Kenzaka Tsuneaki, Yahata Shinsuke, Kumabe Ayako, Mizutani Naoya, Nishisaki Hogara, Okayama Masanobu
Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, JPN.
Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Kobe, JPN.
Cureus. 2025 Jul 17;17(7):e88174. doi: 10.7759/cureus.88174. eCollection 2025 Jul.
In this study, we compared four practice areas showing a medium-term effect of community-based medical education (CBME) with those that did not examine more effective practice content.
This observational study analyzed summer internship programs between 2015 to 2019 undertaken by Hyogo Prefecture community-based physicians who initiated training for regional quota students in 2017-2021. For applying to become a resident in each hospital, risk ratios (RRs) and 95% confidence intervals (CIs) were calculated based on the presence or absence of practice experience and grade of experience for each region. The content of practical CBME training in Tamba and three other regions was compared.
Ninety-four participants were included (58 men and 36 women). CBME experience in Tamba during their senior years significantly increased the number of applicants for initial residency training compared with the number of participants who had no CBME experience in a determined region (RR=1.58, 95% CI: 1.04-2.39) and who experienced CBME during their junior years (RR=2.23, 95% CI: 1.15-4.33). In contrast to other regions, practice times in Tamba were longer for fostering empathy toward the community, understanding local healthcare needs, and building harmony with community residents.
CBME with such training content enhances interaction with residents, thus demonstrating its educational value for the first time. As a next step, we should consider interviewing participants directly about their interactions with residents and whether CBME influenced their choice of place of employment.
在本研究中，我们比较了四个显示出社区医学教育（CBME）中期效果的实践领域与那些未研究更有效实践内容的领域。
这项观察性研究分析了2015年至2019年兵库县社区医生开展的暑期实习项目，这些医生在2017 - 2021年为地区配额学生启动了培训。对于申请各医院住院医师职位的情况，根据每个地区实践经验的有无和经验等级计算风险比（RRs）及95%置信区间（CIs）。比较了丹波及其他三个地区CBME实践培训的内容。
纳入94名参与者（58名男性和36名女性）。与在特定地区没有CBME经验的参与者（RR = 1.58，95% CI：1.04 - 2.39）以及在大学低年级时有CBME经验的参与者（RR = 2.23，95% CI：1.15 - 4.33）相比，丹波地区的参与者在大学高年级时的CBME经验显著增加了初次住院医师培训的申请者数量。与其他地区不同，丹波地区培养对社区的同理心、理解当地医疗需求以及与社区居民建立和谐关系的实践时间更长。
具有此类培训内容的CBME增强了与居民的互动，从而首次证明了其教育价值。下一步，我们应考虑直接采访参与者，了解他们与居民的互动情况以及CBME是否影响了他们的就业地点选择。
