Abstract
BackgroundCommunity based education (CBE), defined as “a means of achieving educational relevance to community needs and, consequently, of implementing a community oriented educational program,” is reported to be useful for producing rural physicians in Western countries. However, why some physicians withdraw from their teaching roles is not well known, especially in Asian countries. The aim of this study was to clarify the requisites and obstacles for taking part in CBE.MethodsWe combined two steps: preliminary semi-structured interviews followed by workshop discussions. First of all, we interviewed four designated physicians (all male, mean age 48 years) working in one rural area of Japan, with less than 10,000 residents. Secondly, we held a workshop at the academic conference of the Japan Primary Care Association. Fourteen participants attending the workshop (seven male physicians, mean age 45 years, and seven medical students (one female and six male), mean age 24 years) were divided into two groups and their opinions were summarized.ResultsIn the first stage, we extracted three common needs from interviewees; 1. Sustained significant human relationships; 2. Intrinsic motivation; and 3. Tangible rewards. In the second stage, we summarized three major problems from three different standpoints; A. Preceptors’ issues: more educational knowledge or skills, B. Learner issues: role models in rural areas, and C. System issues: supportive educational system for raising rural physicians.ConclusionsOur research findings revealed that community physicians require non-monetary support or intrinsic motivation for their CBE activities, which is in accordance with previous Western studies. In addition, we found that system support, as well as personal support, is required. Complementary questionnaire surveys in other Asian countries will be needed to validate our results.
Highlights
Community based education (CBE), defined as “a means of achieving educational relevance to community needs and, of implementing a community oriented educational program,” is reported to be useful for producing rural physicians in Western countries
To promote CBE and increase the number of physicians working in rural areas, we explored requisites for the retention of physicians engages in CBE activities
Since increasing the number of community physicians’ “role models (Workshop Problem B)” is needed, it might be a useful strategy for recruiting younger rural physicians if CBE were promoted [3,4,5]
Summary
Community based education (CBE), defined as “a means of achieving educational relevance to community needs and, of implementing a community oriented educational program,” is reported to be useful for producing rural physicians in Western countries. Some studies have shown that CBE is effective, from the standpoint of: the effect on recruitment of new community primary care physicians [3,4,5]; promoting professional development in students when they are Community preceptors, including general physicians working in rural areas, seem to have an interest in teaching students and feel strong intrinsic motivation for their teaching role [8,9] Some obstacles such as too much clinical work and shortage of administrative support or financial compensation, may result in burnout and inability to sustain their educational activities [1,10,11]. Educational policies, like teaching in rural or small village locations, seem to be important factors
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