Japanese Medical Students Research Articles

Factors Affecting Undergraduate Medical Science Students’ Motivation to Study during the COVID-19 Pandemic

In the current study, we investigated the motivational status and underlying factors of the motivational changes among Japanese medical science students brought by the COVID-19 pandemic. Two groups of second-year undergraduate medical science students (training to become medical technologists and/or medical science researchers) participated in this study in the summers of 2020 and 2021 by writing essays describing how the pandemic had affected their motivation to study. A content analysis of the motivation status and underlying factors (both motivating and demotivating factors) was conducted before statistical analysis was used to investigate possible differences between the sexes and the two groups. In total, 73 essays were included in the analysis. The students had increased motivation to study in both groups (89% and 62%, respectively); however, in Group 2021, 19% of the students (all women) had decreased motivation. Among the underlying reasons behind the increased motivation, students showed a desire to help/save others, contribute to the development of medical science, increase knowledge, and disseminate correct information. The demotivating factors were largely linked to online learning and the negative emotions associated with lockdown. Our findings suggest that, for Japanese medical science students, the COVID-19 pandemic has been an overall motivating experience for our students. However, the prolonged pandemic and lockdown measures could attenuate this and be particularly disruptive for women.

Impact of Telemedicine Lecture on Online Medical Interview Performance

In 2019, Showa University implemented a compulsory clinical English course for all 4th-year medical students that included a medical interview with an English-speaking standardized patient (ESSP), but since 2020 the interviews have been conducted online due to the novel coronavirus pandemic. These students reported difficulties with eye contact and reading body language/non-verbal cues of the ESSP. In this project report, we describe a telemedicine lecture that we included in the 2021 course and compare students’ reported difficulties during the online medical interview for two years. The 2021 cohort reported significantly less difficulties with eye contact than the 2020 cohort, and a similar trend was found for reading body language/nonverbal cues and creating rapport with the ESSP. While possible third variables, such as 2021 cohort’s greater comfort in using teleconference platforms, may limit the interpretation of these results, we conclude that Japanese medical students can clearly benefit from the inclusion of telemedicine education into the medical curriculum as online healthcare services become the “new normal” in Japan.

Perspectives of medical students on future work-life balance in Japan: A qualitative study using postlecture comments.

Recently, work-life balance (WLB) has grown in popularity among medical professionals, and an increasing number of institutions are including WLB lectures into medical school curricula. In Japan, medical student lectures concerning WLB were given in at least 50% of universities. However, with these changes in social awareness, it is not fully clear how current medical students view WLB. The purpose of this study is to explore how Japanese medical students think about their future WLB from the perspective of constructivism. We used one of the present authors' work career and life cycle as an example of a physician's career in a lecture for medical students on community medicine in 2020. Students were asked to remark on their thoughts on the talk and their views on future WLB, and we analyzed their comments qualitatively to understand the current male and female medical students' perspectives on future WLB. We used the feedback of 119 participants (71 males and 48 females). Most students, regardless of gender, thought WLB was essential, but the factors they mentioned as being connected to WLB mirrored the continuing traditional notions of gender-based division of labor and doctors' fixed-job image. Male students' views, on the other hand, were more varied, reflecting recent generational shifts. For the improved WLB in medical doctors, it would be required to tackle the problem from several angles, including not just increasing support for WLB but also fostering an awareness of the essence of WLB in pregraduate medical school.

Gender differences in repeat-year experience, clinical clerkship performance, and related examinations in Japanese medical students.

While the number of female medical students is increasing in Japan, gender differences in medical school performance have not been studied extensively. This study aimed to compare gender differences in repeat-year experience, Clinical Clerkship (CC) performance, and related examinations in Japanese medical students. We retrospectively analyzed the number of repeat-year students and years to graduation for male and female medical students, and assessed gender differences in performance on computer-based testing (CBT) before CC, CC as evaluated by clinical teachers, the CC integrative test, and the graduation examination in 2018-2020 graduates from our medical school. Subgroup analyses excluding repeat-year students were also performed. From 2018 to 2020, 328 medical students graduated from our medical school. There were significantly fewer repeat-year female students compared to male students (P = .010), and the average number of years to graduate was significantly higher for male students than female students (P < .001). Female students showed higher scores and performance in all integrative tests and CC (P < .05, each). In analysis excluding repeat-year students, there were no significant gender difference in performance on the CBT, and CC integrative test, although female students significantly outperformed male students on the CC and graduation examination. Female medical students had a fewer number of repeat-years and performed better in the CC and graduation examination compared to their male counterparts.

