The New Japanese Postgraduate Medical Education and Quality of Emergency Medical Care

Tokuda, Yasuharu; Gotō, Eiji; Otaki, Junji; Shapiro, Mina; Soejima, Kumiko; Ishida, Yasushi; Ohde, Sachiko; Takahashi, Osamu; Fukui, Tsuguya

doi:10.1016/j.jemermed.2011.01.020

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…In the 2-year residency, residents rotate through major departments for 4−12 weeks each [9]. They also work night shifts in emergency departments approximately 4−6 days a month throughout the residency, and their clinical responsibility tends to be higher in the emergency department than in day shift rotation [10]. Near-peer teaching commonly occurs in the workplace learning environment consisting of post-graduate year 1 residents (PGY1s), postgraduate year 2 residents (PGY2s), and supervising doctors [10,11].…”

Section: Settingmentioning

confidence: 99%

“…They also work night shifts in emergency departments approximately 4−6 days a month throughout the residency, and their clinical responsibility tends to be higher in the emergency department than in day shift rotation [10]. Near-peer teaching commonly occurs in the workplace learning environment consisting of post-graduate year 1 residents (PGY1s), postgraduate year 2 residents (PGY2s), and supervising doctors [10,11]. PGY2s teach PGY1s, young supervising doctors teach PGY2s, and senior supervising doctors teach young supervising doctors.…”

Section: Settingmentioning

confidence: 99%

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To teach is to learn twice, revisited: A qualitative study of how residents learn through teaching in clinical environments

Kondo

Takahashi

Aomatsu

et al. 2023

Preprint

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Background As the saying goes, ‘to teach is to learn twice’; the teaching role contributes to one’s own learning as a professional. Near-peer teaching in clinical practice has been shown to contribute to the development of not only teaching skills but also necessary competencies for doctors. Research on how near-peer teachers learn through their teaching roles has mainly focused on classroom learning. Understanding how the phenomenon of ‘teaching is learning twice’ occurs in clinical settings and its influencing factors is important for the development of a quality workplace learning environment. We, therefore, investigated how residents learn through teaching in clinical practice and the factors influencing this process. Methods The study was conducted using a methodology based on grounded theory and from a social constructivist perspective. Several teaching hospitals in Japan were included, and the study participants were post-graduate year 2 residents (PGY2s) from these hospitals. The interviews were recorded, transcribed into text, and analysed by the first author. Results From January 2016 to July 2022, we conducted 13 interviews with 11 PGY2s from nine educational hospitals. PGY2s played diverse educational roles in clinical settings and learned competencies in almost all areas as physicians through such roles. Knowledge transfer and serving as role models stimulated their intrinsic motivation, encouraged reflection on their own experiences, and promoted self-regulated learning. Educating on procedural skills and clinical reasoning prompted reflection on their own procedural skills and thought processes, and supporting post-graduate year 1 residents’ reflections led to the refinement of their own knowledge and thought processes through the verbal expression of their learning experiences. Such processes required the formation of a community of practice. Education promoted learning through reflection and made the image of the expert that PGY2s aspired to be clearer. Conclusions We found that residents acquire various physician competencies through multiple processes by teaching as near-peer teachers in clinical settings, that a community of practice must be formed for near-peer teaching to occur in a clinical setting, and that teaching brings learning to those who teach by promoting reflection and helping them envision the professionals they seek to be.

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Section: Settingmentioning

confidence: 99%

Section: Settingmentioning

confidence: 99%

To teach is to learn twice, revisited: A qualitative study of how residents learn through teaching in clinical environments

Kondo

Takahashi

Aomatsu

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Objectives of this PGME are to educate residents to acquire attitudes, skills, and knowledge for providing basic clinical care. A study showed that physicians who received the current PGME program were more likely to adhere to an appropriate standard of care in emergency medicine and were more confident in caring for patients with acute illnesses, compared to those who graduated before 2004 and did not receive the current PGME …”

Section: Comparison Of Gm‐ite Scores Between Pgy‐1 and Pgy‐2mentioning

confidence: 99%

“…A study showed that physicians who received the current PGME program were more likely to adhere to an appropriate standard of care in emergency medicine and were more confident in caring for patients with acute illnesses, compared to those who graduated before 2004 and did not receive the current PGME. 4 Although the current PGME is better than the no-rotation training prior to 2004, there may be still some weaknesses of the current PGME. First, overtesting in diagnostic process is highly prevalent in Japanese hospitals, 5 This subgroup analysis showed mean score 34.9 ± 5.0 of PGY-2 was significantly higher than that 34.4 ± 4.7 of PGY-1 (Table 1).…”

mentioning

confidence: 92%

Postgraduate medical education in Japan: Missed opportunity for learning clinical reasoning

Tokuda

Soshi²,

Okubo

et al. 2018

J of Gen and Family Med

Self Cite

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“…Previous literature has shown that education about clinical reasoning and the diagnostic process may be lacking in Japan 4 and that Japanese residents are less knowledgeable about diagnostic errors than are their American residents 5 . Additionally, since overtesting is very common in Japanese hospitals, 6 residents can order unnecessary tests without clinical reasoning 7 …”

Section: Introductionmentioning

confidence: 99%

Analysis of diagnostic error cases among Japanese residents using diagnosis error evaluation and research taxonomy

Harada

Miyagami

Watari

et al. 2021

J of Gen and Family Med

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The process of diagnostic errors among Japanese residents has not been previously studied. This descriptive study was conducted in June 2019 on junior residents at a single‐center educational hospital in Japan. Diagnosis Error Evaluation and Research taxonomy was used to measure the process of diagnostic error in the most memorable error cases. High frequency of diagnostic errors resulted from inaccurate/misinterpretation of history, failure/delay in eliciting physical examination findings, inaccurate/misinterpretation of physical examination, failure in weighting of physical examination, and failure/delay in considering the diagnosis. Residents made diagnostic errors mainly during history taking, physical examination, and assessment.

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The New Japanese Postgraduate Medical Education and Quality of Emergency Medical Care

Abstract: Japanese physicians who complete the new PGME program are likely to provide higher quality of care and have greater confidence in emergency medicine compared to those who completed the old PGME program.

Cited by 5 publications

References 11 publications

To teach is to learn twice, revisited: A qualitative study of how residents learn through teaching in clinical environments

To teach is to learn twice, revisited: A qualitative study of how residents learn through teaching in clinical environments

Postgraduate medical education in Japan: Missed opportunity for learning clinical reasoning

Analysis of diagnostic error cases among Japanese residents using diagnosis error evaluation and research taxonomy

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