研究者詳細 - 錦織　宏

論文 - 錦織　宏

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【地域医療実習・研修でなにを学ぶのか】実際に学ぶこと文化人類学的医療を学ぶ査読有り

宮地純一郎, 錦織宏

地域医学 37 巻 ( 9 ) 頁： 879 - 884 2023年9月

記述言語：日本語出版者・発行元：(公社)地域医療振興協会

＜POINT＞(1)文化人類学は現場に自分の生身の体を置くフィールドワーク,参与観察,文脈を踏まえた視点,自己相対化と自己変容を特徴とした学問である(2)文化人類学は,文脈にまつわる探究および医療者集団の価値体系と習慣に対する感受性と言語化を通じて臨床実践を変えうる(3)文化人類学の特徴を地域医療教育に加味することで,ただ現場に行くだけでは届かない深み・厚みが生まれうる(著者抄録)

教育実践報告航空業界の安全から医療安全を相対化するFaculty development

木村武司, 種村文孝, 清水郁夫, 錦織宏

医学教育 54 巻 ( Suppl. ) 頁： 199 - 199 2023年7月

職種横断的な内省を通して思いのすれ違いを連携に活かす "多職種連携モヤっと研究会"の取り組み査読有り

佐野樹, 森下真理子, 錦織宏

医学教育 54 巻 ( 3 ) 頁： 281 - 287 2023年6月

記述言語：日本語出版者・発行元：(一社)日本医学教育学会

専門職間で起こる思いのすれ違いを「モヤっと」と名づけ,それを医療/教育現場での連携に活かすため,2014年から研究会を立ち上げた.多施設の多職種で月1回1時間のオンライン研究会を行い,モヤっとした経験について内省を行った.本稿では研究会について振り返る中で,会の発足と歩み,会の中で起きている学習プロセスや根拠となっている理論について述べる.さらに研究会での実践とその変化について共有しつつ,多職種連携(教育)での内省には,専門領域内でする一次内省と,領域の外から自らの専門を見つめる二次内省の両輪が必要であることを示す.(著者抄録)

10. 医学教育モデル・コア・カリキュラム (令和4年度改訂版) 国際発信・医学教育先進国の動向査読有り

矢野晴美, 松山泰, 及川沙耶佳, 菊川誠, 清水郁夫, 野村理, 錦織宏

医学教育 54 巻 ( 2 ) 頁： 194 - 198 2023年4月

記述言語：日本語出版者・発行元：日本医学教育学会

世界で主流のコンピテンシーモデルとして, カナダのCanMEDS 2015, 米国卒後臨床研修諮問機関ACGMEモデル, 英国Tomorrow's Doctorsがある. 文部科学省医学教育モデル・コア・カリキュラム改訂では, 海外調査が実施された. 調査対象国の医学部では上記3つのいずれかが採用されており, これらのモデルの活用は, 柔軟であった. 各大学のカリキュラム・デザイン, 教育の提供の自由度は高いが, 質保証体制として, 各国は世界医学教育連盟 (WFME) などの認証が必要で, 規制されている. また令和4年度改訂版モデル・コア・カリキュラムは英訳され世界に情報発信されている.

DOI： 10.11307/mededjapan.54.2_194

CiNii Research

8. 学修評価とGood Practice (2) 査読有り

伊藤彰一, 岡崎仁昭, 小松弘幸, 錦織宏, 松山泰, 山脇正永, 菊川誠, 清水郁夫, 中村真理子, 三谷昌平

医学教育 54 巻 ( 2 ) 頁： 182 - 186 2023年4月

記述言語：日本語出版者・発行元：日本医学教育学会

医学教育モデル・コア・カリキュラム (令和4年度改訂版) で新たに記載された「第3章学修方略・評価」の「II. 学修評価」は, 1. 学修評価の考え方, 2. 学修評価の方法, 3. 学修評価の問いの三部構成となっている. 3. 学修評価の問いでは, 「評価の在り方は教育機関によって異なる」という基本的な考え方にもとづいて, あえて「問い」に対する回答が記載されていない. カリキュラム開発において学修評価を計画する際には, 「 II . 学修評価」の記載を参考にしつつ, カリキュラムの背景や文脈をふまえて検討を重ねていただきたい.