Relationship between rural self-efficacy and rural career intent after rural clinical training: a study on medical students in Japan.

BackgroundIn Japan, community medicine clerkships facilitate positive attitudes toward rural medical practice and encourage rural recruitment. Rural self-efficacy has been shown to influence rural career intent following a rural clinical placement. However, the impact of subjective difficulties of living in a rural area on future rural career intent is also important. This study aims to explore whether rural self-efficacy influences the relationship between difficulty with living in a rural area and rural career intent. MethodsThe subjects included 308 male and 255 female participants aged 20–41 [median (interquartile range): 22 (21–22)] years. Rural self-efficacy was based on a validated scale consisting of 15 questions. Difficulty with living in a rural area was measured asking students. A cohort survey was conducted to evaluate the effect of the rural self-efficacy score on the rural career intent of Japanese medical students after they completed their rural clinical training.ResultsThe following variables were significantly associated with a higher rural self-efficacy score: female sex (p = 0.003), age < 21 years (p = 0.013), having a doctor as a role model (p < 0.001), gaining admission through a school recommendation (p = 0.016), living in a rural or remote area until the age of 18 years (p = 0.018), and orientation towards general medicine (p < 0.001). In addition, baseline difficulty with living in a rural area was significantly associated with a lower self-efficacy score (p < 0.001). Participants with a stronger intent to practice in a rural area before rural clinical training had higher rural self-efficacy and showed a stronger positive rural career intent after rural clinical training (p < 0.001). A multivariable logistic regression analysis demonstrated that difficulty with living in a rural area [odds ratio (OR): 0.61; 95% confidence interval (CI), 0.39–0.84] was still associated with lower rural career intent after rural clinical training, independent of all confounders such as gender, age, scholarship for regional duty, rural background, and orientation towards general medicine. However, when rural self-efficacy (OR, 1.12; 95% CI, 1.07–1.16) was added as a factor for rural career intent, difficulty with living in a rural area (OR, 0.68; 95% CI, 0.43–1.06) was no longer observed as an associated factor.ConclusionSubjective difficulty with living in a rural area was shown to reduce future rural career intent, but high rural self-efficacy ameliorated this decline.

Association between sedentary behavior and depression among Japanese medical students during the COVID-19 pandemic: a cross-sectional online survey

BackgroundSedentary behavior, particularly prevalent during the 2019 coronavirus disease (COVID-19), has been shown to lead to depression. In medical students, this could negatively affect the provision of healthcare. Thus, this study aimed to investigate the association between sedentary behavior and depression in Japanese medical students during the COVID-19 pandemic.MethodsAn online cross-sectional survey was conducted from July 30 to August 30, 2021, using anonymous questionnaire system to assess respondents’ sociodemographic characteristics, physical activity, sedentary behavior among 1000 Japanese university students. Depression was assessed using the Patient Health Questionnaire-2 (PHQ-2). The data of 484 respondents (48.4%) were included in a stepwise analysis, where we set the difference between medical and non-medical students as Model 1 and that between medical students with and without depression as Model 2. For group comparisons of both models, the chi-square test was used for sociodemographic characteristics, and the Mann–Whitney U-test was used for physical activity and sedentary behavior. In Model 2, factors associated with depression among medical students were analyzed by logistic regression analysis.ResultsIn Model 1, medical students were less physically active (p < 0.001), had longer sedentary time (p < 0.001), and had higher PHQ-2 scores (p = 0.048) than non-medical students. In Model 2, medical students with depression had longer sedentary time (p = 0.004) and longer leisure screen time than those without depression (p = 0.007). Moreover, logistic regression analysis adjusted for potential confounders showed that sedentary time (OR = 1.001, p = 0.048) and leisure screen time (OR = 1.003, p = 0.003) were significantly associated with depression among medical students.ConclusionsBased on these results, it is evident that reducing Japanese medical students’ sedentary time and leisure screen time can help combat depression during the COVID-19 pandemic; thus, these results can guide the development of appropriate interventions to prevent and treat depression.

