Hiramine Satoshi, Nagata Masaharu, Kainuma Mosaburo
Community Medicine Education Unit, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JPN.
Internal Medicine, Shin-eikai Hospital, Kitakyushu, JPN.
Cureus. 2024 Feb 14;16(2):e54204. doi: 10.7759/cureus.54204. eCollection 2024 Feb.
With an aging global population posing healthcare challenges, especially in community healthcare, training professionals for community healthcare remains a global educational challenge, including in Japan. While previous research shows increased student interest in community healthcare through practical experiences, the focus has primarily been on rural areas, leaving a gap in understanding urban-based community medical education. This study aimed to evaluate the impact of urban community-based medical education on students' understanding and attitudes toward community healthcare.
This study was conducted at Kyushu University in Fukuoka City, the sixth-largest city in Japan. For fifth-grade medical students, a community-based medical education program is mandatory, with a one-week schedule that includes orientation, one day in a clinic, and three days in a community hospital. The program aimed to expose students to various healthcare settings, emphasizing outpatient care, inpatient management, home health care, home nursing, and rehabilitation. A self-administered questionnaire referencing the Model Core Curriculum for medical education was administered immediately before and after the program, and the differences in students' perceptions were assessed using the Student's t-test.
Findings from 188 students completing both pre- and post-program questionnaires revealed significant improvements in perceptions of students' knowledge and skills related to community healthcare. After the training, there was a noteworthy positive shift in attitudes toward community healthcare and increased interest in primary care physicians as a career choice. Although students maintained a preference for urban areas, there was a notable inclination towards rural settings. The study highlights the program's success in enhancing students' understanding and positive attitudes toward community healthcare within an urban context. It challenges prior notions regarding work-life balance and urban-rural preferences in career choices.
Urban community-based medical education significantly improved students' perceptions and attitudes toward community healthcare. It offers valuable insights for curriculum planners, emphasizing the need for continued research into sustained effects and broader applicability.
全球人口老龄化给医疗保健带来了挑战，尤其是在社区医疗保健方面。培养社区医疗保健专业人员仍然是一项全球性的教育挑战，在日本也不例外。虽然先前的研究表明，通过实践经验，学生对社区医疗保健的兴趣有所增加，但重点主要放在农村地区，在理解城市社区医学教育方面存在差距。本研究旨在评估城市社区医学教育对学生对社区医疗保健的理解和态度的影响。
本研究在日本第六大城市福冈市的九州大学进行。对于五年级医学生，社区医学教育计划是强制性的，为期一周，包括入职培训、在诊所实习一天以及在社区医院实习三天。该计划旨在让学生接触各种医疗保健环境，重点是门诊护理、住院管理、家庭医疗保健、家庭护理和康复。在课程开始前和结束后，立即发放一份参考医学教育核心课程模型的自填式问卷，并使用学生t检验评估学生认知的差异。
188名完成课程前后问卷的学生的调查结果显示，学生对社区医疗保健相关知识和技能的认知有显著提高。培训后，学生对社区医疗保健的态度出现了显著的积极转变，对选择初级保健医生作为职业的兴趣增加。尽管学生仍然倾向于城市地区，但对农村地区也有明显的倾向。该研究强调了该计划在提高学生对城市背景下社区医疗保健的理解和积极态度方面的成功。它挑战了之前关于职业选择中工作与生活平衡以及城乡偏好的观念。
城市社区医学教育显著改善了学生对社区医疗保健的认知和态度。它为课程规划者提供了有价值的见解，强调需要继续研究其持续影响和更广泛的适用性。
