Abstract/References

Impact of general practice / family medicine training on Japanese junior residents:a descriptive study

Koki Nakamura, Satoshi Kanke, Atsushi Ishii, Fuyuto Mori, Goro Hoshi, Kanako Kanto, Yoshihiro Toyoda, Ryuki Kassai

Author information
  • Koki Nakamura

    Department of Community and Family Medicine, Fukushima Medical University
    Fukushima Centre for General Physicians, Fukushima Medical University
    Center for Medical Education and Career Development, Fukushima Medical University

  • Satoshi Kanke

    Department of Community and Family Medicine, Fukushima Medical University
    Fukushima Centre for General Physicians, Fukushima Medical University

  • Atsushi Ishii

    Kashima Hospital

  • Fuyuto Mori

    Kitakata Centre for Community and Family Medicine

  • Goro Hoshi

    Hoshi Yokozuka Clinic

  • Kanako Kanto

    Hobara Central Clinic

  • Yoshihiro Toyoda

    Department of Community and Family Medicine, Fukushima Medical University

  • Ryuki Kassai

    Department of Community and Family Medicine, Fukushima Medical University

Abstract

Background: Despite international recognition of the impact of general practice / family medicine training on postgraduate training outcomes, there have been few reports from Japan.


Methods: Junior residents who participated in community medicine training for one month between 2019 and 2022 were enrolled in the study. The settings were five medical institutions (one hospital and four clinics) that had full-time family doctors. The junior residents were assigned to one of these institutions. The training content mainly consisted of general ambulatory care, home medical care, community-based care, and reflection. The junior residents evaluated themselves at the beginning and end of their training, and the family doctors evaluated the junior residents at the end. The evaluation items were 36 items in 10 areas, based on the objectives outlined in the Guidelines for Residency Training - 2020 Edition, and were rated on a 10-point Likert scale. In the statistical analysis, Wilcoxon signed rank test of two related groups was performed to analyze changes between pre and post self-evaluation, and the effect size r was calculated.


Results: Ninety-one junior residents completed the study. Their self-evaluations showed statistically significant increases in all 36 items. The effect size was large in 33 items. The family doctors’ evaluation was 8-9 points for all 36 items.


Conclusion: General practice / family medicine training may greatly contribute to the acquisition of various required clinical abilities in postgraduate training even in Japan.

The cintent of reseach paper

References

1. World Organization of Family Doctors. The contribution of family medicine to improving health systems a guidebook from the World Organization of Family Doctors. 2nd ed. London:Radcliffe Publishing Ltd;2013.


2. Kung K, Lam A, Wong KW, et al. Family medicine internship training:Importance for Hong Kong’s primary care. Hong Kong Med J, 18(2):167-169, 2012.


3. Kjaer NK, Kodal T, Qvesel D. The role of general practice in postgraduate basic training. Med Teach, 32(10):e448-e452, 2010.


4. Illing J, Van Zwanenberg T, Cunningham WF, Taylor G, O’Halloran C, Prescott R. Preregistration house officers in general practice:Review of evidence. BMJ, 326(7397):1019-1022, 2003.


5. Scallan S. Training for general practice in the foundation programme:lessons from the pre-registration house officer experience. Educ Primary Care, 16:256-264, 2005.


6. Japan Primary Care Association. New Family Medicine Expert Training Program [https://www.shin-kateiiryo.primary-care.or.jp/endorsement] (in Japanese) (Accessed 30 September 2022.).


7. Ministry of Health, Labour and Welfare. Objectives, Strategies, and Evaluation in Residency Training [https://www.mhlw.go.jp/content/10800000/ishirinsyokensyu_guideline_2020.pdf] (in Japanese) [https://www.mhlw.go.jp/content/10800000/000719078.pdf] (in English) (Accessed 7 June 2022.).


8. Ministry of Health, Labour and Welfare. Overview of FY2022 Medical Fee Revision -Home Medical Care- [https://www.mhlw.go.jp/content/12400000/000920430.pdf] (in Japanese) (Accessed 18 December 2022.).


9. Mizumoto A, Takeuchi O. Basics and Considerations for Reporting Effect Sizes in Research Papers. English Education and Research, 31:57-66, 2008.


10. Martin AA, Laurence CO, Black LE, Mugford BV. General practice placements for pre-registration junior doctors:Adding value to intern education and training. Med J Aust, 186(7):346-349, 2007.


11. Walzman M, Allen M, Wall D. General practice and the Foundation Programme:The view of Foundation Year Two doctors from the Coventry and Warwickshire Foundation School. Educ Primary Care, 19(2):151-159, 2008.


12. Zolle O, Odbert R. The Foundation Programme in general practice:The value added of the attachment - A Wessex experience. Educ Primary Care, 20(6):455-461, 2009.


13. Cantillon P, MacDermott M. Does responsibility drive learning? Lessons from intern rotations in general practice. Med Teach, 30(3):254-259, 2008.


14. Anderson K, Haesler E, Stubbs A, Molinari K. Comparing general practice and hospital. Clin Teach, 12(1):8-13, 2015.

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