DOI： 10.11307/mededjapan.54.2_182

CiNii Research

【Making of医学教育モデル・コア・カリキュラム】資質・能力に新設された総合的に患者・生活者をみる姿勢について査読有り

春田淳志, 安藤崇之, 遠藤周, 金子惇, 鋪野紀好, 長嶺由衣子, 錦織宏, 藤川裕恭, 山梨啓友

医学教育 54 巻 ( 2 ) 頁： 142 - 148 2023年4月

記述言語：日本語出版者・発行元：(一社)日本医学教育学会

少子高齢化社会の背景と令和2年度からの調査を踏まえ,患者の抱える問題を臓器横断的に捉えた上で,心理社会的背景も踏まえた総合的な視点とアプローチの必要性が示され,医学教育モデル・コア・カリキュラム(令和4年改訂版)に総合的に患者・生活者をみる姿勢が資質・能力に新設された.下位目標として「全人的な視点とアプローチ」「地域の視点とアプローチ」「人生の視点とアプローチ」「社会の視点とアプローチ」が位置づけられた.抽象と具体,概念と経験,自己と他者等の視点を統合し,自己の在り方を省察できるような複数の学習理論を踏まえた教育方法が提案された.このような医学教育を通じて,患者・生活者のウェルビーイングが向上することを期待する.(著者抄録)

【Making of医学教育モデル・コア・カリキュラム】資質・能力に新設された総合的に患者・生活者をみる姿勢について査読有り

春田淳志, 安藤崇之, 遠藤周, 金子惇, 鋪野紀好, 長嶺由衣子, 錦織宏, 藤川裕恭, 山梨啓友

医学教育 54 巻 ( 2 ) 頁： 142 - 148 2023年4月

記述言語：日本語出版者・発行元：(一社)日本医学教育学会

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00050&link_issn=&doc_id=20230516210002&doc_link_id=10.11307%2Fmededjapan.54.2_142&url=https%3A%2F%2Fdoi.org%2F10.11307%2Fmededjapan.54.2_142&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Reconstructing the concept of empathy: an analysis of Japanese doctors' narratives of their experiences with illness 査読有り国際誌 Open Access

Morishita, M; Iida, J; Nishigori, H

ADVANCES IN HEALTH SCIENCES EDUCATION 28 巻 ( 1 ) 頁： 87 - 106 2023年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Advances in Health Sciences Education

The ability of doctors to empathise with patients is a crucial concern in establishing humanistic medicine. Therefore, the cultivation of this ability has been discussed extensively in medical education. One theory suggests that the experience of patienthood can increase empathy among doctors. This theory is supported by previous research that published doctors’ illness narratives. However, the concept of empathy has been ambiguously defined in academic fields, including medicine; therefore, analysing how doctors experience ‘empathy’ in their interactions with patients is difficult. Our research question is how doctors who became patients describe the relationship between their illness experiences and the interactions with patients after their illness. To this end, this paper initially tracks the debates on ‘empathy’ in medicine and other disciplines, to develop a lens for analysing doctors’ illness narratives. Next, we conduct a narrative analysis of illness stories from 18 Japanese medical doctors who became patients. Our analysis supports the traditional idea that an illness can enable a doctor to become more empathetic. However, this is overly simplistic; how doctors experience and subsequently process their illness is more complex. Moreover, this notion can disregard doctors’ suffering in these circumstances, and fail to represent the often-lengthy process of mastering ‘empathy’ based on their experiences. Therefore, our analysis deconstructed the concept of ‘empathy’, showing that it can appear in various ways. Further research is required to elucidate how empathy is cultivated during the process of transformation of doctors’ illnesses, focusing on their communities and practices.

DOI： 10.1007/s10459-022-10143-5

Web of Science

Scopus

PubMed

Psychological safety and Safety-II paradigm for faculty development 査読有り Open Access

Shimizu, I; Lee, SS; Findyartini, A; Shikino, K; Asada, Y; Nishigori, H

ASIA PACIFIC SCHOLAR 7 巻 ( 3 ) 頁： 60 - 62 2022年7月

Locally adapting generic rubrics for the implementation of outcome-based medical education: a mixed-methods approach 査読有り Open Access

Kondo, T; Nishigori, H; van der Vleuten, C

BMC MEDICAL EDUCATION 22 巻 ( 1 ) 頁： 262 2022年4月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC Medical Education

