A case study of an international fellowship to improve clinical education in a cross-cultural setting

Abstract

I hadthe privilege of participating in the developmentand implementation of a fellowship programdesigned to provide Japanese physician educa-tors exposure to USA academic primary care. I played an active role in designing my fellow-ship curriculum. Dr. Taylor and I negotiated andagreed upon three goals for the one-year pro-gram: i) develop a strong knowledge base in theliterature relevant to learner-centered clinicaleducation in primary care and office based prac-tice, ii) develop skills in independent functioningand creative problem-solving related to the rele-vant issues in medical education through activeparticipation in experiential learning, and iii)develop an attitude toward the educationalprocess to become a life-long student of learner-centered education focused on service toimprove population health through primary care.Every two weeks Dr. Taylor and I discussed theobjectives and activities of the fellowship. I wasexpected to provide a detailed report about myprogress. Based on this report, we modified myplanned activities or objectives as needed. My principal fellowship activities included thefollowing: i) a literature review to identify keyreferences on education of medical students inoffice setting; ii) observation of Harvard medicalstudents’ learning, including Patient Doctor(PD) I course for interviewing, PD II for physicalexamination, PD III for quality improvement,analysis of systems, and reflection, the ObjectiveStructured Clinical Examination of the entiresecond-year class, ambulatory teaching in theambulatory month of the core medicine clerk-ship and the longitudinal primary care clerkship;iii) interactive reviews of video recordings ofambulatory teaching, iv) precepting a medicalstudent in office practice, and v) participation inthe Harvard Macy Institute’s Program forEducators in the Healthcare Professions in 2009.After completing the fellowship program, Ithought carefully about what I had learned.There were four principal lessons learned.