<p>Structured debate is broadly played by university students and graduates as a competition. The educational benefits of debates, such as fostering critical thinking, are acknowledged across various disciplines.<span><sup>1</sup></span> Hence, we proposed using debates as a self-learning method for medical students and young healthcare providers. Herein, we report a trial where debate serves as a tool for self-learning in Japan.</p><p>Our debate adhered to the systematic procedures outlined by the Japan Debate Association.<span><sup>2</sup></span> Time allocation was slightly modified (Table S1). We held debates using Zoom, with approximately 5–10 voluntary participants: medical students and young healthcare providers. A “plan (agenda)” was collaboratively based on participants' daily observations and interests (Table 1). The participants were divided into two sides: the “pro” (Affirmative side) and the “con” (Negative side), enabling the debate. After the debate, a panel of three judges decided the persuasiveness of each side. The roles of “pro” and “con” were blindly assigned by a third party, irrespective of individuals' opinions on the topic. We performed four debates, as shown below (Table 1). Participants' motivation for these topics is also described.</p><p>After each debate, time for reflection was provided. Summarizing the participants' feedback, we found three distinctive characteristics of learning through structured debate as follows. First, students and early-career healthcare providers demonstrated their capability of thinking and researching actively (more easily with a single axis) when given the role of agreeing or disagreeing with a topic in which their interest was vague rather than with no axis. Second, developing discussions within a certain structure will foster the ability to think logically. Lastly, the students will be able to have a multifaceted viewpoint through arguments from both sides, rather than from one point of view.</p><p>Of note, our structured debate was conducted online. Given the increased attention toward online educational systems in light of the COVID-19 pandemic, this trial could potentially serve as a promising alternative tool in the future.</p><p>As a limitation, our debates were performed without the involvement of leadership experts, as we intended to provide a voluntarily investigating platform to explore topics of participants' interest. Consequently, the quality of the debates depended markedly on the participants' motivation. Moreover, given that participants of this trial were sufficiently motivated at least enough to invest their precious time voluntarily, well-organized and appealing instructions should be required to install our method in the usual classroom education. For instance, supervision by senior group mentors, who have already acquired the credit, during participants' preparation stage may be beneficial. Prior discussion and consultation with such mentors could also serve as studen
{"title":"A trial of structured debate as a self-learning method for students and young healthcare providers to discuss social issues in general and family medicine: A case report in Japan","authors":"Tatsuki Ikejiri MD, Jeonse Lee MD, Natsuki Yokoyama BS, Arisa Hakariya MD, Yuki Otsuka MD, PhD, Hayase Hakariya PhD","doi":"10.1002/jgf2.706","DOIUrl":"https://doi.org/10.1002/jgf2.706","url":null,"abstract":"<p>Structured debate is broadly played by university students and graduates as a competition. The educational benefits of debates, such as fostering critical thinking, are acknowledged across various disciplines.<span><sup>1</sup></span> Hence, we proposed using debates as a self-learning method for medical students and young healthcare providers. Herein, we report a trial where debate serves as a tool for self-learning in Japan.</p><p>Our debate adhered to the systematic procedures outlined by the Japan Debate Association.<span><sup>2</sup></span> Time allocation was slightly modified (Table S1). We held debates using Zoom, with approximately 5–10 voluntary participants: medical students and young healthcare providers. A “plan (agenda)” was collaboratively based on participants' daily observations and interests (Table 1). The participants were divided into two sides: the “pro” (Affirmative side) and the “con” (Negative side), enabling the debate. After the debate, a panel of three judges decided the persuasiveness of each side. The roles of “pro” and “con” were blindly assigned by a third party, irrespective of individuals' opinions on the topic. We performed four debates, as shown below (Table 1). Participants' motivation for these topics is also described.</p><p>After each debate, time for reflection was provided. Summarizing the participants' feedback, we found three distinctive characteristics of learning through structured debate as follows. First, students and early-career healthcare providers demonstrated their capability of thinking and researching actively (more easily with a single axis) when given the role of agreeing or disagreeing with a topic in which their interest was vague rather than with no axis. Second, developing discussions within a certain structure will foster the ability to think logically. Lastly, the students will be able to have a multifaceted viewpoint through arguments from both sides, rather than from one point of view.</p><p>Of note, our structured debate was conducted online. Given the increased attention toward online educational systems in light of the COVID-19 pandemic, this trial could potentially serve as a promising alternative tool in the future.</p><p>As a limitation, our debates were performed without the involvement of leadership experts, as we intended to provide a voluntarily investigating platform to explore topics of participants' interest. Consequently, the quality of the debates depended markedly on the participants' motivation. Moreover, given that participants of this trial were sufficiently motivated at least enough to invest their precious time voluntarily, well-organized and appealing instructions should be required to install our method in the usual classroom education. For instance, supervision by senior group mentors, who have already acquired the credit, during participants' preparation stage may be beneficial. Prior discussion and consultation with such mentors could also serve as studen","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"293-294"},"PeriodicalIF":1.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.706","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Research on the social determinants of health (SDH) aims to foster a healthier, more equitable society by reducing health disparities. Nonetheless, primary care researchers often face challenges in engaging marginalized populations in their studies. It is essential to explore diverse methodologies to promote inclusive research.</p><p>During the fifth annual Primary Care Research (PCR) Connect conference, dedicated to primary care research in Japan, we held a symposium to discuss strategies for enhancing inclusivity in SDH research.