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Background: Multimorbidity increases with age, leading to various adverse outcomes, including higher mortality, care dependency, hospitalizations, and healthcare costs. Polydoctoring, managing a patient with multimorbidity by multiple healthcare providers, can be a risk of fragmented care and increased healthcare expenditures. This study aims to identify patient‐related factors contributing to polydoctoring in older adults with multimorbidity. Methods: This study is a cross‐sectional study using baseline data from the Kawasaki Aging and Wellbeing Project. Participants were residents of Kawasaki City aged 85–89 years, without disability in basic activities of daily living, and being able to visit study site. The regularly visited facilities (RVF) index was employed to quantify polydoctoring. Polydoctoring was defined as having two or more RVFs. Poisson regression analysis was conducted to assess the association between polydoctoring and patient demographics, including types of chronic conditions and socioeconomic factors. Results: A total of, 968 participants with multimorbidity were analyzed. Increased RVF was significantly associated with eye diseases (rate ratio [RR] 1.27, 95% confidence interval [CI] 1.12–1.44), osteoporosis (RR 1.22, 95% CI 1.08–1.38), prostate diseases (RR 1.22, 95% CI 1.07–1.40), and osteoarthritis (RR 1.16, 95% CI 1.05–1.27). No significant correlation was found with educational status or financial hardship. Conclusion: The study indicated that certain chronic conditions are linked to increased polydoctoring among multimorbid older adults in Japan. However, most of those conditions are considered to be within a scope of family medicine/general practice. Training general practitioners to manage these conditions could reduce healthcare costs and the treatment burden, indicating a direction for future healthcare policy and medical education. [ABSTRACT FROM AUTHOR]

Purpose: This study examines the impact of the 2010 and 2016 Model Core Curriculum (MCC) revisions on medical education across all 82 medical schools in Japan. Methods: A cross-sectional survey was conducted in 2021, focusing on the response to the MCC revisions, curriculum changes, and factors influencing these changes. The survey included questions on approaches to implementing the MCC revisions, timing of curriculum updates, factors triggering these revisions, changes in student performance and career paths, and the introduction of new subjects. Results: The response rate was 100%. Most universities rapidly implemented changes following the 2016 MCC revision, demonstrating agility in adapting to national standards. Key factors influencing curriculum revisions included external evaluations and the MCC revisions themselves. Despite no significant changes in student performance or career paths from faculties' perspective, an increase in scholarly activities was noted. The introduction of new subjects post-2016 reflects a shift toward holistic perspectives such as behavioral science, general medicine/community medicine, and professionalism. Conclusions: The findings highlight a commitment to maintaining educational quality in Japanese medical education. The responsiveness to MCC revisions suggests a growing interest in medical education among faculties and an alignment with global medical education trends to meet evolving healthcare needs. [ABSTRACT FROM AUTHOR]

Introduction: Medical education globally has evolved, with community-based medical education (CBME) and interprofessional education (IPE). This study aimed to explore the implementation of CBME, community comprehensive education, and IPE in Japan. Methods: A cross-sectional study was conducted across all Japanese medical universities in 2021. Data on CBME clinical clerkships, community comprehensive care education, and IPE were collected from 82 medical universities using a self-administered questionnaire and analyzed using descriptive statistics. Results: The study achieved a 100% response rate. 91.5% of universities offered CBME clinical clerkships, with 39.0% providing training periods up to 10 d. Outpatient practices were the primary CBME location in 90% of cases. 85.4% of institutions provided clinical care services, home medical care, and interprofessional collaboration. Direct observations were adopted 85.4% of the universities as an assessment method. Community comprehensive care education peaked in the fourth year (32.9%), while IPE was most prevalent in the first year (48.3%), followed by the fourth year (35.4%). Conclusion: This study, notable for its 100% response rate, highlights the significant incorporation of CBME. Future research should focus on the long-term effects, with recommendations for standardizing CBME curricula and enhancing staff development in a community to improve healthcare outcomes. [ABSTRACT FROM AUTHOR]

Objective: To identify generalism-related competencies that medical students in Japan should acquire in order to provide comprehensive care for patients. Methods: The team responsible for developing the new 'Generalism' section of the 2022 revision of the Model Core Curriculum for Medical Education in Japan (MCC) consisted of nine members from diverse medical backgrounds across Japan. We adopted pragmatism paradigm and analyzed to identify decision-making processes using a qualitative document analysis. Results: The competency list was presented as a four-tier structure. The first tier of generalism was defined as 'take a multi-systemic view of the patient's problems and consider the patient's psychosocial background in order to provide comprehensive, flexible medical care that responds to the needs of the patient and is not limited to one's own specialty, supporting the achievement of individual and societal well-being.' The second tier was framed in terms of 'perspectives' and constructed of four different domains: 'holistic,' 'community,' 'life,' and 'social.' Conclusion: We identified and defined the competencies required by medical students in Japan to provide comprehensive care for patients. By including these competencies in the MCC, undergraduate medical education will be better placed to respond to anticipated changes in the demand for medical care in Japan. Success factors in our guideline development process include facilitating a collaborative and iterative development process, ensuring that diverse perspectives are integrated, and using practical examples and feedback to refine competencies based on a pragmatic approach. [ABSTRACT FROM AUTHOR]

The article provides an overview of the revised Model Core Curriculum for Medical Education (MCC) of Japan, its development process in the Japanese context, and introduces the articles in the issue. Topics include chapters included in the MCC, examples of the research questions asked before proceeding with the revision work, and the results of research and surveys conducted in preparation for the 2022 MCC revision presented in the issue.

