Asia Pac Fam Med. 2015 Oct 07;14:8. doi: 10.1186/s12930-015-0025-4. eCollection 2015.
The cultural context of teaching and learning sexual health care examinations in Japan: a mixed methods case study assessing the use of standardized patient instructors among Japanese family physician trainees of the Shizuoka Family Medicine Program.
Asia Pacific family medicine
Cameron G Shultz, Michael S Chu, Ayaka Yajima, Eric P Skye, Kiyoshi Sano, Machiko Inoue, Tsukasa Tsuda, Michael D Fetters
Affiliations
Affiliations
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213 USA.
- University of Michigan Medical School, Ann Arbor, MI USA ; Virginia Mason Medical Center, Internal Medicine Residency, Seattle, Washington USA.
- Department of Family Medicine, Tokushukai Hospital Corporation, Haibara General Hospital, Makinohara, Shizuoka Japan.
- Department of Family and Community Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka Japan.
- Akatchi Family Medicine Center, Kikugawa, Shizuoka Japan.
PMID: 26451130
PMCID: PMC4597438 DOI: 10.1186/s12930-015-0025-4
Abstract
BACKGROUND: In contrast to many western nations where family medicine is a cornerstone of the primary care workforce, in Japan the specialty is still developing. A number of services within the bailiwick of family medicine have yet to be fully incorporated into Japanese family medicine training programs, especially those associated with sexual health. This gap constitutes a lost opportunity for addressing sexual health-related conditions, including cancer prevention, diagnosis, and treatment. In this mixed methods case study we investigated the perceived acceptability and impact of a standardized patient instructor (SPI) program that trained Japanese family medicine residents in female breast, pelvic, male genital, and prostate examinations.
CASE DESCRIPTION: Building on an existing partnership between the University of Michigan, USA, and the Shizuoka Family Medicine Program, Japan, Japanese family medicine residents received SPI-based training in female breast, pelvic, male genital, and prostate examinations at the University of Michigan. A mixed methods case study targeting residents, trainers, and staff was employed using post-training feedback, semi-structured interviews, and web-based questionnaire.
DISCUSSION AND EVALUATION: Residents' and SPIs' perceptions of the training were universally positive, with SPIs observing a positive effect on residents' knowledge, confidence, and skill. SPIs found specific instruction-related approaches to be particularly helpful, such as the positioning of the interpreter and the timing of interpreter use. SPIs provided an important opportunity for residents to learn about the patient's perspective and to practice newly learned skills. Respondents noted a general preference for gender concordance when providing gender-specific health care; also noted were too few opportunities to practice skills after returning to Japan. For cultural reasons, both residents and staff deemed it would be difficult to implement a similar SPI-based program within Japan.
CONCLUSIONS: While the SPI program was perceived favorably, without sufficient practice and supervision the skills acquired by residents during the training may not be fully retained. Deep-rooted taboos surrounding gender-specific health care appear to be a significant barrier preventing experimentation with SPI-based sexual health training in Japan. The feasibility of implementing a similar training program within Japan remains uncertain. More research is needed to understand challenges and how they can be overcome.
Keywords: Family medicine; Japan; Sexual health; Standardized patient instructors
References
- Lancet. 2013 May 11;381(9878):1642-52 - PubMed
- BMC Med Educ. 2005 Sep 15;5:33 - PubMed
- Lancet. 2011 Sep 17;378(9796):1106-15 - PubMed
- Cancer Sci. 2011 Apr;102(4):877-82 - PubMed
- Lancet. 2011 Sep 24;378(9797):1174-82 - PubMed
- Asian Pac J Cancer Prev. 2013;14(7):4313-8 - PubMed
- Asia Pac Fam Med. 2013 May 22;12(1):1 - PubMed
- J Reprod Med. 2003 Mar;48(3):194-200 - PubMed
- J Obstet Gynaecol Res. 2011 Jul;37(7):887-92 - PubMed
- Int J Womens Health. 2013 Dec 17;6:11-23 - PubMed
- Bull World Health Organ. 2008 Oct;86(10):805-12, A - PubMed
- Vaccine. 2012 Nov 20;30 Suppl 5:F12-23 - PubMed
- J Epidemiol. 2007 Dec;17 Suppl:S3-13 - PubMed
- Vaccine. 2008 Aug 19;26 Suppl 12:M30-42 - PubMed
- Cancer Sci. 2009 Jul;100(7):1312-6 - PubMed
- Acad Med. 2006 Dec;81(12):1069-75 - PubMed
- Anthropol Med. 2013;20(3):299-310 - PubMed
- Kansenshogaku Zasshi. 2013 Sep;87(5 Suppl 8):24-8 - PubMed
- J Fam Pract. 2002 Jan;51(1):72-3 - PubMed
- BMC Med Educ. 2007 Sep 11;7:31 - PubMed
- Asia Pac Fam Med. 2014 Apr 28;13(1):6 - PubMed
- Soc Sci Med. 1994 Feb;38(4):489-95 - PubMed
- Br J Gen Pract. 2009 Sep;59(566):699-701 - PubMed
- Arch Fam Med. 1997 Jan-Feb;6(1):59-62 - PubMed
- Health Place. 2010 Jan;16(1):164-6 - PubMed
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