Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study
BackgroundJapan faces a health care delivery challenge due to physician maldistribution, with insufficient physicians practicing in rural areas. This issue impacts health care access in remote areas and affects patient outcomes. Educational interventions targeting students’ c...
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JMIR Publications
2025-01-01
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| Series: | JMIR Medical Education |
| Online Access: | https://mededu.jmir.org/2025/1/e68743 |
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| author | Kiyoshi Shikino Kazuyo Yamauchi Nobuyuki Araki Ikuo Shimizu Hajime Kasai Tomoko Tsukamoto Hiroshi Tajima Yu Li Misaki Onodera Shoichi Ito |
| author_facet | Kiyoshi Shikino Kazuyo Yamauchi Nobuyuki Araki Ikuo Shimizu Hajime Kasai Tomoko Tsukamoto Hiroshi Tajima Yu Li Misaki Onodera Shoichi Ito |
| author_sort | Kiyoshi Shikino |
| collection | DOAJ |
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BackgroundJapan faces a health care delivery challenge due to physician maldistribution, with insufficient physicians practicing in rural areas. This issue impacts health care access in remote areas and affects patient outcomes. Educational interventions targeting students’ career decision-making can potentially address this problem by promoting interest in rural medicine. We hypothesized that community-based problem-based learning (PBL) using real-patient videos could foster students’ understanding of community health care and encourage positive attitudes toward rural health care.
ObjectiveThis study investigated the impact of community-based PBL on medical students’ understanding and engagement with rural health care, focusing on their knowledge, skills, and career orientation.
MethodsParticipants were 113 fourth-year medical students from Chiba University, engaged in a transition course between preclinical and clinical clerkships from October 24 to November 2, 2023. The students were randomly divided into 16 groups (7-8 participants per group). Each group participated in two 3-hour PBL sessions per week over 2 consecutive weeks. Quantitative data were collected using pre- and postintervention questionnaires, comprehension tests, and tutor-assessed rubrics. Self-assessment questionnaires evaluated the students’ interest in community health care and their ability to envision community health care settings before and after the intervention. Qualitative data from the students’ semistructured interviews after the PBL sessions assessed the influence of PBL experience on clinical clerkship in community hospitals. Statistical analysis included median (IQR), effect sizes, and P values for quantitative outcomes. Thematic analysis was used for qualitative data.
ResultsOf the 113 participants, 71 (62.8%) were male and 42 (37.2%) female. The total comprehension test scores improved significantly (pretest: median 4.0, IQR 2.5-5.0; posttest: median 5, IQR 4-5; P<.001; effect size r=0.528). Rubric-based assessments showed increased knowledge application (pretest: median 8, IQR 7-9; posttest: median 8, IQR 8-8; P<.001; r=0.494) and self-directed learning (pretest: median 8, IQR 7-9; posttest: median 8, IQR 8-8; P<.001; r=0.553). Self-assessment questionnaires revealed significant improvements in the students’ interest in community health care (median 3, IQR 3-4 to median 4, IQR 3-4; P<.001) and their ability to envision community health care settings (median 3, IQR 3-4 to median 4, IQR 3-4; P<.001). Thematic analysis revealed key themes, such as “empathy in patient care,” “challenges in home health care,” and “professional identity formation.”