Factors Associated with Motivation for General Medicine among Rural Medical Students: A Cross-Sectional Study.

General medicine, as the Japanese version of primary care or family medicine, is critical for healthcare in aging societies. Medical students’ perceptions of general medicine and education might be associated with changes in the number of general physicians. This study aimed to clarify the association between these perceptions and students’ preferences for general medicine. A cross-sectional survey was conducted among Japanese medical students using a questionnaire on their perceptions regarding general medicine, background, and preferences for general medicine (knowledge, interest, motivation, and intention). The response rate was 70.3% (490/697). There was a large percentage gap between interest and motivation; therefore, a logistic regression analysis was performed to investigate the cause of this difference. The perceptions that general medicine meets the needs of society and the lack of general medicine educators were positively associated with motivation to become a general physician. In contrast, perceptions of lack of exposure to general medicine beyond the curriculum and inaccessibility were negatively associated with motivation. Medical students’ motivation to pursue general medicine may increase with improvements in flexible general medicine education and accessibility. Future research should investigate the relationship between students’ perceptions of general medicine and their motivation to become general physicians through longitudinal studies.

Interest in Infectious Diseases specialty among Japanese medical students amidst the COVID-19 pandemic: A web-based, cross-sectional study.

IntroductionThe emergence of the novel coronavirus disease of 2019 (COVID-19) has led to huge disruptions in the medical field and society. The significance of training and education for experts has been increasingly acknowledged in Japan, where the number of infectious disease (ID) specialists is reportedly insufficient. In this paper, we report the results of a web-based survey that was conducted to reveal the ways in which the COVID-19 pandemic has influenced medical students’ awareness of ID specialists and future career choices.MethodThis cross-sectional descriptive study was conducted in March 2021 and targeted 717 medical students belonging to Medical School of Okayama University, Japan. The questionnaire consisted of four questions meant to assess students’ knowledge and future intentions of becoming ID specialists.ResultsWe obtained 328 eligible questionnaires (response rate: 45.7%). Of 227 (69.2%) students who were aware of ID specialists, 99 (43.6%) answered that they came to know about them only after the pandemic, 12 (3.7%) answered that their interest in being an ID specialist arose during the pandemic, while 36 (11.0%) responded that they would rather not become ID specialists. At the time of the survey, 5 students (1.5%) were aiming to become ID specialists.ConclusionWe observed a very low rate of interest to be an ID specialist among medical students. The experience of the pandemic does not seem to have influenced Japanese medical students to choose ID as a specialty for their careers. Continuous efforts to increase the number of ID specialists are necessary in Japan as a countermeasure against the coming pandemic.

The Decreasing Trends of Pulse Wave Velocity and Ankle- Brachial Pressure Index in Japanese Medical Students: A Sixteen-Year Study

The Decreasing Trends of Pulse Wave Velocity and Ankle- Brachial Pressure Index in Japanese Medical Students: A Sixteen-Year Study

Complex motivations of Japanese medical students to an online medical English course during the COVID-19 pandemic.

Background: In response to globalism, many East-Asian countries now include a Medical English course in their undergraduate medical education syllabus. The purpose of this study was to explore the relationship between the related attribute factors of students' motivation to learn medical English through an online modality. Methods: Of 134 eligible fourth-year medical students who participated in an Online Medical English course at a Japanese medical school, 105 were enrolled in this single cohort study. The participants completed pre- and post-course surveys regarding their motivation during the course, including perceived academic control and task value, and their assignment scores. A structural equation model was used to examine the hypothesized relationship of constructs, based on control-value theory. Results: The model showed a good fit for the data (χ 2[df=7] = 1.821, p=0.969, CFI = 1.000, RMSEA < 0.001, SRMR < 0.05, GFI = 0.993, AGFI = 0.980). The latent variables of the perceived course achievement related to the observed variables of academic control and task value scale scores, and negatively predicted willingness for self-study after course completion. In addition, the preference of English as the course language negatively predicted willingness for self-study of medical English. Conclusion: Choice of English as the language of instruction and perceived high course achievement negatively predicted students' motivation for further English self-study after the class. The importance of incorporating the perspective of lifelong learning into the teaching of medical English was recognized.

