How do medical students develop the selfawareness as social entities during the longitudinal communication experience with citizens?

Abstract

Objective: Diverse interactions with local citizens are known to broaden the health perspectives of medical students, stimulating their motivation to learn, and improving their communication skills. In recent years, the rapid decrease in birth rates and the transition toward a nuclear family structure have posed a challenge for medical students in Japan, given their lack of experience in communicating with citizens who are older than they are or whose social backgrounds differ from their own. We aim at exploring how a longitudinal interaction with citizens can develop medical students’ communication skills and understanding of themselves as social entities. Method: Thematic analysis was used to analyze descriptive comments submitted to an e-portfolio by 100 first-year medical students who participated in longitudinal community-based experiential learning for six weeks with one of three different kinds of citizens such as the elderly, pregnant mothers, or nursery school children in 2011. Five independent researchers extracted themes from comments collected from 45 individual students on each six weekly encounters. The remaining data were used to confirm data saturation. Results: Two different themes emerged from the analysis: 1) understanding of citizen’s centeredness in communication, and 2) understanding of human relationship and expansion of world as a social existence. The first theme contained three different stages: i) survival, ii) trial and error, and iii) shifting gaze. The second theme contained four different stages: i) narrow, self-centered worlds, ii) awareness of the citizen’s existence, iii) understanding the worlds of the citizens and expanding their views of life, and iv) self-realization as a social entity within an expanded worldview. These two themes became progressively deeper through the longitudinal and mutual interaction. Conclusion: The longitudinal, mutual communication experiences with citizens has an impact on the students’ development of self-awareness as social entities accompanied with improving their communication skills.