Background: Rubrics are frequently used to assess competencies in outcome-based medical education (OBE). The implementation of assessment systems using rubrics is usually realised through years of involvement in projects with various stakeholders. However, for countries or specialities new to OBE, faster and more simplified processes are required. In March 2019, Japan introduced nine competencies and generic rubrics of competencies for medical residents. We explored the local adaptation of these generic rubrics and its consequences for assessors. Methods: The study followed three steps. First, we locally adapted the generic rubrics. This was followed by conducting mixed-method research to explore the effect of the local adaptation. In step two, we examined the correlations between the scores in the locally adapted assessment sheets for supervising doctors and generic rubrics. In step three, we conducted interviews with supervising doctors. The study was conducted in the General Internal Medicine Department of Nagoya University, Japan. In the first step, doctors in the Medical Education Center and other medical departments, clerks, and residents participated. Supervising doctors in the General Internal Medicine Department participated in the second and third steps. Results: A locally adapted assessment system was developed and implemented in seven months. The scores of the generic rubrics and the adapted assessment tool completed by the supervising doctors showed good correlations in some items as opposed to others, assessed mainly with other tools. Participant interviews revealed that local adaptation decreased their cognitive load leading to consistent ratings, increased writing of comments, and promoting reflection on instruction. Conclusions: This adaptation process is a feasible way to begin the implementation of OBE. Local adaptation has advantages over direct use of generic rubrics.

DOI： 10.1186/s12909-022-03352-4

Cultivating cultural awareness among medical educators by integrating cultural anthropology in faculty development: an action research study 査読有り Open Access

Oikawa, S; Iida, J; Ito, Y; Nishigori, H

BMC MEDICAL EDUCATION 22 巻 ( 1 ) 頁： 196 2022年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC Medical Education

Background: In faculty development, understanding each participant’s cultural context is important. However, there is scarce evidence on how to improve cultural understanding in faculty development. Cultural anthropology is a discipline that focuses on developing cultural self-awareness by understanding different cultures. Professionals from this field can be crucial to the goal of cultivating cultural awareness among medical educators. The aims of this study are to 1) develop and modify cultural anthropology sessions in faculty development and 2) evaluate the effectiveness of these sessions, including their long-term impacts. Methods: The cultural anthropology sessions were organized as part of a longitudinal faculty development program—Foundation Course for Medical Education—at Kyoto University in Japan. The study included 47 medical educators participating in faculty development and three lecturers: two cultural anthropologists and a medical educator. We developed the cultural anthropology sessions and implemented them in the longitudinal faculty development program. In these sessions, cultural anthropologists used inquiry-guided reflection. An action research methodology was employed and repeated in four cycles from 2015 to 2018. Qualitative and quantitative data were collected during the action research cycles. The qualitative data were thematically analyzed. Results: The cultural anthropologists’ inquiries fostered learning during the sessions, and three themes—cultural relativism, attention to context, and reframing—were synthesized. As a long-term impact of the sessions, the learners reported becoming more aware of the cultural contexts in their daily educational and clinical activities. Conclusions: The cultural anthropology sessions in the faculty development program were shown to have enhanced the participants’ awareness of cultural contexts. The concept and format of these sessions may be used more widely in faculty development programs.

DOI： 10.1186/s12909-022-03260-7

その他リンク： https://link.springer.com/article/10.1186/s12909-022-03260-7/fulltext.html

Medical Students' and Trainees' Country-By-Gender Profiles: Hofstede's Cultural Dimensions Across Sixteen Diverse Countries 査読有り Open Access

Monrouxe, LV; Chandratilake, M; Chen, JL; Chhabra, S; Zheng, LB; Costa, PS; Lee, YM; Karnieli-Miller, O; Nishigori, H; Ogden, K; Pawlikowska, T; Riquelme, A; Sethi, A; Soemantri, D; Wearn, A; Wolvaardt, L; Yusoff, MSB; Yau, SY

FRONTIERS IN MEDICINE 8 巻頁： 746288 2022年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Frontiers in Medicine