Text analysis of personal statements written in English by Japanese medical students

Introduction: Personal statements are important documents in the admission and programme application processes, including international elective programmes, in medical education. However, writing these is challenging for international applicants not only because of their unfamiliarity with this genre but also their English academic writing skills. This study aims to explore the organisation and elaboration of text in personal statements written by Japanese medical students for international elective programme application. Methods: Drawing on genre analysis, the first draft of personal statements written by eight fifth-year medical students at a Japanese university were analysed. The text data were deductively classified into moves and steps, using Chiu’s framework of the personal statement genre. Results: In the introduction, Japanese medical students commonly described the context and issues of healthcare in Japan and the future goals for physicians. In the move of the relevant background, it was notable that six out of eight personal statements showed personality. Although a range of moves was covered when writing about the reasons for applying, only two students described their understanding of programmes and institutional attributes. In the move of conclusion, they focused more on writing their goals of future success and contribution to the course. Furthermore, no applicant expressed self-promotion and praise for academics, programmes, and institutions. Conclusion: The findings of this study can provide a springboard for the development of support for Japanese students’ academic writing in English in medical education across cultures.

Cross-Country Student Perceptions about Online Medical Education during the COVID-19 Pandemic.

(1) Introduction: Most educational institutions around the world have shifted from traditional face-to-face to online education amid COVID-19. This change may particularly impact medical students, whose education is heavily influenced by clinical learning experiences. Accordingly, we investigated medical students’ perceptions about positive and negative aspects of online medical education in Japan and overseas during the COVID-19 pandemic. (2) Methods: In-depth online interviews were conducted among 13 Japanese medical students and five medical students from Slovakia, Norway, and Hungary. Interviews were conducted from 23rd September to 3rd October 2020 using the snowball sampling method. Questions were focused on five main areas: Q1 the type of online education; Q2 advantages and disadvantages of online education; Q3 any changes in the relationship with teachers, friends, and family; Q4 any opinions about further improvements in online education; and Q5 any needs for affiliation with a particular university. Then thematic analysis was conducted. (3) Results: The results of the thematic analysis revealed the following four themes that represent the positive and negative aspects of online medical education; Theme 1: Timesaving and Flexibility; Theme 2: Technical problems and lack of digital skills; Theme 3: Unstandardized teaching skills; Theme 4: Lack of experience beyond medical school lectures. (4) Conclusions: While online education was found useful in terms of saving time and creating a flexible learning environment, many important drawbacks were noted such as internet and computer problems and unstandardized teaching skills, and lack of quality assurance. In addition, experiences outside the classroom such as making relationships with faculty and friends, conducting research and participating in extracurricular activities were missed, which they normally enjoy in college life.

Japanese medical students' awareness of cardiopulmonary resuscitation in the context of the COVID-19 pandemic.

ABSTRACTAimTo evaluate Japanese medical students’ awareness of newly recommended cardiopulmonary resuscitation (CPR) and airway management procedures in the context of the coronavirus disease (COVID‐19) pandemic.MethodsAn online survey was sent in December 2020 to all medical students at Hirosaki University in Japan. The survey included 15 questions and quizzes regarding prior experience of learning the new CPR guidelines in response to COVID‐19, knowledge of conventional CPR, and COVID‐19 context CPR and airway management procedures.ResultsOf all medical students at the university, 457 (57.1%) responded to the survey. Among these, 22% reported that they were knowledgeable about CPR procedure in the COVID‐19 pandemic setting. Prior knowledge of CPR in the context of COVID‐19 was a significant positive predictor of quiz score regarding the CPR procedure (β = 0.60, P < 0.01) and the airway management procedure (β = 0.34, P = 0.02) in the context of the COVID‐19 pandemic.ConclusionsMedical students with experience learning the new COVID‐19 context CPR guidelines had sufficient knowledge of CPR and advanced airway management procedures in the setting of the COVID‐19 pandemic. Implementation of a formal medical education curriculum based on the newly recommended CPR and advanced life support guidelines is needed to improve medical students’ awareness and skills of CPR and airway management in the context of the COVID‐19 pandemic.

