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Article ; Online: Safety culture survey among medical residents in Japan

Yasuharu Tokuda / Takashi Watari / Yuji Nishizaki / Masaru Kurihara / Yoshimasa Nagao

BMJ Open Quality, Vol 12, Iss

a nationwide cross-sectional study

2023 Volume 4

Abstract: Purpose This study aimed to examine safety culture among Japanese medical residents through a comparative analysis of university and community hospitals and an investigation of the factors related to safety culture.Method This nationwide cross-sectional ... ...

Abstract	Purpose This study aimed to examine safety culture among Japanese medical residents through a comparative analysis of university and community hospitals and an investigation of the factors related to safety culture.Method This nationwide cross-sectional study used a survey to assess first and second-year medical residents’ perception of safety culture. We adapted nine key items from the Safety Awareness Questionnaire to the Japanese training environment and healthcare system. Additionally, we explored specific factors relevant to safety culture, such as gender, year of graduation, age, number of emergency room duties per month, average number of admissions per day, incident experience, incident reporting experience, barriers to incident reporting and safety culture. We analysed the data using descriptive statistics and multivariate logistic regression analysis.Results We included 5289 residents (88.6%) from community training hospitals and 679 residents (11.4%) from university hospitals. A comparative analysis of safety culture between the two groups on nine representative questions revealed that the percentage of residents who reported a positive atmosphere at their institution was significantly lower at university hospitals (81.7%) than at community hospitals (87.8%) (p<0.001). The other items were also significantly lower for university hospital residents. After adjusting for multivariate logistic analysis, university hospital training remained significantly and negatively associated with all nine safety culture items. Furthermore, we also found that university hospital residents perceived a significantly lower level of safety culture than community hospital residents.Implications Further research and discussion on medical professionals’ perception of safety culture in their institutions as well as other healthcare professionals’ experiences are necessary to identify possible explanations for our findings and develop strategies for improvement.
Keywords	Medicine (General) ; R5-920
Subject code	690
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The impact of cardiac rehabilitation for older adults with heart failure who underwent invasive cardiac treatment eligible for long‐term care needs certification

Masaru Asai / Yuji Nishizaki / Shuko Nojiri / Sachiko Nakagami / Soshi Dohmae / Yukio Suzuki / Taiga Chiba / Miho Yokoyama / Tohru Minamino

Journal of General and Family Medicine, Vol 25, Iss 1, Pp 36-

A retrospective cohort study

2024 Volume 44

Abstract: Abstract Background This study aimed to assess the usefulness of cardiac rehabilitation (CR) for older adults with heart failure (HF) who need nursing care and investigate the effect of CR on cognitive function (CF) and basic activities of daily living ( ... ...

Abstract	Abstract Background This study aimed to assess the usefulness of cardiac rehabilitation (CR) for older adults with heart failure (HF) who need nursing care and investigate the effect of CR on cognitive function (CF) and basic activities of daily living (BADL). Methods This was a retrospective cohort study. The study included older adults with HF eligible for long‐term care insurance in fiscal year 2014 (FY2014) as the baseline and followed them up until March 2018. Patients were divided into two groups, CR (+) and CR (−), and the changes in their CF and BADL scores over time for 3 years were investigated. Results Of the 765 patients included in the study, 36.5% performed CR. BADL scores in the CR (+) and CR (−) groups (mean (SE)) were 5.81 (0.26) vs. 5.87 (0.20) in FY2014, 5.6 (0.28) vs. 5.92 (0.21) in FY2015, 5.72 (0.31) vs. 6.15 (0.22) in FY2016, and 5.64 (0.33) vs. 6.40 (0.25) in FY2017, respectively. BADL scores worsened over time in the CR (−) group but had a trend to inhibit decline in the CR (+) group, and a significant difference was observed between both groups (p = 0.04). Multivariate analysis showed a significant difference in CR as a factor suppressing ADL decline after 1 year (adjusted odds ratios: 0.54, 95% confidence intervals: 0.36–0.82; p = 0.004). However, no significant difference in the CF scores was observed. Conclusion CR for older adults with HF eligible for long‐term care needs certification does not affect CF and may suppress ADL decline.
Keywords	activities of daily living ; cardiac rehabilitation ; database study ; heart failure ; long‐term care insurance ; Medicine (General) ; R5-920
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Association between mentorship and mental health among junior residents