ConclusionsCommunity-based PBL with real-patient videos effectively enhances medical students’ understanding of rural health care settings, clinician roles, and the social needs of rural patients. This approach holds potential as an educational strategy to address physician maldistribution. Although this study suggests potential for fostering positive attitudes toward rural health care, further research is needed to assess its long-term impact on students’ career trajectories. |
| format | Article |
| id | doaj-art-3159844231ff4db6bca4528ad2da04a4 |
| institution | Kabale University |
| issn | 2369-3762 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Medical Education |
| spelling | doaj-art-3159844231ff4db6bca4528ad2da04a42025-01-31T20:01:19ZengJMIR PublicationsJMIR Medical Education2369-37622025-01-0111e6874310.2196/68743Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods StudyKiyoshi Shikinohttps://orcid.org/0000-0002-3721-3443Kazuyo Yamauchihttps://orcid.org/0000-0001-6587-2393Nobuyuki Arakihttps://orcid.org/0000-0002-5703-3829Ikuo Shimizuhttps://orcid.org/0000-0002-6731-7104Hajime Kasaihttps://orcid.org/0000-0002-6759-2026Tomoko Tsukamotohttps://orcid.org/0000-0002-1350-203XHiroshi Tajimahttps://orcid.org/0009-0004-2581-6193Yu Lihttps://orcid.org/0000-0002-7978-9627Misaki Onoderahttps://orcid.org/0009-0002-0126-9143Shoichi Itohttps://orcid.org/0000-0003-3659-6152 BackgroundJapan faces a health care delivery challenge due to physician maldistribution, with insufficient physicians practicing in rural areas. This issue impacts health care access in remote areas and affects patient outcomes. Educational interventions targeting students’ career decision-making can potentially address this problem by promoting interest in rural medicine. We hypothesized that community-based problem-based learning (PBL) using real-patient videos could foster students’ understanding of community health care and encourage positive attitudes toward rural health care. ObjectiveThis study investigated the impact of community-based PBL on medical students’ understanding and engagement with rural health care, focusing on their knowledge, skills, and career orientation. MethodsParticipants were 113 fourth-year medical students from Chiba University, engaged in a transition course between preclinical and clinical clerkships from October 24 to November 2, 2023. The students were randomly divided into 16 groups (7-8 participants per group). Each group participated in two 3-hour PBL sessions per week over 2 consecutive weeks. Quantitative data were collected using pre- and postintervention questionnaires, comprehension tests, and tutor-assessed rubrics. Self-assessment questionnaires evaluated the students’ interest in community health care and their ability to envision community health care settings before and after the intervention. Qualitative data from the students’ semistructured interviews after the PBL sessions assessed the influence of PBL experience on clinical clerkship in community hospitals. Statistical analysis included median (IQR), effect sizes, and P values for quantitative outcomes. Thematic analysis was used for qualitative data. ResultsOf the 113 participants, 71 (62.8%) were male and 42 (37.2%) female. The total comprehension test scores improved significantly (pretest: median 4.0, IQR 2.5-5.0; posttest: median 5, IQR 4-5; P<.001; effect size r=0.528). Rubric-based assessments showed increased knowledge application (pretest: median 8, IQR 7-9; posttest: median 8, IQR 8-8; P<.001; r=0.494) and self-directed learning (pretest: median 8, IQR 7-9; posttest: median 8, IQR 8-8; P<.001; r=0.553). Self-assessment questionnaires revealed significant improvements in the students’ interest in community health care (median 3, IQR 3-4 to median 4, IQR 3-4; P<.001) and their ability to envision community health care settings (median 3, IQR 3-4 to median 4, IQR 3-4; P<.001). Thematic analysis revealed key themes, such as “empathy in patient care,” “challenges in home health care,” and “professional identity formation.” ConclusionsCommunity-based PBL with real-patient videos effectively enhances medical students’ understanding of rural health care settings, clinician roles, and the social needs of rural patients. This approach holds potential as an educational strategy to address physician maldistribution. Although this study suggests potential for fostering positive attitudes toward rural health care, further research is needed to assess its long-term impact on students’ career trajectories.https://mededu.jmir.org/2025/1/e68743 |
| spellingShingle | Kiyoshi Shikino Kazuyo Yamauchi Nobuyuki Araki Ikuo Shimizu Hajime Kasai Tomoko Tsukamoto Hiroshi Tajima Yu Li Misaki Onodera Shoichi Ito Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study JMIR Medical Education |
| title | Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study |
| title_full | Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study |
| title_fullStr | Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study |
| title_full_unstemmed | Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study |
| title_short | Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study |
| title_sort | understanding community health care through problem based learning with real patient videos single arm pre post mixed methods study |
| url | https://mededu.jmir.org/2025/1/e68743 |
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