Purpose: The global mobility of medical student and trainee populations has drawn researchers' attention to consider internationalization in medical education. Recently, researchers have focused on cultural diversity, predominately drawing on Hofstede's cross-cultural analysis of cultural dimensions from general population data to explain their findings. However, to date no research has been specifically undertaken to examine cultural dimensions within a medical student or trainee population. This is problematic as within-country differences between gender and professional groups have been identified within these dimensions. We address this gap by drawing on the theoretical concept of national context effects: specifically Hofstede's six-dimensional perspective. In doing so we examine medical students' and trainees' country profiles across dimensions, country-by-gender clustering, and differences between our data and Hofstede's general population data. Methods: We undertook a cross-cultural online questionnaire study (eight languages) containing Hofstede's 2013 Values Survey. Our questionnaire was live between 1st March to 19th Aug 2018, and December 2018 to mitigate country holiday periods. We recruited undergraduate medical students and trainees with at least 6-months' clinical training using school-specific methods including emails, announcements, and snowballing. Results: We received 2,529 responses. Sixteen countries were retained for analyses (n = 2,307, 91%): Australia, Chile, China, Hong Kong, India, Indonesia, Ireland, Israel, Japan, Malaysia, New Zealand, Pakistan, South Africa, South Korea, Sri-Lanka, Taiwan. Power distance and masculinity are homogenous across countries. Uncertainty avoidance shows the greatest diversity. We identified four country clusters. Masculinity and uncertainty are uncorrelated with Hofstede's general population data. Conclusions: Our medical student and trainee data provides medical education researchers with more appropriate cultural dimension profiles than those from general population data. Country cluster profiles stimulate useful hypotheses for further research, especially as patterning between clusters cuts across traditional Eastern-Western divides with national culture being stronger than gendered influences. The Uncertainty dimension with its complex pattern across clusters is a particularly fruitful avenue for further investigation.

DOI： 10.3389/fmed.2021.746288

Advancing the science of health professions education through a shared understanding of terminology: a content analysis of terms for "faculty" 査読有り Open Access

Teunissen, PW; Atherley, A; Cleland, JJ; Holmboe, E; Hu, WCY; Durning, SJ; Nishigori, H; Samarasekera, DD; Schuwirth, L; van Schalkwyk, S; Maggio, LA

PERSPECTIVES ON MEDICAL EDUCATION 11 巻 ( 1 ) 頁： 22 - 27 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Perspectives on Medical Education

Introduction: Health professions educators risk misunderstandings where terms and concepts are not clearly defined, hampering the field’s progress. This risk is especially pronounced with ambiguity in describing roles. This study explores the variety of terms used by researchers and educators to describe “faculty”, with the aim to facilitate definitional clarity, and create a shared terminology and approach to describing this term. Methods: The authors analyzed journal article abstracts to identify the specific words and phrases used to describe individuals or groups of people referred to as faculty. To identify abstracts, PubMed articles indexed with the Medical Subject Heading “faculty” published between 2007 and 2017 were retrieved. Authors iteratively extracted data and used content analysis to identify patterns and themes. Results: A total of 5,436 citations were retrieved, of which 3,354 were deemed eligible. Based on a sample of 594 abstracts (17.7%), we found 279 unique terms. The most commonly used terms accounted for approximately one-third of the sample and included faculty or faculty member/s (n = 252; 26.4%); teacher/s (n = 59; 6.2%) and medical educator/s (n = 26; 2.7%) were also well represented. Content analysis highlighted that the different descriptors authors used referred to four role types: healthcare (e.g., doctor, physician), education (e.g., educator, teacher), academia (e.g., professor), and/or relationship to the learner (e.g., mentor). Discussion: Faculty are described using a wide variety of terms, which can be linked to four role descriptions. The authors propose a template for researchers and educators who want to refer to faculty in their papers. This is important to advance the field and increase readers’ assessment of transferability.

DOI： 10.1007/s40037-021-00683-8

その他リンク： https://link.springer.com/article/10.1007/s40037-021-00683-8/fulltext.html

A scoping review of clinical reasoning research with Asian healthcare professionals. 査読有り Open Access

Lee CY, Jenq CC, Chandratilake M, Chen J, Chen MM, Nishigori H, Wajid G, Yang PH, Yusoff MSB, Monrouxe L

Advances in health sciences education : theory and practice 26 巻 ( 5 ) 頁： 1555 - 1579 2021年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Advances in Health Sciences Education

Clinical reasoning is the thought process that guides practice. Although a plethora of clinical reasoning studies in healthcare professionals exists, the majority appear to originate from Western cultures. A scoping review was undertaken to examine clinical reasoning related research across Asian cultures. PubMed, SciVerse Scopus, Web of Science and Airiti Library databases were searched. Inclusion criteria included full-text articles published in Asian countries (2007 to 2019). Search terms included clinical reasoning, thinking process, differential diagnosis, decision making, problem-based learning, critical thinking, healthcare profession, institution, medical students and nursing students. After applying exclusion criteria, n = 240 were included in the review. The number of publications increased in 2012 (from 5%, n = 13 in 2011 to 9%, n = 22) with a steady increase onwards to 12% (n = 29) in 2016. South Korea published the most articles (19%, n = 46) followed by Iran (17%, n = 41). Nurse Education Today published 11% of the articles (n = 26), followed by BMC Medical Education (5%, n = 13). Nursing and Medical students account for the largest population groups studied. Analysis of the articles resulted in seven themes: Evaluation of existing courses (30%, n = 73) being the most frequently identified theme. Only seven comparative articles showed cultural implications, but none provided direct evidence of the impact of culture on clinical reasoning. We illuminate the potential necessity of further research in clinical reasoning, specifically with a focus on how clinical reasoning is affected by national culture. A better understanding of current clinical reasoning research in Asian cultures may assist curricula developers in establishing a culturally appropriate learning environment.

