"Easy Japanese" for Everyone: Another Way to Enhance Communication Skills for Promoting Partnerships with Patients Including Those from Overseas / 医学教育

Many healthcare professionals believe they must speak English to communicate with patients from overseas. However, a survey revealed more than 70% of overseas patients comfortably use Japanese in their daily life. Therefore “Easy Japanese” has been promoted at municipal offices, tourism agencies, or schools attended by children with ties to overseas countries. However, Easy Japanese is not known to clinical staff.　This article introduced an overview of “Easy Japanese” and the educational materials we have developed for busy clinicians. As the number of international residents has been increasing, hospitals must be equipped with medical interpreters and “Easy Japanese.” Easy Japanese is also helpful for the elderly, especially those with hearing and/or cognitive impairment. Medical interpreters and sign-language interpreters often express the merits of “Easy Japanese,” which is a valuable tool for multicultural societies and should be implemented in medical education.

Expectation in Development of Healthcare Professionals in Multicultural Society / 医学教育

While the number of foreign residents in Japan is increasing, it is desired that opportunities that healthcare professionals learn about “specific difficulties foreign residents have” and “communication between foreigners” are to be increased. Especially, it is effective that healthcare professionals know about the presence of “Yasashii Nihongo” and practice it in the communication between foreign residents.

Educational Environment in a Multicultural Society to Meet the Challenges of Diversity.

Educators in a multicultural-environment face complex-tasks in teaching for diversity. The objective of this study was to determine the educational environment in a Malaysian medical school, aimed to face the diversity. This cross-sectional study was conducted utilising “Dundee Ready Education Environment Measure”, a validated instrument that contained 50 items rated 0-4 with a maximum 200 score under five sub-scales. Sub-scales were perceptions of: learning, teacher, academic-self, atmosphere and social-self. Respondents were 193 year-5 medical students of session 2011-2012, comprised of Malays, Chinese, Indians and Other ethnic-group. The overall mean score perceived by all ethnicity was 130/200 (65%). All sub-scales perceived >60% scores except social-self and atmosphere. The social-self sub-scale perceived the lowest score (53.57%) by the Other ethnic group while interestingly social-self also perceived highest (75%) by the Indians. Atmosphere sub-scale perceived a score of 58.33% by Other ethnic-group. Positive perceptions of educational enviornment among the students of diverse ethnicity reflects that educational environment at the medical school is well equiped to meet the challenges of diversity. However, there is opportunity to increase further positivity in general and social-self and atmosphere sub-scales in particular. Educators in a multicultural-environment must work to avoid monocultural instructional methodoligies to promote a multicultrul society.

The Nijmegen Method of Case Deliberation and Clinical Decision in a Multicultural Society.

Abstract: The Nijmegen method of ethical case deliberation is one of the ways of reflecting, clarifying, evaluating and making decisions about moral problems, conflicts and dilemmas in the clinical settings. It is a hybrid concentration of relevant ideas from different normative ethical traditions applied to the clinical practices. As a team multidisciplinary based deliberation, the method involves a professional ethicist serving as both a critical tutor and a facilitator in the process of deliberating and arriving at most ethical decision in clinical dilemmas. In such process, the Nijmegen method is not a democratic replacement of the decision and responsibility of the healthcare team. Rather it helps to motivate rational decision and reasoned responsibility in healthcare through consensus building which does not attenuate moral uprightness. The Nijmegen method is part of the healthcare process and aims at improving communication among patient, family and the healthcare team as well as enriching the decision making process. It is a promising method in resolving moral dilemmas in healthcare especially in multicultural societies. Besides enhancing the quality and transparency of the decision making process, ethical case deliberation on the ward using the Nijmegen method has prospect of serving as a baseline in guiding through similar dilemmas in the future.

A Survey of the Awareness and Ability of Health Care Providers to Cope with Language Barriers at Medical Facilities in Hyogo, Japan / 国際保健医療

<B>OBJECTIVE:</B><br>This study aims to examine the awareness and ability of health care providers to cope with language barriers at medical facilities in Hyogo Prefecture, Japan, and to clarify the issues concerning health care for foreigners.<br><B>METHODS:</B><br>In total, 2100 copies of self-report questionnaires on issues of health care for foreigners were mailed to health care providers of 352 hospitals in Hyogo. The survey was conducted from February to March 2010.<br><B>RESULTS:</B><br>The response rate of medical facilities was 21.6% (76/352), whereas that of the health care providers was 15.2% (320/2100). Approximately 10% hospitals handled foreign patients at least once per month, and they dealt with patients using several languages, including English, Chinese, Korean, and others. The providers' main issue was communication with their foreign patients. The documents and booklets for guidance regarding some health care procedures at the hospitals were also poorly prepared. It is therefore exceedingly necessary for hospitals to provide common documents in different languages; moreover, the government or local authorities should arrange for public medical interpretation services.<br><B>DISCUSSION:</B><br>Medical facilities in Hyogo have been struggling to improve their linguistic capabilities, and it is difficult to indicate whether public organizations concerned with medical interpretation are being recognized. Efforts on the part of medical facilities and local and national governments, as well as cooperation of nonprofit organizations, are immensely essential to resolve the issue of multilingual health care. This survey suggests that to help people with diverse languages, the health care system in Japan should be improved rapidly, particularly with regard to the establishment of licensed professional medical interpreters.