Ohta Ryuichi, Sano Chiaki
Community Care, Unnan City Hospital, Unnan, JPN.
Community Medicine Management, Faculty of Medicine, Shimane University, Izumo, JPN.
Cureus. 2024 Feb 7;16(2):e53800. doi: 10.7759/cureus.53800. eCollection 2024 Feb.
Introduction As societies age globally, medical education faces the challenge of adapting to the evolving healthcare needs of an aging population. This study focuses on the education of medical residents in outpatient departments in Japan, a country with a rapidly aging society. The research aims to understand the perceptions and challenges medical residents face in outpatient management, highlighting the areas for potential improvement in their educational framework. Method This study involved first-year medical residents at Fuchu Hospital in Osaka, using thematic analysis based on relativist ontology and constructivist epistemology. Data were collected through field notes and reflection sheets, documenting residents' interactions with patients, learning difficulties, and personal reflections. Semi-structured interviews were conducted to gain profound insights into their experiences and views on outpatient management education. Results Three main themes emerged from the analysis: The experience of continuity of care, the view regarding comprehensive management, and the gap between purposes and learning content. Residents expressed concerns about the limited opportunities for continuous patient care, leading to challenges in managing chronic diseases effectively. The focus on organ-specific specialties in acute care hospitals resulted in a fragmented understanding of patient care, particularly for elderly patients with multimorbidity. Furthermore, the study identified a discrepancy between the educational goals of outpatient management and the actual content delivered, highlighting the need for more observational experiences and practical guidance in outpatient settings. Conclusion The findings suggest a pressing need for a more structured, comprehensive, and personalized approach to outpatient management education for medical residents. As aging populations continue to grow, it is vital to equip medical professionals with the skills and knowledge to manage a wide range of patient conditions effectively. Improving the educational framework in outpatient departments can enhance patient care quality and prepare medical residents to meet the challenges of an aging society. This study contributes valuable insights into improving medical education in outpatient settings, particularly in aging societies like Japan.
引言 随着全球社会老龄化,医学教育面临着适应老年人口不断变化的医疗保健需求的挑战。本研究聚焦于日本这个社会快速老龄化国家门诊科室住院医师的教育。该研究旨在了解住院医师在门诊管理中面临的认知和挑战,突出其教育框架中潜在的改进领域。方法 本研究以大阪府立府中病院的一年级住院医师为对象,采用基于相对主义本体论和建构主义认识论的主题分析方法。通过现场记录和反思表收集数据,记录住院医师与患者的互动、学习困难及个人反思。进行半结构化访谈以深入了解他们在门诊管理教育方面的经历和观点。结果 分析得出三个主要主题:连续护理的体验、综合管理的观点以及目标与学习内容之间的差距。住院医师对持续患者护理机会有限表示担忧,这导致有效管理慢性病面临挑战。急性病医院对器官特异性专科的关注导致对患者护理的理解碎片化,尤其是对患有多种疾病的老年患者。此外,该研究发现门诊管理的教育目标与实际授课内容之间存在差异,突出表明在门诊环境中需要更多的观察体验和实践指导。结论 研究结果表明,迫切需要为住院医师的门诊管理教育采用更结构化、全面且个性化的方法。随着老年人口持续增长,使医学专业人员具备有效管理各种患者病情的技能和知识至关重要。改善门诊科室的教育框架可提高患者护理质量,并使住院医师做好应对老龄化社会挑战的准备。本研究为改善门诊环境中的医学教育,特别是在日本这样的老龄化社会,提供了宝贵的见解。