DOI： 10.1007/s10459-021-10060-z

Open Access

Scopus

PubMed

その他リンク： https://link.springer.com/article/10.1007/s10459-021-10060-z/fulltext.html

【医学・医療者教育学を学ぶ我が国のプログラム】京大FCME(ふくみん) 現場で働く指導医のための医学教育学プログラム基礎編

錦織宏, 及川沙耶佳, 谷昇子, 木村武司, 種村文孝

医学教育 52 巻 ( 6 ) 頁： 515 - 523 2021年12月

記述言語：日本語出版者・発行元：(一社)日本医学教育学会

2015年に文部科学省の助成を受けて開講した京都大学の「現場で働く指導医のための医学教育学プログラム-基礎編」は対面型と遠隔型を組み合わせた形で医学教育学を体系的に学ぶプログラムである。1年間で約120時間学修することになる受講生は、課題に追われながらも12名の仲間と強固な学修コミュニティを形成していき、その様は講師が羨むほどである。また、プログラムに思想・哲学を掲げていること、そして文化人類学を重視したプログラムであることが特徴である。(著者抄録)

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J00050&link_issn=&doc_id=20220112190004&doc_link_id=10.11307%2Fmededjapan.52.6_515&url=https%3A%2F%2Fdoi.org%2F10.11307%2Fmededjapan.52.6_515&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

52巻3号掲載「拘束からの解放―反転授業を活用した完全オンライン型臨床研修指導医講習会―」を読んで, への応答査読有り

近藤猛, 錦織宏

医学教育 52 巻 ( 5 ) 頁： 450 - 451 2021年10月

外科系医師はどのようにして医学教育のキャリアを形成していくのか? 臨床医から、臨床医の教育、そして医学教育学へ医学教育学を学ぶ産婦人科医として査読有り

磯部真倫, 榎本隆之, 錦織宏

医学教育 52 巻 ( Suppl. ) 頁： 37 - 37 2021年7月

Lists of potential diagnoses that final-year medical students need to consider: a modified Delphi study 査読有り Open Access

Urushibara-Miyachi, Y; Kikukawa, M; Ikusaka, M; Otaki, J; Nishigori, H

BMC MEDICAL EDUCATION 21 巻 ( 1 ) 頁： 234 2021年4月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC Medical Education

Background: Contrastive learning is known to be effective in teaching medical students how to generate diagnostic hypotheses in clinical reasoning. However, there is no international consensus on lists of diagnostic considerations across different medical disciplines regarding the common signs and symptoms that should be learned as part of the undergraduate medical curriculum. In Japan, the national model core curriculum for undergraduate medical education was revised in 2016, and lists of potential diagnoses for 37 common signs, symptoms, and pathophysiology were introduced into the curriculum. This study aimed to validate the list of items based on expert consensus. Methods: The authors used a modified Delphi method to develop consensus among a panel of 23 expert physician-teachers in clinical reasoning from across Japan. The panel evaluated the items on a 5-point Likert scale, based on whether a disease should be hypothesized by final-year medical students considering given signs, symptoms, or pathophysiology. They also added other diseases that should be hypothesized. A positive consensus was defined as both a 75% rate of panel agreement and a mean of 4 or higher with a standard deviation of less than 1 on the 5-point scale. The study was conducted between September 2017 and March 2018. Results: This modified Delphi study identified 275 basic and 67 essential other than basic items corresponding to the potential diagnoses for 37 common signs, symptoms, and pathophysiology that Japanese medical students should master before graduation. Conclusions: The lists developed in the study can be useful for teaching and learning how to generate initial hypotheses by encouraging students’ contrastive learning. Although they were focused on the Japanese educational context, the lists and process of validation are generalizable to other countries for building national consensus on the content of medical education curricula.

