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我们如何帮助医生留在日本农村地区?日本和瑞典一所医学院的医学生对全科医疗和临床研究态度的比较。

How can we help doctors stay in rural areas of Japan? A comparison in medical students' attitudes toward general practice and clinical research of a medical school in Japan and in Sweden.

作者信息

Hirose Masahiro, Watari Takashi, Sato Rie, Midlöv Patrik, Okayama Masanobu, Yoshikawa Hiroo, Imanaka Yuichi

机构信息

Department of Community Medicine and Medical Education, Graduate School of Medicine, Kobe University, Japan.

Department of General Medicine and Clinical Research, Izumo Tokushukai Hospital, Japan.

出版信息

J Rural Med. 2024 Oct;19(4):264-272. doi: 10.2185/jrm.2023-011. Epub 2024 Oct 1.

Abstract

OBJECTIVE

In Sweden, primary healthcare centers play an important role in the performance of general practice, education, and clinical research. In Japan, general physicians or general practitioners are expected to be more active in the small-scale hospitals and clinics in rural areas. This study aimed to explore the differences in attitudes toward general practice and clinical research among medical students in Japan and Sweden to present solutions to help doctors stay in rural areas of Japan.

MATERIALS AND METHODS

This cross-sectional study was conducted at two medical schools in Japan and Sweden in 2018, using an anonymous and self-administered questionnaire survey that comprised 16 items including 9 items on clinical research.

RESULTS

Participants were 154 medical students (response rate: 69.4% for 222 students) in Japan and 56 (27.1% for 201 students) in Sweden. The proportion of medical students who wanted to become general physicians was greater in Japan than in Sweden (Japan:Sweden=36.4%:17.9%; =0.012). Although fewer Japanese students wanted to conduct research in rural areas than Swedish students (43.5%:57.1%; <0.001), the positive proportion of Japanese students working in clinical research and/or taking an academic degree in rural areas was greater than that of Swedish students (52.0%:23.2%; =0.032).

CONCLUSION

As Swedish medical students and young doctors learn considerably from primary healthcare centers, their attitudes toward clinical research are more developed than those of their Japanese counterparts. However, more Japanese medical students than Swedish students wish to become general practitioners, and they are likely to strive to conduct clinical research at small-scale hospitals/clinics in rural areas. Therefore, the improvement of the clinical research environment in small-scale hospitals and clinics in rural areas is needed at the earliest in Japan.

摘要

目的

在瑞典,初级医疗保健中心在全科医疗、教育和临床研究方面发挥着重要作用。在日本,全科医生预计在农村地区的小型医院和诊所中发挥更积极的作用。本研究旨在探讨日本和瑞典医学生对全科医疗和临床研究态度的差异,以提出帮助医生留在日本农村地区的解决方案。

材料与方法

2018年在日本和瑞典的两所医学院开展了这项横断面研究,采用匿名自填式问卷调查,问卷包含16个项目,其中9个项目涉及临床研究。

结果

日本有154名医学生参与(222名学生的回复率为69.4%),瑞典有56名(201名学生的回复率为27.1%)。想成为全科医生的医学生比例在日本高于瑞典(日本:瑞典 = 36.4%:17.9%;P = 0.012)。虽然想在农村地区开展研究的日本学生比瑞典学生少(43.5%:57.1%;P < 0.001),但在农村地区从事临床研究和/或攻读学术学位的日本学生的积极比例高于瑞典学生(52.0%:23.2%;P = 0.032)。

结论

由于瑞典医学生和年轻医生从初级医疗保健中心学到很多,他们对临床研究的态度比日本同行更成熟。然而,希望成为全科医生的日本医学生比瑞典学生更多,并且他们可能会努力在农村地区的小型医院/诊所开展临床研究。因此,日本最早需要改善农村地区小型医院和诊所的临床研究环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe4d/11442082/fdc538a430d2/jrm-19-264-g001.jpg

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