Medical Student-led Activities to Listen to Patients' Narratives and Laugh at Each Other / 日本プライマリ・ケア連合学会誌

We organized regular, student-led activities in which medical students listened to patients' narratives and engaged in casual conversation. This report reviews these activities, which were conducted 28 times between June 2020 and September 2022. Through the activities, we received feedback on feelings, new perspectives, and realizations that arose from both students and patients. Our findings suggest that listening to patients' narratives helped students self-reflect and understand the patients' perspectives. Moreover, interacting with students helped patients feel a sense of meaning and a new understanding of their illness.

Quality Improvement and Reflection on Inter-professional Moral Case Deliberation Using the REFLECT Rubric, and Promotion of Reflection Skills / 日本プライマリ・ケア連合学会誌

This study examined and improved the quality of inter-professional moral case deliberation (MCD) in a home-based medical care clinic by altering the MCD process and evaluating it using the REFLECT rubric. After altering the MCD process, four of the five main evaluation items in the questionnaire were shifted to a higher evaluation level employing a scaled evaluation. The free-entry field revealed future tasks. This report suggested that improving the quality and assessment of MCD using REFLECT promotes the reflection skills of clinical teams.

A Questionnaire Survey of Primary Care Physicians on Dialects in the Hokushinetsu Region -A Quantitative and Qualitative Study of Dialects and Physicians' Perceptions- / 日本プライマリ・ケア連合学会誌

Introduction: Primary care (PC) physicians often struggle with the local dialects of patients, especially when they work away from their hometowns.Method: We conducted a questionnaire survey of PC physicians in the Hokushinetsu region, the northcentral part of Honshu island of Japan, to understand how doctors recognize and deal with local dialects in their daily clinical practice.We also analyzed their comments qualitatively using the Steps for Coding and Theorization (SCAT) method.Results: Thirty-one physicians (21 men and 10 women) completed the questionnaire. Of the total, 71% of respondents worked away from their hometowns.Moreover, 81.8% of these respondents stated they had difficulties understanding the dialect spoken in the region of their workplaces and 36.3% misunderstood the meanings of the dialect spoken by their local patients as a result. Respondents often heard "ui" or "tekinai" as the chief complaints of local patients, and interpreted these words as physical symptoms such as fatigue, dyspnea, and abdominal distension. SCAT analysis suggested that these words can have different meanings depending on the context. PC physicians translate them into medical terms using paraphrasing techniques based on each patient's medical history. Furthermore, PC physicians use dialects according to their relationship with the patient.Conclusion: Understanding the characteristics of these dialects and using them appropriately may improve the doctor-patient relationship.

Report on the Toronto International Program to Strengthen Family Medicine and Primary Care / 日本プライマリ・ケア連合学会誌

We participated in TIPS-FM (Toronto International Program to Strengthen Family Medicine and Primary Care) for two weeks in Toronto in June 2019. This program enabled us to learn many important factors for developing family medicine. Based on Canadian family medicine, which has a long history, we were able to review the missions of family medicine in Japan, and gained further insight into multilayered essentials on the patient-, community-, and global-levels.