The characteristics of a good clinical teacher as perceived by resident physicians in Japan: a qualitative study

BMC Medical Education

Takanobu Sakemi²  Shunzo Koizumi¹  Yasutomo Oda²  Sei Emura⁶  Maiko Ono³  Hiromi Nabeta⁵  Makoto Kikukawa⁴ 

[1] Shichijo Clinic, Kyoto, Japan;Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga, Japan;Karatsu Municipal Hospital Kitahata, Saga, Japan;Kyushu University, Japan Department of Medical Education, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8285, Japan;Department of Neuropsychiatry, Faculty of Medicine, Saga University, Saga, Japan;Center for Graduate Medical Education Development and Research, Saga University Hospital, Saga, Japan

关键词: Japan;    Qualitative study;    Culture;    Clinical teacher;    Resident;   

Others  :  1138854
DOI  :  10.1186/1472-6920-13-100

 received in 2012-04-23, accepted in 2013-07-22,  发布年份 2013

【 摘 要 】

Background

It is not known whether the characteristics of a good clinical teacher as perceived by resident physicians are the same in Western countries as in non-Western countries including Japan. The objective of this study was to identify the characteristics of a good clinical teacher as perceived by resident physicians in Japan, a non-Western country, and to compare the results with those obtained in Western countries.

Methods

Data for this qualitative research were collected using semi-structured focus group interviews. Focus group transcripts were independently analyzed and coded by three authors. Residents were recruited by maximum variation sampling until thematic saturation was achieved.

Results

Twenty-three residents participated in five focus group interviews regarding the perceived characteristics of a good clinical teacher in Japan. The 197 descriptions of characteristics that were identified were grouped into 30 themes. The most commonly identified theme was “provided sufficient support”, followed by “presented residents with chances to think”, “provided feedback”, and “provided specific indications of areas needing improvement”. Using Sutkin’s main categories (teacher, physician, and human characteristics), 24 of the 30 themes were categorized as teacher characteristics, 6 as physician characteristics, and none as human characteristics.

Conclusions

“Medical knowledge” of teachers was not identified as a concern of residents, and “clinical competence of teachers” was not emphasized, whereas these were the two most commonly recorded themes in Sutkin’s study. Our results suggest that Japanese and Western resident physicians place emphasis on different characteristics of their teachers. We speculate that such perceptions are influenced by educational systems, educational settings, and culture. Globalization of medical education is important, but it is also important to consider differences in educational systems, local settings, and culture when evaluating clinical teachers.