Kohta Katayama / Yuji Nishizaki / Toshihiko Takada / Koshi Kataoka / Nathan Houchens / Takashi Watari / Yasuharu Tokuda / Yoshiyuki Ohira

Journal of General and Family Medicine, Vol 25, Iss 1, Pp 62-

A nationwide cross‐sectional study in Japan

2024 Volume 70

Abstract: Abstract Background Mentorship is a dynamic, reciprocal relationship in which an advanced careerist (mentor) encourages the growth of a novice (mentee). Mentorship may protect the mental health of residents at risk for depression and burnout, yet despite ...

Abstract	Abstract Background Mentorship is a dynamic, reciprocal relationship in which an advanced careerist (mentor) encourages the growth of a novice (mentee). Mentorship may protect the mental health of residents at risk for depression and burnout, yet despite its frequent use and known benefits, limited reports exist regarding the prevalence and mental effects of mentorship on residents in Japan. Methods We conducted a cross‐sectional study involving postgraduate year 1 and 2 (PGY‐1 and PGY‐2) residents in Japan who took the General Medicine In‐Training Examination (GM‐ITE) at the end of the 2021 academic year. Data on mentorship were collected using surveys administered immediately following GM‐ITE completion. The primary outcome was the Patient Health Questionaire‐2 (PHQ‐2), which consisted depressed mood and loss of interest. A positive response for either item indicated PHQ‐2 positive. We examined associations between self‐reported mentorship and PHQ‐2 by multi‐level analysis. Results Of 4929 residents, 3266 (66.3%) residents reported having at least one mentor. Compared to residents without any mentor, those with a mentor were associated with a lower likelihood of a positive PHQ‐2 response (adjusted odds ratio [aOR] 0.75; 95% confidence interval [95% CI] 0.65–0.86). Mentor characteristic significantly associated with negative PHQ‐2 response was a formal mentor (aOR; 0.68; 95% CI 0.55–0.84). Conclusions A mentor‐based support system was positively associated with residents' mental health. Further research is needed to determine the quality of mentorship during clinical residency in Japan.
Keywords	clinical residency ; formal mentor ; Japan ; mental health ; mentorship ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Performance Comparison of ChatGPT-4 and Japanese Medical Residents in the General Medicine In-Training Examination

Takashi Watari / Soshi Takagi / Kota Sakaguchi / Yuji Nishizaki / Taro Shimizu / Yu Yamamoto / Yasuharu Tokuda

JMIR Medical Education, Vol 9, p e

Comparison Study

2023 Volume 52202

Abstract: BackgroundThe reliability of GPT-4, a state-of-the-art expansive language model specializing in clinical reasoning and medical knowledge, remains largely unverified across non-English languages. ObjectiveThis study aims to compare fundamental clinical ... ...

