Murakami Manabu, Kawabata Hidenobu, Maezawa Masaji
Department of Healthcare Systems Research, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Asia Pac Fam Med. 2009 Dec 15;8(1):9. doi: 10.1186/1447-056X-8-9.
Major curriculum reform of undergraduate medical education occurred during the past decades in the United Kingdom (UK); however, the effects of the hidden curriculum, which influence the choice of primary care as a career, have not been sufficiently recognized. While Japan, where traditionally few institutions systematically foster primary care physicians and very few have truly embraced family medicine as their guiding discipline, has also experienced meaningful curriculum reform, the effect of the hidden curriculum is not well known. The aim of this study is to identify themes pertaining to the students' perceptions of the hidden curriculum affecting undergraduate medical education in bedside learning in Japan.
Semi-structured interviews with thematic content analysis were implemented. Undergraduate year-5 students from a Japanese medical school at a Japanese teaching hospital were recruited. Interview were planned to last between 30 to 60 minutes each, over an 8-month period in 2007. The interviewees' perceptions concerning the quality of teaching in their bedside learning and related experiences were collected and analysed thematically.
Twenty five medical students (18 males and 7 females, mean age 25 years old) consented to participate in the interviews, and seven main themes emerged: "the perception of education as having a low priority," "the prevalence of positive/negative role models," "the persistence of hierarchy and exclusivity," "the existence of gender issues," "an overburdened medical knowledge," "human relationships with colleagues and medical team members," and "first experience from the practical wards and their patients."
Both similarities and differences were found when comparing the results to those of previous studies in the UK. Some effects of the hidden curriculum in medical education likely exist in common between the UK and Japan, despite the differences in their demographic backgrounds, cultures and philosophies.
在过去几十年里，英国对本科医学教育进行了重大课程改革；然而，隐性课程对选择初级保健作为职业的影响尚未得到充分认识。在日本，传统上很少有机构系统地培养初级保健医生，很少有机构真正将家庭医学作为其指导学科，日本也经历了有意义的课程改革，但隐性课程的影响尚不清楚。本研究的目的是确定与日本本科医学教育床边学习中影响学生对隐性课程认知相关的主题。
采用半结构化访谈并进行主题内容分析。招募了日本一家教学医院的一所日本医学院的本科五年级学生。访谈计划在2007年的8个月期间进行，每次访谈持续30至60分钟。收集受访者对床边学习教学质量及相关经历的看法，并进行主题分析。
25名医学生（18名男性和7名女性，平均年龄25岁）同意参与访谈，出现了七个主要主题：“对教育重视程度低的认知”、“正面/负面榜样的普遍存在”、“等级制度和排他性的持续存在”、“性别问题的存在”、“医学知识负担过重”、“与同事和医疗团队成员的人际关系”以及“在实际病房与患者的初次经历”。
将结果与英国以前的研究结果进行比较时，发现了异同之处。尽管英国和日本在人口背景、文化和理念上存在差异，但医学教育中隐性课程的一些影响可能是共同存在的。
