scholarly journals The Uncertainty of COVID-19 Inducing Social Fear and Pressure on the Continuity of Rural, Community-Based Medical Education: A Thematic Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 223
Author(s):  
Ryuichi Ohta ◽  
Yoshinori Ryu ◽  
Chiaki Sano
Keyword(s):  
Medical Education ◽  
Direct Observation ◽  
Rural Community ◽  
Thematic Analysis ◽  
Community Based ◽  
Postgraduate Students ◽  
Medical Trainees ◽  
Rural Settings ◽  
Social Fear ◽  
Medical Educators

Rural community-based medical education (CBME) enriches undergraduate and postgraduate students’ learning but has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. We identified the challenges faced by stakeholders as well as the relevant solutions to provide recommendations for sustainable CBME in community hospitals during the COVID-19 pandemic. A total of 31 pages of field and reflection notes were collated through direct observation and used for analysis. Five physicians, eight nurses, one clerk, fourteen medical trainees, and three rural citizens were interviewed between 1 April and 30 September 2020. The interviews were recorded and their contents were transcribed verbatim and analyzed using thematic analysis. Three themes emerged: uncertainty surrounding COVID-19, an overwhelming sense of social fear and pressure within and outside communities, and motivation and determination to continue providing CBME. Rural CBME was impacted by not only the fear of infection but also social fear and pressure within and outside communities. Constant assessment of the risks associated with the pandemic and the implications for CMBE is essential to ensure the sustainability of CBME in rural settings, not only for medical educators and students but also stakeholders who administrate rural CBME.

scholarly journals Challenging the uncertainty of COVID-19 in rural community based medical education for family medicine: A thematic analysis

2020 ◽  
Author(s):  
Ryuichi Ohta ◽  
Yoshinori Ryu ◽  
Chiaki Sano
Keyword(s):  
Medical Education ◽  
Rural Communities ◽  
Family Medicine ◽  
Direct Observation ◽  
Rural Community ◽  
Thematic Analysis ◽  
Rural Areas ◽  
Community Hospitals ◽  
Rural Medicine ◽  
Postgraduate Students

Abstract BackgroundCommunity based medical education (CBME) enriches undergraduate and postgraduate students’ perspectives, especially in rural settings. For the continuity of rural CBME in Japan, the present disruption caused by the coronavirus must be overcome to drive CBME and educate future family physicians adequately in rural community hospitals. In this study, we examine the challenges faced by and solutions for sustainable CBME in community hospitals during the COVID-19 pandemic.MethodsA qualitative study was performed with CBME stakeholders in a community hospital. First, direct observation was performed by the first author. Through this method, field and reflection notes were taken by observing and interviewing the dean, medical teachers, nurses, medical students, a medical clerk, and rural citizens in the hospital and its surrounding rural communities from April 1 to September 30, 2020. Interviews were recorded, and their contents were transcribed verbatim. The authors analyzed the transcriptions using on a thematic analysis.ResultsOverall, 31 pages of field and reflection notes were collated through direct observation and used for analysis. Five physicians, eight nurses, one clerk, fourteen medical trainees, and three rural citizens were interviewed. Through the thematic analysis, three themes emerged: the uncertainty of COVID-19, an overwhelming fear within medical institutions, and motivation and determination to continue providing CBME.ConclusionRural CBME for family medicine should be continued for the sustainability of rural medicine, even during the COVID-19 pandemic. The end of the pandemic cannot be foreseen, and CBME in rural areas should be continued to serve its true purpose by carefully considering precautions and through continuous dialogue between stakeholders and medical educators.

scholarly journals Effect of Residents-as-Teachers in Rural Community-Based Medical Education on the Learning of Medical Students and Residents: A Thematic Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12410
Author(s):  
Nozomi Nishikura ◽  
Ryuichi Ohta ◽  
Chiaki Sano
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Family Medicine ◽  
Rural Community ◽  
Community Hospital ◽  
Community Based ◽  
Approach To Teaching ◽  
Medical Teams ◽  
The Impact ◽  
Residents As Teachers

Residents-as-teachers (RaT) is a theoretical framework emphasizing the significance of the similar learning background of teachers and learners. In Japan, community-based medical education (CBME) is a practical approach to teaching family medicine. This study aimed to investigate the impact and challenges of RaT on the learning of medical students and residents in CBME at a rural community hospital in Japan. Over the course of a year, the researchers conducted one-on-one interviews with three residents and ten medical students participating in family medicine training at the hospital. The interviews were recorded and transcribed verbatim. Grounded theory was used in the data analysis to clarify the findings. Three key themes emerged from the research: lack of educational experience with RaT, effectiveness of RaT, and challenges of RaT. Although participants were prejudiced against RaT, they felt its implementation could facilitate the establishment of beneficial relationships between learners and teachers. They were also able to participate in medical teams effectively. The findings suggest that the increased participation of senior doctors in RaT could strengthen its learning effects. RaT in rural CBME should be applied in various contexts, and its effectiveness should be further investigated both qualitatively and quantitatively.

