Components and Outcomes in Under- and Postgraduate Medical Education to Prepare for the Delivery of Integrated Care for the Elderly: A Scoping Review

Challenges Faced by Medical Trainees in Outpatient Management Education in Acute Care Hospitals: A Thematic Analysis

Introduction As societies age globally, medical education faces the challenge of adapting to the evolving healthcare needs of an aging population. This study focuses on the education of medical residents in outpatient departments in Japan, a country with a rapidly aging society. The research aims to understand the perceptions and challenges medical residents face in outpatient management, highlighting the areas for potential improvement in their educational framework. Method This study involved first-year medical residents at Fuchu Hospital in Osaka, using thematic analysis based on relativist ontology and constructivist epistemology. Data were collected through field notes and reflection sheets, documenting residents' interactions with patients, learning difficulties, and personal reflections. Semi-structured interviews were conducted to gain profound insights into their experiences and views on outpatient management education. Results Three main themes emerged from the analysis: The experience of continuity of care, the view regarding comprehensive management, and the gap between purposes and learning content. Residents expressed concerns about the limited opportunities for continuous patient care, leading to challenges in managing chronic diseases effectively. The focus on organ-specific specialties in acute care hospitals resulted in a fragmented understanding of patient care, particularly for elderly patients with multimorbidity. Furthermore, the study identified a discrepancy between the educational goals of outpatient management and the actual content delivered, highlighting the need for more observational experiences and practical guidance in outpatient settings. Conclusion The findings suggest a pressing need for a more structured, comprehensive, and personalized approach to outpatient management education for medical residents. As aging populations continue to grow, it is vital to equip medical professionals with the skills and knowledge to manage a wide range of patient conditions effectively. Improving the educational framework in outpatient departments can enhance patient care quality and prepare medical residents to meet the challenges of an aging society. This study contributes valuable insights into improving medical education in outpatient settings, particularly in aging societies like Japan.

Healthcare Profession Students' Motivations for Learning About Community Organizing: A Thematic Analysis

Background Medical care now emphasizes community health, prevention, health promotion, and collaboration. Integrating medical students into community health initiatives enhances their community health and student skills. In an aging multicultural population, the involvement of healthcare professionals in community health management is vital. However, medical education in Japan lacks sufficient exposure to community health issues. A program in Shimane Prefecture aimed to address this gap by revolutionizing medical education through community organizations. Methods This study employed a reflexive thematic analysis based on relativist ontology and constructivist epistemology. Participants aspiring to be healthcare professionals from Japanese high schools and universities were recruited from rural Shimane Prefecture. Computer-based questionnaires were used to collect data on participants' reasons, motivations, and visions for community-organizing education. The thematic analysis followed Braun and Clarke's approach and involved systematic coding, theme identification, and refinement. Results Three themes emerged from the analysis. In expanding hopes for unknown potential, participants sought improved communication skills, real-world understandings, and fresh perspectives and aimed to promote personal growth through community engagement. In acquiring activeness and new perspectives through connections with peers, hands-on learning and collaboration with peers with shared interests were motivating factors. Participants sought to generate inquiries and discover their activities. Regarding the desire to connect with diverse individuals driven by a strong curiosity about the community, participants aimed to learn community engagement techniques, understand community involvement methods, and explore the relationship between social issues and health. Conclusion Community-organizing education plays a pivotal role in shaping future healthcare professionals. Our analysis underscores the need for curriculum reform, including experiential learning and peer interaction, to facilitate a comprehensive understanding of health and community dynamics. Future studies should assess the long-term impacts of these experiences on students' careers and community health to contribute to advancements in medical education and community-oriented healthcare professionalism.

Effectiveness of multi-professional educational interventions to train Comprehensive Geriatric Assessment (CGA) - a Systematic Review

Introduction

As the world population ages, health and social care professionals are increasingly confronted with patients with chronic long-term conditions and multimorbidity, requiring an extensive assessment and integrated care management strategy. The aim of this paper was to systematically collect and assess evidence of interprofessional education and training strategies for Comprehensive Geriatric Assessment (CGA) to build a competent health workforce.

Methods

A systematic review was conducted according to PRISMA guidelines and the databases Medline, CINAHL, Cochrane and Embase were searched for studies illustrating effectiveness of educational interventions for teaching and training CGA in an interprofessional context.

Results

Based on 21 identified studies, a great variability and heterogeneity in duration, setting and design of the interventions was identified. Promising results were found in the domains analysed, ranging from knowledge and skills; practices and behaviour; patient health outcomes; attitudes and perceptions to collaboration and quality of care.

Discussion

Education and training of transversal skills within a continuous learning approach is key to equip the health care workforce for successful CGA performance in an interprofessional environment.

Conclusion

Further research in this field is recommended to strengthen the evidence-base towards development of a resilient and integrated health care workforce for an ageing population.