Impact of general practice / family medicine clerkships on Japanese medical students: Using text mining to analyze reflective writing.

Background: In order for general practice / family medicine clerkships to be improved in undergraduate medical education, it is necessary to clarify the impacts of general practice / family medicine clerkships. Using text mining to analyze the reflective writing of medical students may be useful for further understanding the impacts of clinical clerkships on medical students. Methods: The study involved 125 fifth-year Fukushima Medical University School of Medicine students in the academic year 2018-2019. The settings were three clinics and the study period was 5 days. The clerkships included outpatient and home visits. Students’ reflective writing on their clerkship experience was collected on the final day. Text mining was used to extract the most frequent words (nouns) from the reflective writing. A co-occurrence network map was created to illustrate the relationships between the most frequent words. Results: 124 students participated in the study. The total number of sentences extracted was 321 and the total number of words was 10,627. The top five frequently-occurring words were patient, home-visit, medical practice, medical care, and family. From the co-occurrence network map, a co-occurrence relationship was recognized between home-visit and family. Conclusion: Data suggest that medical students may learn the necessity of care for the family as well as the patient in a home-care setting.

English as a Vocational Passport: Japanese Medical Students and Second Language Learning Motivation

Recently, Japanese medical students are expected to acquire a high degree of English proficiency with the tacit understanding that it will feature in their future profession through interactions with non-Japanese patients and/or engagement with medical research. However, to the best of our knowledge, the motivation of Japanese medical students to learn English as a second language (L2) has not been studied. Using quantitative and qualitative questionnaires, we investigated the L2 learning motivation of second-year Japanese medical students and the degree to which the students have international posture, i.e., their awareness and openness to internationalization. The results revealed that the students were primarily instrumentally and vocationally motivated; in other words, their chief motivation for L2 learning came from an understanding of the usefulness of L2 proficiency for their future profession. The results also showed that the students had strong international posture, as evidenced by a deep desire to communicate internationally and an understanding of the role of English as a tool for global communication. The findings suggest that, to sustain or improve L2 learning motivation, educators should employ study materials that are pertinent to students’ future needs and professions.

Impact of the Pressure-Free Yutori Education Program on Myopia in Japan.

This study aimed to investigate the influence of educational pressure on myopia. A less-intense school curriculum was introduced nationally in Japan beginning in 2012 based on a pressure-free education policy. In this retrospective observational study, a total of 1025 Japanese medical students of Asahikawa Medical University underwent measurements of the cycloplegic refractive error and axial length (AL), from 2011 to 2020. The spherical equivalent (SE) and AL were correlated significantly with the fiscal year of births (p = 0.004 and p = 0.034, respectively) only during enforcement of the system of high-pressure education. The SE and AL regression rates during the two educational approaches differed significantly (p = 0.004 and p = 0.037, respectively). The prevalence of high myopia was correlated significantly (p < 0.001) only during the system of high-pressure education. The regression of the prevalence rate of high myopia during the two education approaches differed significantly (p = 0.010). The progression rates of myopia and increased prevalence of high myopia were observed only during high-pressure education, suggesting that not only ophthalmologists but also educators and the government should work on together to control the progression of myopia.

