Cultural anthropology is the systematic study of humankind everywhere, both in the past and the present. It focuses on the study of different ethnic and cultural groups throughout the world. With a meaning-centered approach, medical anthropologists have developed “explanatory models,” schemata for understanding illness representations by patients and families and by medical practitioners. This approach to illness representations has provided clinicians with broader perspectives on what illness means to people in their particular social and cultural settings. Cultural anthropology provides another approach that further broadens the view of human behavior by considering social and political contexts, such as the globalization of health-care systems and medical practice and the increased application of pharmacoeconomics. Culture is not just a set of rules influencing human behavior; it also includes local activities performed with practical knowledge, both creatively and improvisationally. We should study culture in situ, as these activities are performed in a particular social field.
The first role of anthropology in health and welfare education is to provide and cultivate viewpoints for understanding other cultures, including cultural relativism and holism, which is considered to be the basis of cultural competence. Second, this paper deals with legitimate peripheral participation as an example of the theoretical contributions of anthropology to medical, health, and welfare education. Third, ethnography, the method used in anthropology, has a further potential to be applied to qualitative studies of health and welfare. Constructive dialogue between anthropologists and medical specialists should be promoted to consider health and welfare education in the future.
In 1917, occupational therapy was founded, and practitioners began to be educated in the United States in a health profession that supports people with illness or disability or both to return to society through being engaged in an occupation. Occupational therapy’s founders based the profession on a holistic view of human health shaped by daily occupations, and, in response, education of practitioners was broadly focused. Since its inception, the profession of occupational therapy has had 2 major transitions in its concept of health which have affected the education of practitioners. In the first transition, occupational therapy gained professional protection by its close association with rehabilitation medicine but was heavily influenced by the conventional medical model and developed practice methods based on the patient’s medical diagnosis. In its second transition, the occupational therapy profession moved again to a broader concept of health, a participatory model. Anthropology has supported and continues to assist occupational therapy in this transition. This article discusses the contribution of anthropology from the viewpoint of an occupational therapy researcher and educator.
In the current Japanese education for medical and health professionals, experiential learning in communities is widely promoted. Students visit a community and participate in community life. This paper introduces the perspectives and methods of cultural anthropological fieldwork and examines how they can be applied to community-based experiential learning and what effects are produced. This paper is based on a case study in a Japanese medical school. What is significant in experiential learning through fieldwork is that students participate in community life firsthand and retain this firsthand experience as a sensory experience. This ingrained sense is then transformed into new findings, not through application of the students’ pre-existing knowledge but through subsequent reflective practices.
I compared the education experiences of cultural anthropology majors and nursing students, with an emphasis on the later, and discuss how the experience of making bamboo musical instruments is effective for revealing the relations among humans, nature, and health. The aim of learning to make bamboo musical instruments for students not specializing in cultural anthropology, such as nursing students, is to encourage thinking about the origin of medicine and welfare from a universal viewpoint more rooted in life. Developing a new method leading to education to maintain “a sense of life” possessed by all people is as important as professional training in medical education. To provide a way of gaining an understanding of “life” through taking part in the activities of life is the role of cultural anthropology.
I summarized what we medical educators expect from cultural anthropology from the following 2 points. One is the viewpoint of cultural relativism. Japanese medical educators tend to be Western supremacists. We expect cultural anthropologists to promote discussion in the medical／healthcare professions from the viewpoint of cultural relativism. The other point is to promote the teaching of anthropology in a clinical context. Referring to an explanatory model as a good example, we expect anthropologists to consider what physicians or healthcare professionals should know about cultural anthropology.
Objectives: To clarify differences in medical students’ emotional intelligence and empathy among 4 school years and sex. Methods: A cross-sectional study of 370 medical students in years 1, 2, 4, and 6 was performed with Japanese versions of 2 self-reported questionnaires: the Trait Emotional Intelligence Questionnaire–Short Form （TEIQue-SF） and the Jefferson Scale of Physician Empathy–Student Version （JSPE-S）. Results: Total scores of the TEIQue–SF tended to decrease in higher school years. However, the total score of the JSPE-S was significantly increased in year 6 but was decreased in year 4. Male students had higher TEIQue–SF scores, and female students had higher JSPE-S scores. Of the 4 factors of the TEIQue–SF compared （well-being, self-control, emotionality, and sociability）, only sociability was higher in males. No differences were found among school years. The scores of the TEIQue–SF and the JSPE-S showed a weak correlation. Of the factors of the TEIQue–SF, only self-control showed no correlation with the JSPE-S. Discussion and Conclusion: These results suggest that the emotional intelligence of both male and female medical students tends to decline. The increase in JSPE-S scores in year 6 suggests that medical interview training is effective. Furthermore, training is important both to enhance emotional intelligence and to teach self-control skills.
