Changes in Pediatric Hospital Staff’s Sense of Difficulty Toward Palliative Care:A Single-pediatric Hospital Survey Report

The purpose of this study was to clarify the changes in the sense of difficulty hospital staff felt toward palliative care before and after a palliative care team of the pediatric hospital started in-hospital consultation. A self-administered questionnaire about the difficulty, consisting of 21 items in five areas, was used to conduct a survey in 2015 for the pre-consultation period, and in 2018 for the post-consultation period. Responses were obtained from 222 people in the pre-consultation period (response rate of 70.9%) and from 384 people in the post-consultation period (response rate of 87.3%). Over 70% of the respondents were nurses and midwives. A lower sense of difficulty was observed in three of the items including “relief of painful symptoms”, “family care during caregiving”, and “support when oneself and surrounding staff feeling inadequate and lost”. Further, a significant decrease was observed in the sense of difficulty in six items reported by nurses and midwives in departments receiving the interventions. Eleven of the 16 cases in which the palliative care team intervened involved multiple requests for intervention for 2 patients with pain control difficulties, suggesting that the consultation activities contributed to the decrease in the sense of difficulty experienced by nurses and midwives.

Past Activities and Prospects of Japanese Association of Family Physician Trainees / 日本プライマリ・ケア連合学会誌

A certain period of time has passed since the transition to the General Medicine residency system under the Japanese Medical Specialty Board and Family Medicine specialist training system by the Japan Primary Care Association. We have summarized the needs of residents identified in the survey, and detailed the activities to date and prospects of the Japanese Association of Family Physician Trainees, a self-help support organization, which is an official subcommittee of the Japan Primary Care Association, from the viewpoint of the residents. We believe that this paper will serve as a resource for the training of residents, help guide them under the new system, and help to improve the training system, considering evidence suggesting that information may not be reaching residents who need support.

Rats (Residents-as-Teachers) Fellowship / 医学教育

Residents have teaching roles in clinical practice, and the importance of these roles has been pointed out. This is due to their proximity to learners as Near-Peers. There are two aspects to consider: cognitive proximity, which allows them to share what learners don’t know, and spatial proximity, which allows us to share time and space for an extended period. Residents-as-teachers programs, which aim to improve teaching skills for residents, are being developed all over the world, but are still rare in Japan. We are conducting research to determine what teaching competencies residents should have. We are running a one-year fellowship based on the results of that research. The scale of the program has gradually increased, and in 2020, due to COVID-19, the fellowship went online. We restructured the fellowship in terms of Study/Workload, Enhancing Engagement, and Technical Issues. We received high satisfaction ratings for the online implementation.