Community Policing and Local Self Government: Case Study of Serbia

2013 ◽  
Vol 11 (3) ◽  
pp. 293-309 ◽  
Author(s):  
Danijela Spasic ◽  
Sladjana Djuric ◽  
Zelimir Kesetovic
Keyword(s):  
Complex System ◽  
Direct Observation ◽  
Rural Community ◽  
Police Officers ◽  
Community Policing ◽  
Middle Managers ◽  
Qualitative Approach ◽  
Project Implementation ◽  
Community Based

The concept of community policing is based on constant consultations between the police and the local self-government and a complex system of preventative responses. A qualitative approach has been applied in a rural community based on the analysis of administrative documents from 2003 to 2011, direct observation and a survey examining the attitudes of 65 police officers who participated directly in the project implementation. The major findings include the existence of a centralized police model and traditional policing, the resistance of low and middle managers to change and the absence of continuous consultations between the police and local self-government.

scholarly journals Addressing shame: what role does shame play in the formation of a modern medical professional identity?

2019 ◽  
Vol 44 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Sandy Miles
Keyword(s):  
Medical Education ◽  
Professional Identity ◽  
Moral Values ◽  
Medical Professional ◽  
Medical Trainees ◽  
Medical Educators ◽  
Maladaptive Behaviours

SummaryShame is a highly prevalent, though rarely discussed, emotion experienced by trainee doctors. Seeking to avoid the pain of shame can cause significant distress and maladaptive behaviours. However, it plays a key role in helping doctors identify their moral values which, in turn, form the basis of their medical professional identity. This article uses personal doctors’ narratives together with sources from sociology, psychology and medical education to address shame as experienced by medical trainees – its causes, effects and remedies that doctors and medical educators can use to neutralise its malign effects.

Examining the Feasibility and Fit of Family Implemented TEACCH for Toddlers in Rural Settings

2021 ◽  
pp. 105381512110093
Author(s):  
Heather Coleman ◽  
Kara Hume ◽  
Leslie Fanning ◽  
Samantha Scott
Keyword(s):  
Rural Communities ◽  
Rural Community ◽  
Autism Spectrum ◽  
Community Based ◽  
Parent Coaching ◽  
Part C ◽  
Coaching Strategies ◽  
Rural Settings ◽  
The University ◽  
Model Family

Many autism-focused early intervention (EI) models have not yet been adopted by community-based providers in rural settings due to fit and feasibility when working within the Part C model. Family Implemented TEACCH for Toddlers (FITT, based on the University of North Carolina TEACCH Autism Program) is a research-based, Part-C compatible, EI model incorporating parent-coaching and naturalistic strategies with early evidence of efficacy in rural communities. Its use by rural community providers has not yet been examined. Thus, in this multiple baseline study, rural EI professionals ( n = 3) working with caregivers and their toddlers with autism spectrum disorder (ASD) were provided training and weekly coaching on the use of the FITT model and parent-coaching strategies. The implementation of FITT and parent-coaching strategies were measured, and social validity information was gathered from participants. Results indicate that FITT is both feasible to implement, as demonstrated by provider implementation, and acceptable to both EI providers and caregivers.

scholarly journals The Contribution of Citizens to Community-Based Medical Education in Japan: A Systematic Review

2021 ◽  
Vol 18 (4) ◽  
pp. 1575 ◽  
Author(s):  
Ryuichi Ohta ◽  
Yoshinori Ryu ◽  
Chiaki Sano
Keyword(s):  
Systematic Review ◽  
Medical Education ◽  
Comprehensive Care ◽  
Rural Medicine ◽  
Community Based ◽  
Medical Trainees ◽  
Kirkpatrick Model ◽  
Care Practices ◽  
Aging Societies ◽  
The Impact

Community-based medical education (CBME) offers vital support to healthcare professionals in aging societies, which need medical trainees who understand comprehensive care. In teaching comprehensive care practices, CBME can involve citizens from the relevant community. This research synthesizes the impact of the involvement of communities on the learning of medical trainees in CBME. We conducted a systematic review, in which we searched ten databases from April 1990 to August 2020 for original articles in Japan regarding CBME involving citizens and descriptively analyzed them. The Kirkpatrick model was used to categorize the outcomes. Our search for studies following the protocol returned 1240 results; 21 articles were included in this systematic review. Medical trainees reported satisfaction with the content, teaching processes, and teachers’ qualities. Medical trainees’ attitudes toward community and rural medicine improved; they were motivated to become family physicians and work in communities and remote areas. This review clarified that citizen involvement in CBME had an effective impact on medical trainees, positively affecting perceptions of this type of education, as well as improving trainees’ knowledge about and attitude toward community and rural medicine.

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