Abstract	BackgroundThe reliability of GPT-4, a state-of-the-art expansive language model specializing in clinical reasoning and medical knowledge, remains largely unverified across non-English languages. ObjectiveThis study aims to compare fundamental clinical competencies between Japanese residents and GPT-4 by using the General Medicine In-Training Examination (GM-ITE). MethodsWe used the GPT-4 model provided by OpenAI and the GM-ITE examination questions for the years 2020, 2021, and 2022 to conduct a comparative analysis. This analysis focused on evaluating the performance of individuals who were concluding their second year of residency in comparison to that of GPT-4. Given the current abilities of GPT-4, our study included only single-choice exam questions, excluding those involving audio, video, or image data. The assessment included 4 categories: general theory (professionalism and medical interviewing), symptomatology and clinical reasoning, physical examinations and clinical procedures, and specific diseases. Additionally, we categorized the questions into 7 specialty fields and 3 levels of difficulty, which were determined based on residents’ correct response rates. ResultsUpon examination of 137 GM-ITE questions in Japanese, GPT-4 scores were significantly higher than the mean scores of residents (residents: 55.8%, GPT-4: 70.1%; P<.001). In terms of specific disciplines, GPT-4 scored 23.5 points higher in the “specific diseases,” 30.9 points higher in “obstetrics and gynecology,” and 26.1 points higher in “internal medicine.” In contrast, GPT-4 scores in “medical interviewing and professionalism,” “general practice,” and “psychiatry” were lower than those of the residents, although this discrepancy was not statistically significant. Upon analyzing scores based on question difficulty, GPT-4 scores were 17.2 points lower for easy problems (P=.007) but were 25.4 and 24.4 points higher for normal and difficult problems, respectively (P<.001). In year-on-year comparisons, GPT-4 scores were 21.7 and 21.5 ...
Keywords	Special aspects of education ; LC8-6691 ; Medicine (General) ; R5-920
Subject code	310
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The relationship between contributions of authors and author order

Rieko Ueda / Yuji Nishizaki / Yasuhiro Homma / Patrick Devos / Shoji Sanada

Journal of General and Family Medicine, Vol 22, Iss 6, Pp 361-

2021 Volume 362

Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Changes in social environment due to the state of emergency and Go To campaign during the COVID-19 pandemic in Japan

Rie Kanamori / Yuta Kawakami / Shuko Nojiri / Satoshi Miyazawa / Manabu Kuroki / Yuji Nishizaki

PLoS ONE, Vol 17, Iss 4, p e

An ecological study.

2022 Volume 0267395

Abstract: Background During the coronavirus disease 2019 (COVID-19) pandemic in Japan, the state of emergency, as a public health measure to control the spread of COVID-19, and the Go To campaign, which included the Go To Travel and Go To Eat campaigns and was ... ...

Abstract	Background During the coronavirus disease 2019 (COVID-19) pandemic in Japan, the state of emergency, as a public health measure to control the spread of COVID-19, and the Go To campaign, which included the Go To Travel and Go To Eat campaigns and was purposed to stimulate economic activities, were implemented. This study investigated the impact of these government policies on COVID-19 spread. Methods This ecological study included all 47 prefectures in Japan as samples between February 3 and December 27, 2020. We used COVID-19 cases and mobility as variables. Additionally, places where social contacts could accrue, defined as restaurants, companies, transportation, and tourist spots; mean temperature and humidity; the number of inhabitants in their twenties to fifties; and the number of COVID-19 cases in the previous period, which were factors or covariates in the graphical modeling analysis, were divided into five periods according to the timing of the implementation of the state of emergency and Go To campaign. Results Graphical changes occurred throughout all five periods of COVID-19. During the state of emergency (period 2), a correlation between COVID-19 cases and those before the state of emergency (period 1) was observed, although this correlation was not significant in the period after the state of emergency was lifted (period 3). During the implementation of Go To Travel and the Go To Eat campaigns (period 5), the number of places where social contacts could accrue was correlated with COVID-19 cases, with complex associations and mobility. Conclusions This study confirms that the state of emergency affected the control of COVID-19 spread and that the Go To campaign led to increased COVID-19 cases due to increased mobility by changing behavior in the social environment where social contacts potentially accrue.
Keywords	Medicine ; R ; Science ; Q
Subject code	950
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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Article ; Online: Effects of COVID-19 on Japanese medical students' knowledge and attitudes toward e-learning in relation to performance on achievement tests.