Background: Social determinants of health (SDH) are intricately intertwined with various social and economic factors. Reflection is essential for learning about SDH. However, only a few reports have focused on reflection in SDH programs; most were cross-sectional studies. We aimed to longitudinally evaluate a SDH program in a community-based medical education (CBME) curriculum that we introduced in 2018 based on the level of reflection and content on SDH in students' reports. Methods: Study design: General inductive approach for qualitative data analysis. Education program: A 4-week mandatory clinical clerkship in general medicine and primary care at the University of Tsukuba School of Medicine in Japan was provided to all fifth- and sixth-year medical students. Students underwent a 3-week rotation in community clinics and hospitals in suburban and rural areas of Ibaraki Prefecture. After a lecture on SDH on the first day, students were instructed to prepare a structural case description based on encounters during the curriculum. On the final day, students shared their experiences in a small group session and submitted a report on SDH. The program was continuously improved and faculty development was provided. Study participants: Students who completed the program during October 2018–June 2021. Analysis: Levels of reflection were categorized as reflective, analytical, or descriptive. The content was analyzed based on the Solid Facts framework. Results: We analyzed 118 reports from 2018–19, 101 reports from 2019–20, and 142 reports from 2020–21. There were 2 (1.7%), 6 (5.9%), and 7 (4.8%) reflective reports; 9 (7.6%), 24 (23.8%), and 52 (35.9%) analytical reports; and 36 (30.5%), 48 (47.5%), and 79 (54.5%) descriptive reports, respectively. The others were not evaluable. The number of Solid Facts framework items in reports were 2.0 ± 1.2, 2.6 ± 1.3, and 3.3 ± 1.4, respectively. Conclusions: Students' understanding of SDH deepened as the SDH program in the CBME curriculum improved. Faculty development might have contributed to the results. Reflective understanding of SDH might require more faculty development and integrated education of social science and medicine. [ABSTRACT FROM AUTHOR]

Background: To respond to increasingly complicated healthcare needs in primary care settings, all health and medical welfare professionals are required to collaborate with multiprofessionals, namely via "interprofessional work" (IPW). Interprofessional education (IPE) is essential for effective IPW, especially for medical students. This study aimed to determine whether participation in IPE can increase medical students' readiness for interprofessional learning. Method: We examined the difference in readiness of medical students for interprofessional learning before and after an IPE program that used team‐based learning (TBL). Each student was assigned to either a uniprofessional or multiprofessional group. They were evaluated using the Japanese version of the Readiness for Interprofessional Learning Scale (RIPLS). Program participants were 126 second‐year medical students and 18 students of healthcare professions other than medical doctor who participated in a combined IPE program conducted by two universities. Medical students were allocated to 12 uniprofessional and nine multiprofessional groups at random. Results: One hundred and twelve medical students who replied to the questionnaire both before and after the program (valid response rate, 88.9%) were eligible for analysis. Of these, 42 were assigned to uniprofessional groups and 70 to multiprofessional groups. After the program, the RIPLS total score increased to a greater extent in the multiprofessional groups than in the uniprofessional groups (difference 3.17, 95% confidence interval 0.47‐5.88, P =.022). Multiple regression analysis showed the same result. Conclusions: Learning in multiprofessional groups increased medical students' readiness for interprofessional learning in an IPE program using TBL. [ABSTRACT FROM AUTHOR]

Interprofessional education (IPE) for medical students is becoming increasingly important, as reflected in the increasing number of medical schools adopting IPE. However, the current status of and barriers to pre-registration IPE implementation in Japanese medical schools remain unknown. The purpose of this study was to clarify the status and barriers of IPE implementation in medical schools in Japan. We conducted a curriculum survey from September to December 2016 of all 81 medical schools in Japan. We mailed the questionnaire and asked the schools’ undergraduate education staff to respond. The survey items were the IPE implementation status and barriers to program implementation. Sixty-four of the 81 schools responded (response rate 79.0%), of which 46 (71.9%) had implemented IPE, 42 (89.1%) as compulsory programs. Half of IPE programs were implemented in the first 2 years, while less than 10% were implemented in the latter years of medical programs. As part of the IPE programs, medical students collaborated with a wide range of professional student groups. The most common learning strategy was lectures. However, one-third of IPE programs used didactic lectures without interaction between multi-professional students. The most common perceived major barrier to implementing IPE was adjustment of the academic calendar and schedule (82.8%), followed by insufficient staff numbers (73.4%). Our findings indicate that IPE is being promoted in undergraduate education at medical schools in Japan. IPE programs differed according to the circumstances of each school. Barriers to IPE may be resolved by improving learning methods, introducing group discussions between multi-professional students in lectures or introducing IPE programs using team-based learning. In summary, we demonstrated the current status and barriers of IPE implementation in Japanese medical schools. Our findings will likely lead to the promotion of IPE programs in Japan. [ABSTRACT FROM AUTHOR]

Interprofessional education (IPE) for healthcare professionals is important in Japan because of its rapidly aging population and increasingly complex healthcare needs. However, no tools have been validated in the Japanese context to evaluate healthcare professionals’ attitudes towards, or readiness for, IPE. The professional version of the Readiness for Interprofessional Learning Scale (RIPLS) with 23 items was selected for cross-cultural adaptation because it has been widely used internationally and a Japanese edition of the student version has already been developed. We followed a guideline for cross-cultural adaptation and subsequently conducted factor analysis with 368 responses from over 16 professions. Face and content validity was confirmed through the translation process. We obtained four factors with good internal consistency (Cronbach’s alpha > 0.7). These results were similar to those of the original UK study, apart from one factor being divided into two different factors in this study. Studies are required to further confirm the rigor and generalisability of the results; however, the Japanese RIPLS can be used to evaluate healthcare professionals’ attitudes towards IPE, which can eventually lead to a better IPE development for healthcare professionals in Japan. [ABSTRACT FROM PUBLISHER]