【 授权许可】

   
2013 Kikukawa et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Malinowski B: Argonauts of the western Pacific. London: Routledge & Kegan Paul; 1922.
• [2]Nishigori H, Otani T, Plint S, Uchino M, Ban N: I came, I saw, I reflected: a qualitative study into learning outcomes of international electives for Japanese and British medical students. Med Teach 2009, 31(5):e196-e201.
• [3]Harden R: International medical education and future directions: a global perspective. Acad Med 2006, 81(12):S22.
• [4]Harden R, Hart I: An international virtual medical school (IVIMEDS): the future for medical education? Medical Teacher 2002, 24(3):261-267.
• [5]Schwarz M: Globalization and medical education. Medical Teacher 2001, 23(6):533-534.
• [6]Kikukawa M: Igakukyouiku wo subspeciality to shitemanabutoiu sentakushi Igakukaishinbun. Igakkaishinbun 2010., 2874http://www.igaku-shoin.co.jp/paperDetail.do?id=PA02874_02 webcite
• [7]Onishi H, Yoshida I: Rapid change in Japanese medical education. Med Teach 2004, 26(5):403-408.
• [8]Kozu T: Medical education in Japan. Acad Med 2006, 81(12):1069-1075.
• [9]Japan Concil for Evaluation of Clinical Training. http://www.jce-pct.jp webcite
• [10]Nisbett R, Miyamoto Y: The influence of culture: holistic versus analytic perception. Trends Cogn Sci 2005, 9(10):467-473.
• [11]Wortham S: The interdependence of social identification and learning. American Educational Research Journal 2004, 41(3):715.
• [12]Robins L, Fantone J, Hermann J, Alexander G, Zweifler A: Culture, communication, and the informal curriculum: improving cultural awareness and sensitivity training in medical school. Acad Med 1998, 73(10):S31.
• [13]Tang TS, Bozynski ME, Mitchell JM, Haftel HM, Vanston SA, Anderson RM: Are residents more comfortable than faculty members when addressing sociocultural diversity in medicine? Acad Med 2003, 78(6):629-633.
• [14]Kagawa-Singer M, Kassim-Lakha S: A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Acad Med 2003, 78(6):577-587.
• [15]Stern D, Williams B, Gill A, Gruppen L, Woolliscroft J, Grum C: Is there a relationship between attending physicians' and residents' teaching skills and students' examination scores? Acad Med 2000, 75(11):1144.
• [16]Sutkin G, Wagner E, Harris I, Schiffer R: What makes a good clinical teacher in medicine? A review of the literature. Acad Med 2008, 83(5):452-466.
• [17]Elzubeir M, Rizk D: Identifying characteristics that students, interns and residents look for in their role models. Medical Education 2001, 35(3):272-277.
• [18]Lingard L, Albert M, Levinson W: Grounded theory, mixed methods, and action research. BMJ 2008, 337:a567.
• [19]Barbour R: Making sense of focus groups. Medical Education-Oxford 2005, 39(7):742-750.
• [20]Krueger R, Casey M: Focus groups: A practical guide for applied research. London: Sage Publications; 2008.
• [21]Patton MQ: Qualitative research & evaluation methods. 3rd edition. London: Sage Publications; 2002:55-58.
• [22]Shaw I: Qualitative evaluation. London: Sage Publications; 1999:175-176.
• [23]Begley CM: Using triangulation in nursing research. J Adv Nurs 1996, 24(1):122-128.
• [24]Paukert JL, Richards BF: How medical students and residents describe the roles and characteristics of their influential clinical teachers. Acad Med 2000, 75(8):843-845.
• [25]JMA: Igakubukyouiku Shokirinshoukenshuseido nituiteno Nihon Ishikai No Kangae. Japan Medical Association; 2011. http://dl.med.or.jp/dl-med/teireikaiken/20110112_2.pdf webcite
• [26]Ebihara S: More doctors needed before boosting clinical research in Japan. Lancet 2007, 369(9579):2076.
• [27]Nakajima K, Kurata Y, Takeda H: A web-based incident reporting system and multidisciplinary collaborative projects for patient safety in a Japanese hospital. Qual Saf Health Care 2005, 14(2):123.
• [28]Paukert J, Hsieh G: From Medical Student to Intern: Where Are the Role Models? JAMA 2001, 285(21):2781.
• [29]Maeno T, Nakamura A, Maeno T, Ozaki M, Kimura T, Tomita E, Sasahara S, Matsuzaki I: Resident stress in the new postgraduate clinical training system. Medical Education(Japan) 2008, 39(3):175-182.
• [30]Hsu P: Confucian traditions in East Asian modernity: Moral education and economic culture in Japan and the four mini-dragons. Journal article by Pi-Ching Hsu; The Historian 1999, 61:176.
• [31]Iwata Y: Kyoushikyouiku Kyouinyouseikennkyu no Kadai to Houhou. Curriculum Center for Teachers, Tokyo Gakugei University annual research report 2009, 8:64-71.
• [32]Georgakopoulos A: Teacher effectiveness examined as a system: Interpretive structural modeling and facilitation sessions with US and Japanese students. International Education Studies 2009, 2(3):60.
• [33]Mehrabian A: Implicit Communication of Emotions and Attitudes. California: Wadsworth Publishing Company; 1971.
• [34]Kisiel JB, Bundrick JB, Beckman TJ: Resident physicians' perspectives on effective outpatient teaching: a qualitative study. Adv Health Sci Educ Theory Pract 2010, 15(3):357-368.