PDF(Pubmed)
Abstract：
BACKGROUND: Most Japanese medical schools likely continue to rely on peer physical examination (PPE) as a tool to for teaching physical examination skills to students. However, the attitudes of medical students in Japan toward PPEs have not be identified. Therefore, we evaluated students\' attitudes toward PPE in a Japanese medical school as a preparation for developing a PPE policy tailored to the context of Japanese culture.
METHODS: We conducted a mixed-methods study with an explanatory sequential approach, in which qualitative data were used to interpret the quantitative findings. Surveys and interviews were conducted with medical students and junior residents at a Japanese university. A total of 63 medical students and 50 junior residents responded to the questionnaire. We interviewed 16 participants to reach theoretical saturation and investigated the attitudes of medical students toward PPE and the themes emerging from the interview data, providing detailed descriptions of the quantitative findings.
RESULTS: Female participants were significantly more likely than male participants to report varying degrees of resistance to being a model patient during PPE (male: 59.7%, female: 87%, p < 0.001). Most of the participants who took on the role of patients that involved undressing were males. The participants expected improvements in issues related to the guarantee of freedom to refuse to be a model patient and measures to protect confidentiality. Approximately 22% of the participants reported that they witnessed incidental findings (including variations within the normal range) in front of other students during PPE.
CONCLUSIONS: The findings imply that medical students expect high levels of autonomy and confidentiality when volunteering as model patients during PPE. Thus, developing a PPE policy suitable for Japanese culture may be effective in establishing a student-centered PPE environment.
METHODS: We conducted a mixed-methods study with an explanatory sequential approach, in which qualitative data were used to interpret the quantitative findings. Surveys and interviews were conducted with medical students and junior residents at a Japanese university. A total of 63 medical students and 50 junior residents responded to the questionnaire. We interviewed 16 participants to reach theoretical saturation and investigated the attitudes of medical students toward PPE and the themes emerging from the interview data, providing detailed descriptions of the quantitative findings.
RESULTS: Female participants were significantly more likely than male participants to report varying degrees of resistance to being a model patient during PPE (male: 59.7%, female: 87%, p < 0.001). Most of the participants who took on the role of patients that involved undressing were males. The participants expected improvements in issues related to the guarantee of freedom to refuse to be a model patient and measures to protect confidentiality. Approximately 22% of the participants reported that they witnessed incidental findings (including variations within the normal range) in front of other students during PPE.
CONCLUSIONS: The findings imply that medical students expect high levels of autonomy and confidentiality when volunteering as model patients during PPE. Thus, developing a PPE policy suitable for Japanese culture may be effective in establishing a student-centered PPE environment.
摘要：
背景：大多数日本医学院可能继续依靠同伴体检（PPE）作为向学生传授体检技能的工具。然而,日本医学生对PPEs的态度尚未确定。因此,我们评估了日本医学院学生对PPE的态度，作为制定适合日本文化背景的PPE政策的准备。
方法：我们进行了一项混合方法研究，采用解释性顺序方法，使用定性数据解释定量结果.对日本大学的医学生和初级居民进行了调查和访谈。共有63名医学生和50名初级居民回答了问卷。我们采访了16位参与者，以达到理论饱和，并调查了医学生对PPE的态度以及采访数据中出现的主题，提供定量结果的详细描述。
结果：女性参与者比男性参与者显着更有可能报告不同程度的抵抗在PPE期间成为模型患者（男性：59.7％，女性:87%,p<0.001)。承担脱衣服患者角色的大多数参与者是男性。与会者期望在与保证拒绝成为模范患者的自由和保密措施有关的问题上有所改善。大约22％的参与者报告说，他们在PPE期间目睹了其他学生面前的偶然发现（包括正常范围内的变化）。
结论：研究结果表明，医学生在PPE期间志愿作为模范患者时期望高度的自主性和保密性。因此，制定适合日本文化的PPE政策可能会有效地建立以学生为中心的PPE环境。
方法：我们进行了一项混合方法研究，采用解释性顺序方法，使用定性数据解释定量结果.对日本大学的医学生和初级居民进行了调查和访谈。共有63名医学生和50名初级居民回答了问卷。我们采访了16位参与者，以达到理论饱和，并调查了医学生对PPE的态度以及采访数据中出现的主题，提供定量结果的详细描述。
结果：女性参与者比男性参与者显着更有可能报告不同程度的抵抗在PPE期间成为模型患者（男性：59.7％，女性:87%,p<0.001)。承担脱衣服患者角色的大多数参与者是男性。与会者期望在与保证拒绝成为模范患者的自由和保密措施有关的问题上有所改善。大约22％的参与者报告说，他们在PPE期间目睹了其他学生面前的偶然发现（包括正常范围内的变化）。
结论：研究结果表明，医学生在PPE期间志愿作为模范患者时期望高度的自主性和保密性。因此，制定适合日本文化的PPE政策可能会有效地建立以学生为中心的PPE环境。
