Inquiry into short-term learning on Japanese rural islands: a qualitative study

ABSTRACT

Background: Community-based medical education (CBME) improves the learning of medical students. The outcomes depend on the circumstances in which students learn. So far, there has been no study on the short-term learning experienced by medical students on rural islands in Japan; hence, we specifically explored this in the case of islands in Okinawa.

Methods: We conducted one-on-one semi-structured interviews with seven medical students and three focus groups, each comprising three medical students. All subjects underwent a three-day clinical training on the rural islands of Okinawa, Japan. All sessions were audio-recorded and transcribed verbatim. We analysed the contents of the interview using the Steps for Coding and Theorisation.

Results: Ten concepts were extracted and four themes generated: 1) rural resources and environments, 2) interaction with inhabitants, 3) rural physicians’ skills, and 4) proposed revisions. These themes and concepts provide valuable insights into the dynamics of medical care on rural islands as well as the benefit of this experience for students trained in urban contexts. The participants learned the importance of collaborating with multiple professionals in ways specific to each rural context. By interacting with various islanders, they developed an understanding of the different cultural backgrounds in which rural physicians work and their ability to adapt to each. This experience motivated them to pursue studies on rural medicine upon return to the mainland.

Conclusion: This study shows that a short-term learning experience on rural islands in Japan may help medical students understand specific rural resources and their importance, the interconnections among the inhabitants, and the competency of primary care physicians.

KEYWORDS:

• Community-based medical education
• situated learning
• steps for coding and theorization
• rural physicians
• interprofessional collaboration

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical consent

This study was approved by the medical ethics committee of the Okinawa Prefectural Nanbu Medical Center and Children’s Medical Center (Approval Number 2014-32).