General practice / family medicine (GP/FM) has become a clinical field that is not only expected to provide high-quality primary health care, but also to contribute to medical education1). Furthermore, the World Health Organization has recommended increasing the opportunities for medical students to experience primary health care in the real world2). On the other hand, medical schools across the globe are currently undergoing curriculum reforms in accordance with the global standards of the World Federation for Medical Education3). According to the Japanese version of these standards, GP/FM is highlighted as an important clinical discipline, which means that it is a mandatory subject for all medical students4). Despite recognition of the importance of GP/FM, the opportunities for medical students to participate in GP/FM clerkships are still inadequate around the world. It was reported that 50 out of 259 universities (19%) had no or very brief GP/FM clerkships, even in Europe where GP/FM is further developed5). In order for GP/FM clerkships to be improved into undergraduate medical education, it is necessary to clarify the impacts of GP/FM clerkships6). Two important systematic reviews were reported in 2015, discussing the impact of GP/FM clerkships on undergraduate medical education7,8). Turkeshi and colleagues reviewed quantitative studies around the world, whilst Park and colleagues reviewed quantitative and qualitative studies in the United Kingdom7,8). A Japanese quantitative study was reported in 20206), using the evaluation items of the Model Core Curriculum for Medical Education in Japan9). However, no studies have been reported that analyzed qualitative data quantitatively. Reflective writing in medical education has been introduced in many medical schools worldwide10). Analyzing the reflective writing of medical students may be useful for further understanding the impact of clinical clerkships on medical students. However, qualitative judgment in appraising reflective writing may be confounded by reader bias11). Text mining can extract keywords (frequent words) from large samples of reflective writing in an efficient and objective manner. Text mining can also identify relationships between extracted words12).
The purpose of the present study was to clarify which aspects of GP/FM clerkships the students deemed to be most valuable and which experiences they felt were particularly useful, using text mining to analyze reflective writing.