Introduction: We investigated the improvement in and the priorities of patient education training in community pharmacy from the student’s point of view to improve long-term practical training. Method: We conducted a questionnaire survey to assess student satisfaction and the acquisition of behavioral objectives and analyzed the results with customer satisfaction analysis. Questionnaires were distributed to 32 students who had taken part in long-term practical training in the first year. Results: Customer satisfaction analysis showed that 4 factors-“the frequency of patient education,” “the period of patient education,” “the aggressiveness of the student,” and “the facilitation by pharmacists on question-asking by the student”-were preferentially improved. In addition, we found that the level of acquisition varied according to the specific behavioral objectives. Discussion: These results suggest that universities and community pharmacies must work together to organize the training system to increase the frequency of patient education and to improve students’ attitudes about patient education in community pharmacy.
Objectives: This study reviewed the literature on instruments measuring physician-patient communication skills in medical interviews. Our goal was to clarify the features of current instruments and problems in assessing physician-patient communication with them. Methods: In 2012, we searched for published articles about instruments assessing physician-patient communication skills in the bibliographic databases PubMed, PsycINFO, and the Education Resources Information Center using the combination of search terms （“consultation skills” OR “doctor-patient communication” OR “physician-patient relations”） AND “medical education” AND （instruments OR measurement OR assessment）. Instruments designed for faculty observers and to be used in medical education were included in the study. To compare the instruments, we classified the items of each instrument on the basis of the framework of the Kalamazoo Consensus Statement （KCS）, an experts’ consensus statement on 7 essential elements of physician-patient communication. Results: Ten instruments were included in the study. Eighty-three percent of all 277 items of the instruments were classified to any of the 7 elements identified in the KCS. Most of the instruments included more than 6 elements identified in the KCS, and some of the instruments had been constructed on the basis of the KCS. However, the instruments varied considerably in essential communication skills to understand the patient’s perspective, to share information, and to reach agreement on problems and plans. Conclusions: Further study is needed to provide evidence for essential communication skills in physician-patient consultation. Because essential communication skills depend on the educational goals, culture, language, and other factors, ensuring the reliability and validity of tools administered to evaluate communication must be required.
In this manuscript, the basics of development, management, and usage of the results of assessment of learners are discussed. ●Formative assessment facilitates individual learning and is essential in the student-centered and outcome-based medical education. The purposes of high-stakes summative evaluations, which certify program completion or qualifications to be health professionals, is to judge whether the examinees possess the required level of competencies of health professionals. ●Measured scores are interpreted as the generalized ability of examinees. An adequate generalization process should be confirmed by obtaining validity evidence, including reliability and consequences of examination. ●To perform valid assessment, medical educators plan, manage, score, judge, use the results, and evaluate and improve the process of assessment according to the purpose of evaluation.
Because recent changes in medical care security policy have made clinical skills training difficult, even in teaching hospitals, training with suitable models and simulators is becoming essential for medical students to acquire clinical skills. On the basis of these changes, we performed a nationwide survey on the prevalence and application of clinical skills laboratories for clerkships in Japan. Registered questionnaires were sent to all medical schools in Japan （n＝80） in December 2012. The response forms were filled out by clinical instructors and by the staff responsible for the skills laboratory. The response rate was 94% （75 of 80 schools）. Seventy-one schools （95%） have already installed clinical skills laboratory; however, floor area and availability varied greatly among schools. Floor space ranged from 24 to 2,250 m2 （median, 214 m2）. The number of uses of the facility by medical students in the 2011 school year ranged from less than 100 to more than 10,000 （median, 1,402）. Forty-two schools （59%） had a resident director for the skills laboratory. Simulators of most universities （> 90%） were venopuncture simulators, lung-sound simulators, basic life support mannequins, heart-sound simulators, surgical suture trainers, and automated external defibrillator trainers, and all were frequently used. These results suggest considerable differences among schools in simulation-based learning environments during clinical clerkships. Although most medical schools in Japan have their own clinical skills laboratories, their size, service, and frequency of use vary greatly.
Introduction: Kobe University Hospital’s faculty development workshop was unattractive, and people attended it passively. Methods: We attempted to improve the workshop so that faculty would want to attend it independently and proactively. In this report we summarize the changes in the workshop and report the results of questionnaires administered before （2008） and after （2012） the change. Results: Overall contents of the faculty development workshop became more open, and such practices as the Kawakita Jiro method stopped being used. Overall scores for participant satisfaction improved significantly from 2008 to 2012, but the duration of the workshop did not change significantly. Discussion: We improved the quality of the faculty development workshop and increased participant satisfaction. We should continue to improve the workshop through proper assessment.