Miwa Sekine / Makino Watanabe / Shuko Nojiri / Tsutomu Suzuki / Yuji Nishizaki / Yuichi Tomiki / Takao Okada

PLoS ONE, Vol 17, Iss 3, p e

2022 Volume 0265356

Abstract: The COVID-19 pandemic forced many educational institutions to turn to electronic learning to allow education to continue under the stay-at-home orders/requests that were commonly instituted in early 2020. In this cross-sectional study, we evaluated the ... ...

Abstract	The COVID-19 pandemic forced many educational institutions to turn to electronic learning to allow education to continue under the stay-at-home orders/requests that were commonly instituted in early 2020. In this cross-sectional study, we evaluated the effects of the COVID-19 pandemic on medical education in terms of students' attitudes toward online classes and their online accessibility; additionally, we examined the impacts of any disruption caused by the pandemic on achievement test performance based on the test results. The participants were 674 students (412 in pre-clinical, 262 in clinical) at Juntendo University Faculty of Medicine; descriptive analysis was used to examine the respondents' characteristics and responses. The majority of respondents (54.2%) preferred asynchronous classes. Mann-Whitney U tests revealed that while pre-clinical students preferred asynchronous classes significantly more than clinical students (39.6%, p < .001), students who preferred face-to-face classes had significantly higher total achievement test scores (U = 1082, p = .021, r = .22). To examine the impacts of pandemic-induced changes in learning, we conducted Kruskal-Wallis tests and found that the 2020 and 2021 scores were significantly higher than those over the last three years. These results suggest that while medical students may have experienced challenges adapting to electronic learning, the impact of this means of study on their performance on achievement tests was relatively low. Our study found that if possible, face-to-face classes are preferable in an electronic learning environment. However, the benefit of asynchronous classes, such as those that allow multiple viewings, should continue to be recognized even after the pandemic.
Keywords	Medicine ; R ; Science ; Q
Subject code	796
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effects of COVID-19 on Japanese medical students’ knowledge and attitudes toward e-learning in relation to performance on achievement tests

Miwa Sekine / Makino Watanabe / Shuko Nojiri / Tsutomu Suzuki / Yuji Nishizaki / Yuichi Tomiki / Takao Okada

PLoS ONE, Vol 17, Iss

2022 Volume 3

Abstract	The COVID-19 pandemic forced many educational institutions to turn to electronic learning to allow education to continue under the stay-at-home orders/requests that were commonly instituted in early 2020. In this cross-sectional study, we evaluated the effects of the COVID-19 pandemic on medical education in terms of students’ attitudes toward online classes and their online accessibility; additionally, we examined the impacts of any disruption caused by the pandemic on achievement test performance based on the test results. The participants were 674 students (412 in pre-clinical, 262 in clinical) at Juntendo University Faculty of Medicine; descriptive analysis was used to examine the respondents’ characteristics and responses. The majority of respondents (54.2%) preferred asynchronous classes. Mann–Whitney U tests revealed that while pre-clinical students preferred asynchronous classes significantly more than clinical students (39.6%, p < .001), students who preferred face-to-face classes had significantly higher total achievement test scores (U = 1082, p = .021, r = .22). To examine the impacts of pandemic-induced changes in learning, we conducted Kruskal–Wallis tests and found that the 2020 and 2021 scores were significantly higher than those over the last three years. These results suggest that while medical students may have experienced challenges adapting to electronic learning, the impact of this means of study on their performance on achievement tests was relatively low. Our study found that if possible, face-to-face classes are preferable in an electronic learning environment. However, the benefit of asynchronous classes, such as those that allow multiple viewings, should continue to be recognized even after the pandemic.
Keywords	Medicine ; R ; Science ; Q
Subject code	796
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A cross‐sectional survey on principal investigators' clinical research knowledge in Japan

Miwa Sekine / Koshi Kataoka / Yuji Nishizaki / Kotone Matsuyama / Toshiaki Otsuka / Kensuke Sato / Mayumi Idei / Shoji Sanada

Clinical and Translational Science, Vol 16, Iss 3, Pp 459-

2023 Volume 466

Abstract: Abstract Principal investigators (PIs) play a key role in clinical research, and must thus understand the role of clinical research support staff to conduct successful and appropriate clinical research. This study evaluates clinical research capabilities ...

