cite

Rural community-based medical education (CBME) enriches undergraduate and postgraduate students’ learning but has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. We identified the challenges faced by stakeholders as well as the relevant solutions to provide recommendations for sustainable CBME in community hospitals during the COVID-19 pandemic. A total of 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 between 1 April and 30 September 2020. The interviews were recorded and their contents were transcribed verbatim and analyzed using thematic analysis. Three themes emerged: uncertainty surrounding COVID-19, an overwhelming sense of social fear and pressure within and outside communities, and motivation and determination to continue providing CBME. Rural CBME was impacted by not only the fear of infection but also social fear and pressure within and outside communities. Constant assessment of the risks associated with the pandemic and the implications for CMBE is essential to ensure the sustainability of CBME in rural settings, not only for medical educators and students but also stakeholders who administrate rural CBME.