DOI： 10.1186/s12909-021-02652-5

その他リンク： https://link.springer.com/article/10.1186/s12909-021-02652-5/fulltext.html

A Collaborative Clinical Case Conference Model for Teaching Social and Behavioral Science in Medicine: An Action Research Study 査読有り

Junichiro Miyachi, Junko Iida, Yosuke Shimazono, Hiroshi Nishigori

2021年2月

出版者・発行元：Research Square Platform LLC

<title>Abstract</title>
<bold>Background: </bold>Effective social and behavioral sciences teaching in medical education requires integration with clinical experience, as well as collaboration with social and behavioral sciences experts and clinical faculties. However, teaching models for achieving this integration have not been adequately established, nor has the collaboration process been described. This study aims to propose a collaborative clinical case conference model to integrate social and behavioral sciences and clinical experience. Additionally, we describe how social and behavioral science experts and clinical faculties collaborate during the development of the teaching method.<bold>Methods:</bold> A team of clinical teachers and medical anthropologists planned for the development of a case conference based on action research methodology. The initial model planned for a 3-hour session, similar to the Clinicopathological Conference structure. We evaluated each session based on fieldnotes taken by medical anthropologists, and post-session questionnaires that surveyed participants’ reactions and points of improvements. Based on the evaluation, a reflective meeting was held to discuss revisions for the next trial. We incorporated the development process into undergraduate medical curricula in clinical years and in a postgraduate and continuous professional development session for residents and certified family physicians in Japan. We repeated the plan-act-observe-reflection process more than 15 times between 2015 and 2018.<bold>Results:</bold> The development of the collaborative clinical case conference model is summarized in three phases: Quasi-CPC, Interactive, and Co-constructive with unique structures and underlying paradigms. The model successfully contributed to promoting the participants’ recognition of the clinical significance of social and behavioral sciences. The case preparation entailed a unique, significant learning of how social and behavioral sciences inform clinical practice. The model development process promoted the mutual understanding between clinical faculties and anthropologists, which might function as faculty development for teachers involved in social and behavioral sciences teaching in medical education. <bold>Conclusions:</bold> The application of fitting conference models and awareness of their underlying paradigm according to educational situations could promote the integration of social and behavioral sciences with clinical medicine education. Faculty development in social and behavioral sciences in medical education should focus on collaboration with scholars with different paradigmatic orientations.

DOI： 10.21203/rs.3.rs-138564/v1

その他リンク： https://www.researchsquare.com/article/rs-138564/v1.html

Correlation between the number oflaparoscopy-qualifiedgynecologists and the proportion of laparoscopic surgeries for benign gynecological diseases in Japan: An ecological study 査読有り国際誌

Isobe, M; Kataoka, Y; Chikazawa, K; Hada, T; Nishigori, H; Takahashi, T; Enomoto, T

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 47 巻 ( 1 ) 頁： 329 - 336 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Obstetrics and Gynaecology Research

Aim: We aimed to evaluate regional disparities in the proportion of the three main laparoscopic surgeries for benign gynecological diseases among 47 prefectures in Japan and their correlation with the number of laparoscopy-qualified gynecologists per population. Methods: In this retrospective ecological study, we collected the data of patients from 47 prefectures in 2017 using “The National Database of Health Insurance Claims and Specific Health Checkups of Japan” Open Data from the Ministry of Health, Labor and Welfare in Japan. The primary outcome of the study was the proportion of laparoscopic surgeries conducted for benign gynecologic diseases (hysterectomy, myomectomy and surgery for the benign ovarian diseases). The main exposure was the number of laparoscopy-qualified gynecologists per 100 000 females. Results: The average proportion of laparoscopic hysterectomies, myomectomies and surgeries for the benign ovarian disease were 38% (standard deviation (SD) 16, range 12–74), 48% (SD 18, range 9–81) and 60% (SD 11, range 36–79), respectively. Multiple regression analysis showed a significant correlation between the number of laparoscopy-qualified gynecologists per 100 000 females and the proportion of the three main laparoscopic surgeries. Conclusion: There are obvious regional disparities in the proportion of the three main laparoscopic procedures for benign gynecological diseases among 47 prefectures. The number of laparoscopy-qualified gynecologists correlated significantly with these regional disparities. The academic society should monitor these regional disparities and make an effort to reduce these regional disparities by increasing laparoscopy-qualified gynecologists in areas where the widespread use of laparoscopic techniques is lagging.

DOI： 10.1111/jog.14528

<錦織 宏>

論文 - 錦織 宏

<錦織　宏>

論文 - 錦織　宏