Abstract	Abstract Principal investigators (PIs) play a key role in clinical research, and must thus understand the role of clinical research support staff to conduct successful and appropriate clinical research. This study evaluates clinical research capabilities by examining the clinical research knowledge of PIs and clinical research support staff. The participants of this cross‐sectional study were academic researchers and clinical research support staff from Japanese universities and research institutions. The participants comprised of 54 respondents, among whom 36 were PIs (physicians) and 18 were clinical research support staff. A self‐administered electronic survey was created and evaluated by experts, with 50 knowledge items. Mann–Whitney U tests were used to determine the significance of the differences in knowledge between clinical research support staff and PIs. We compared the correct answer rate of clinical research support staff and PIs for each knowledge category and observed that the clinical research support staff scored significantly higher than the PIs in all aspects of clinical research knowledge sections, including total score. Our findings showed that PIs did not have the same amount of clinical research knowledge as the clinical research support staff. Clinical research knowledge is essential for investigators, especially PIs, to protect patients and promote medical breakthroughs. Thus, more accessible clinical research education and mandatory knowledge testing will allow PIs to lead successful clinical research and further the level of medical research in Japan.
Keywords	Therapeutics. Pharmacology ; RM1-950 ; Public aspects of medicine ; RA1-1270
Subject code	028
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Medical resident’s pursuing specialty and differences in clinical proficiency among medical residents in Japan

Takashi Watari / Yuji Nishizaki / Nathan Houchens / Koshi Kataoka / Kota Sakaguchi / Yoshihiko Shiraishi / Taro Shimizu / Yu Yamamoto / Yasuharu Tokuda

BMC Medical Education, Vol 23, Iss 1, Pp 1-

a nationwide cross-sectional study

2023 Volume 15

Abstract: Abstract Importance Standardized examinations assess both learners and training programs within the medical training system in Japan. However, it is unknown if there is an association between clinical proficiency as assessed by the General Medicine In- ... ...

Abstract	Abstract Importance Standardized examinations assess both learners and training programs within the medical training system in Japan. However, it is unknown if there is an association between clinical proficiency as assessed by the General Medicine In-Training Examination (GM-ITE) and pursuing specialty. Objective To determine the relative achievement of fundamental skills as assessed by the standardized GM-ITE based on pursuing career specialty among residents in the Japanese training system. Design Nationwide cross-sectional study. Setting Medical residents in Japan who attempted the GM-ITE in their first or second year were surveyed. Participants A total of 4,363 postgraduate years 1 and 2 residents who completed the GM-ITE were surveyed between January 18 and March 31, 2021. Main measures GM-ITE total scores and individual scores in each of four domains assessing clinical knowledge: 1) medical interview and professionalism, 2) symptomatology and clinical reasoning, 3) physical examination and treatment, and 4) detailed disease knowledge. Results When compared to the most pursued specialty, internal medicine, only those residents who chose general medicine achieved higher GM-ITE scores (coefficient 1.38, 95% CI 0.08 to 2.68, p = 0.038). Conversely, the nine specialties and “Other/Not decided” groups scored significantly lower. Higher scores were noted among residents entering general medicine, emergency medicine, and internal medicine and among those who trained in community hospitals with higher numbers of beds, were more advanced in their training, spent more time working and studying, and cared for a moderate but not an extreme number of patients at a time. Conclusions Levels of basic skill achievement differed depending on respective chosen future specialties among residents in Japan. Scores were higher among those pursuing careers in general medical fields and lower among those pursuing highly specialized careers. Residents in training programs devoid of specialty-specific competition may not possess the ...
Keywords	Postgraduate medical education ; Essential clinical skills ; General medicine ; Cross-sectional study ; Special aspects of education ; LC8-6691 ; Medicine ; R
Subject code	001
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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