Students' perception of problem-based learning at a Japanese medical school: an exploratory sequential mixed method.

Objectives: This study aimed to assess the perception of PBL among Japanese medical students. Methods: Learning effects and challenges of PBL from the students' viewpoint were assessed with an exploratory sequential mixed method. Focus group discussions followed by thematic analysis were conducted with 27 students and residents. Then a questionnaire survey was carried out. A total of 119 out of 258 students (46.1%) responded. The results from 24 questions were analyzed with a residual analysis. Results: Thematic analysis extracted 14 themes from four discussion topics. The participants in focus group discussion regarded the PBL program as a better learning method than lectures. But some key phrases on the challenge of social interaction, including reluctance to actively discuss and collaborate with unfamiliar peers, were found. The questionnaire survey revealed a significantly lower adjusted standardized residual (ASR) for the positive response in five of six questions in the category of social interaction; improvement of communication skills (ASR = -3.303, n = 118, p < .001), enhancement of responsibility at group discussions (ASR = -2.078, n = 119, p = .038), building social networking (ASR = -3.006, n = 119, p = .003), becoming to sympathize with patients (ASR = -2.449, n = 119, p = .014) and understanding social aspects of clinical practice (ASR = -5.790, n = 119, p < .001). Conclusion: The Japanese medical students perceived PBL as an effective learning strategy. However, they had a problem with social interactions.

Peer evaluations of group work in different years of medical school and academic achievement: how are they related?

BACKGROUND: To develop the skills needed in health care teams, training communication and teamwork skills are important in medical education. Small group collaborative learning is one of the methods utilized in such trainings, and peer evaluation is suggested to be useful in reinforcing the effectiveness of group learning activities. In Mie University Faculty of Medicine, group work consisting of book review sessions of liberal arts education in the first grade and problem-based learning (PBL) sessions in preclinical years were conducted using the same peer evaluation system that included three domains: degree of prior learning, contribution to group discussion, and cooperative attitude. This study was conducted to determine the relationships among behaviors during group work and the academic achievement of medical students. METHODS: With the data from a cohort of medical students in three consecutive academic years (n = 340), peer evaluation scores in groupworks of book review sessions, those in PBL sessions and paper test scores of preclinical years were analyzed. The correlations were analyzed with Spearman's correlation coefficient, and the respective scores were compared by using the Wilcoxon signed-ranked test. RESULTS: Significant correlations were observed among the evaluation scores of respective domains in group work and paper test scores. The degree of prior learning had the strongest relationship among the three domains (rs = 0.355, p < 0.001 between book review sessions and PBL; rs = 0.338, p < 0.001 between book review sessions and paper test score; rs = 0.551, p < 0.001 between PBL and paper test score). Peer evaluation scores of respective domains were found to be significantly higher in PBL. CONCLUSION: Medical students maintained their groupwork behaviors to some extent from early school to preclinical years. Those behaviors were positively related to their academic achievement in the later years of the medical education curriculum. Our study highlighted the importance of the early introduction of group work. The results will be useful to motivate medical students to put more effort into group work.

Characteristic profiles among students and junior doctors with specific career preferences.

BACKGROUND: Factors influencing specialty choice have been studied in an attempt to find incentives to enhance the workforce in certain specialties. The notion of "controllable lifestyle (CL) specialties," defined by work hours and income, is gaining in popularity. As a result, many reports advocate providing a 'lifestyle-friendly' work environment to attract medical graduates. However, little has been documented about the priority in choosing specialties across the diverse career opportunities.This nationwide study was conducted in Japan with the aim of identifying factors that influence specialty choice. It looked for characteristic profiles among senior students and junior doctors who were choosing between different specialties. METHODS: We conducted a survey of 4th and 6th (final)-year medical students and foundation year doctors, using a questionnaire enquiring about their specialty preference and to what extent their decision was influenced by a set of given criteria. The results were subjected to a factor analysis. After identifying factors, we analysed a subset of responses from 6th year students and junior doctors who identified a single specialty as their future career, to calculate a z-score (standard score) of each factor and then we plotted the scores on a cobweb chart to visualise characteristic profiles. RESULTS: Factor analysis yielded 5 factors that influence career preference. Fifteen specialties were sorted into 4 groups based on the factor with the highest z-score: "fulfilling life with job security" (radiology, ophthalmology, anaesthesiology, dermatology and psychiatry), "bioscientific orientation" (internal medicine subspecialties, surgery, obstetrics and gynaecology, emergency medicine, urology, and neurosurgery), and "personal reasons" (paediatrics and orthopaedics). Two other factors were "advice from others" and "educational experience". General medicine / family medicine and otolaryngology were categorized as "intermediate" group because of similar degree of influence from 5 factors. CONCLUSION: What is valued in deciding a career varies between specialties. Emphasis on lifestyle issues, albeit important, might dissuade students and junior doctors who are more interested in bioscientific aspects of the specialty or have strong personal reasons to pursue the career choice. In order to secure balanced workforce across the specialties, enrolling students with varied background and beliefs should be considered in the student selection process.