Digital learning in medical education: comparing experiences of Malaysian and Japanese students

BackgroundMedical education has undergone a transformation from conventional to digital learning, enabling learning without any time and place restrictions. Nevertheless, the actual trends of usage and its impact on learning motivation among medical students between developed and developing nations are yet to be investigated. Hence, this study compares the effect of digital learning on learning motivation among Malaysian and Japanese medical students in Universiti Kebangsaan Malaysia (UKM) and Shiga University of Medical Science (SUMS) respectively.MethodsA modified Students Motivation towards Science Learning (SMTSL) was used to assess the digital learning usage and learning motivation among 150 UKM and 147 SUMS medical students throughout Year 1 to 5.ResultsThe frequency of digital learning usage and learning motivation among UKM medical students was significantly higher as compared to SUMS (p < 0.001). Electronic books (e-books) were the most preferred source of digital learning among UKM medical students as compared to SUMS medical students who used research articles, e-books, online courses and videos at similar frequencies. UKM medical students in the clinical phase exhibited a significantly higher learning motivation as compared to preclinical students (p < 0.05) but not among SUMS medical students.ConclusionA suitable learning environment should be developed to encourage digital learning usage among different levels of medical students to enhance its complementary role in medical education and augment the level of motivation among medical students in continuous lifelong learning.

Japanese medical learners\u2019 achievement emotions: Accounting for culture in translating Western medical educational theories and instruments into an asian context

Medical learners’ achievement emotions during educational activities have remained unexamined in Asian cultural contexts. The Medical Emotion Scale (MES) was previously developed to assess achievement emotions experienced by North American medical learners during learning activities. The goal of this study was to create and validate a Japanese version of the Medical Emotion Scale (J-MES). We translated the MES into Japanese and conducted two initial validation studies of the J-MES. In the first pilot study, we asked five, native-Japanese, second-year medical students to assess their emotions with the J-MES during a computer-based clinical reasoning activity. Each participant was then interviewed to assess the clarity and suitability of the items. In a second, larger study, 41 Japanese medical students were recruited to assess the psychometric properties of the J-MES. We also conducted individual, semi-structured interviews with ten of these participants to explore potential cultural features in the achievement emotions of Japanese students. The first pilot study demonstrated that the J-MES descriptions were clear, and that the scale captured an appropriate range of emotions. The second study revealed that the J-MES scale’s profiles and internal structure were largely consistent with control-value theory. The achievement emotions of pride, compassion, and surprise in the J-MES were found to be susceptible to cultural differences between North American and Japanese contexts. Our findings clearly demonstrated the scoring capacity, generalizability, and extrapolability of the J-MES.

Lists of potential diagnoses that final-year medical students need to consider: a modified Delphi study

BackgroundContrastive learning is known to be effective in teaching medical students how to generate diagnostic hypotheses in clinical reasoning. However, there is no international consensus on lists of diagnostic considerations across different medical disciplines regarding the common signs and symptoms that should be learned as part of the undergraduate medical curriculum. In Japan, the national model core curriculum for undergraduate medical education was revised in 2016, and lists of potential diagnoses for 37 common signs, symptoms, and pathophysiology were introduced into the curriculum. This study aimed to validate the list of items based on expert consensus.MethodsThe authors used a modified Delphi method to develop consensus among a panel of 23 expert physician-teachers in clinical reasoning from across Japan. The panel evaluated the items on a 5-point Likert scale, based on whether a disease should be hypothesized by final-year medical students considering given signs, symptoms, or pathophysiology. They also added other diseases that should be hypothesized. A positive consensus was defined as both a 75% rate of panel agreement and a mean of 4 or higher with a standard deviation of less than 1 on the 5-point scale. The study was conducted between September 2017 and March 2018.ResultsThis modified Delphi study identified 275 basic and 67 essential other than basic items corresponding to the potential diagnoses for 37 common signs, symptoms, and pathophysiology that Japanese medical students should master before graduation.ConclusionsThe lists developed in the study can be useful for teaching and learning how to generate initial hypotheses by encouraging students’ contrastive learning. Although they were focused on the Japanese educational context, the lists and process of validation are generalizable to other countries for building national consensus on the content of medical education curricula.

Characteristics of Japanese Medical and Healthcare University Students with Habitual Consumption of Energy Drinks: Relationship with Perceived Stress

Characteristics of Japanese Medical and Healthcare University Students with Habitual Consumption of Energy Drinks: Relationship with Perceived Stress