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Int J Med Educ. 2019 Dec 26;10:232-240. doi: 10.5116/ijme.5de7.99c7.

How a problem-based learning approach could help Japanese primary care physicians: a qualitative study.

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Division of General Medicine, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan.
Division of Clinical Epidemiology, The Jikei University School of Medicine, Tokyo, Japan.



This study aimed to identify training needs among primary care physicians in Japan who had no formal primary care training.


 We conducted a focus group interview with seven Japanese primary care physicians who had not previously undergone specialist training in primary care and had been recruited to a family medicine training program that used a problem-based learning approach. At the start of the program, the physicians attended the interview. The discussion was recorded, and the transcribed interview was analyzed using the Steps for Coding and Theorization method.


 Three main themes emerged. First, there is a lack of standard re-education programs for physicians who move away from their specializations into primary care. Second, there is insufficient training on primary care in undergraduate and postgraduate medical education in Japan. Third, continuing professional development programs should cover the communication skills, attitudes, and behaviors necessary for primary care practice.


 This study clarified the needs to be addressed in our training program for primary care physicians involved in retraining in primary care. It is important to consider how to best include the communication skills, attitudes, and behaviors necessary for primary care among the topics covered in the program. As the program undergoes further iteration, it will be important to check whether it meets the needs of primary care practitioners. It will be necessary to investigate the needs of re-education programs for more physicians in many areas, and to emphasize the importance of primary care re-education in these abilities in undergraduate and postgraduate medical education.


continuing professional development; focus group; general practitioner; japan; primary care; problem-based learning

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