</p><p>Using large-scale datasets from multiple centers or municipalities offers the advantage of evaluating the subtle effects of meso- and macro-level factors on individual health and their heterogeneities. However, the exclusion of individuals because of healthcare access barriers, language barriers, absence from official databases, or unstable housing situations can introduce sampling and selection biases. Such biases may compromise the studies' validity and generalizability of those findings.<span><sup>1</sup></span> Therefore, the following studies focusing on marginalized populations highlight their potential benefits in specific contexts.</p><p>By tailoring surveys to fit the target population, researchers can gather responses from individuals typically overlooked in large-scale surveys, allowing insights into their characteristics and concerns, including their lived experiences. For instance, investigations focus on individuals residing in marginalized communities, such as street dwellers living around train stations<span><sup>2</sup></span> or residents in impoverished neighborhoods.<span><sup>3</sup></span> Collaboration with local authorities ensures access to this data, essential for these studies. Furthermore, researchers should endeavor to mitigate health disparities by implementing interventions.</p><p>Qualitative research offers researchers a window into the lived experiences, thoughts, and emotions of socially marginalized individuals. For instance, qualitative inquiry holds the potential to unveil the barriers perceived by women with a history of substance use, transgender individuals, or youth contemplating suicide,<span><sup>4</sup></span> during their interactions within primary care settings.</p><p>Case reports can elucidate the detailed experiences of patients facing complex social adversities.<span><sup>5</sup></span> Reports concentrating on SDH equip primary care professionals with critical insights for managing SDH-related challenges in daily practice. Maintaining patient confidentiality is a critical responsibility for all reporters.</p><p>Although we did not refer to a systematic review or scoping review in the conference, these reviews will synthesize the available evidence and identify evidence gaps.</p><p>In conclusion, research on SDH can employ diverse methodologies to illuminate the experiences of marginalized populations. Primary care professionals, often the initial point of cont
{"title":"Exploring social determinants of health in primary care: Approaches to increase research inclusivity","authors":"Takuya Maejima MD, Junki Mizumoto MD, Gemmei Iizuka MD, PhD, Maho Haseda MD, PhD","doi":"10.1002/jgf2.705","DOIUrl":"10.1002/jgf2.705","url":null,"abstract":"<p>Research on the social determinants of health (SDH) aims to foster a healthier, more equitable society by reducing health disparities. Nonetheless, primary care researchers often face challenges in engaging marginalized populations in their studies. It is essential to explore diverse methodologies to promote inclusive research.</p><p>During the fifth annual Primary Care Research (PCR) Connect conference, dedicated to primary care research in Japan, we held a symposium to discuss strategies for enhancing inclusivity in SDH research.</p><p>Using large-scale datasets from multiple centers or municipalities offers the advantage of evaluating the subtle effects of meso- and macro-level factors on individual health and their heterogeneities. However, the exclusion of individuals because of healthcare access barriers, language barriers, absence from official databases, or unstable housing situations can introduce sampling and selection biases. Such biases may compromise the studies' validity and generalizability of those findings.<span><sup>1</sup></span> Therefore, the following studies focusing on marginalized populations highlight their potential benefits in specific contexts.</p><p>By tailoring surveys to fit the target population, researchers can gather responses from individuals typically overlooked in large-scale surveys, allowing insights into their characteristics and concerns, including their lived experiences. For instance, investigations focus on individuals residing in marginalized communities, such as street dwellers living around train stations<span><sup>2</sup></span> or residents in impoverished neighborhoods.<span><sup>3</sup></span> Collaboration with local authorities ensures access to this data, essential for these studies. Furthermore, researchers should endeavor to mitigate health disparities by implementing interventions.</p><p>Qualitative research offers researchers a window into the lived experiences, thoughts, and emotions of socially marginalized individuals. For instance, qualitative inquiry holds the potential to unveil the barriers perceived by women with a history of substance use, transgender individuals, or youth contemplating suicide,<span><sup>4</sup></span> during their interactions within primary care settings.</p><p>Case reports can elucidate the detailed experiences of patients facing complex social adversities.<span><sup>5</sup></span> Reports concentrating on SDH equip primary care professionals with critical insights for managing SDH-related challenges in daily practice. Maintaining patient confidentiality is a critical responsibility for all reporters.</p><p>Although we did not refer to a systematic review or scoping review in the conference, these reviews will synthesize the available evidence and identify evidence gaps.</p><p>In conclusion, research on SDH can employ diverse methodologies to illuminate the experiences of marginalized populations. Primary care professionals, often the initial point of cont","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"291-292"},"PeriodicalIF":1.8,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141115875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Designed and implemented over two decades ago, the Chronic Care Model is a well-established chronic disease management framework that has steered several healthcare systems in successfully improving the clinical outcomes of patients with type 2 diabetes mellitus. Research evidence cements the role of the Chronic Care Model (with its six key elements of organization of healthcare delivery system, self-management support, decision support, delivery system design, clinical information systems, and community resources and policies) as an integrated framework to revamp the type 2 diabetes mellitus-related clinical practice and care that betters the patient care and clinical outcomes. The current review is an evidence-lit summary of importance of use of Chronic Care Model in primary care and their impact on clinical outcomes for patients afflicted with one of the most debilitating metabolic diseases, type 2 diabetes mellitus.
{"title":"Improving outcomes of type 2 diabetes mellitus patients in primary care with Chronic Care Model: A narrative review","authors":"Arwa Ahmed Al-Qahtani MD","doi":"10.1002/jgf2.659","DOIUrl":"10.1002/jgf2.659","url":null,"abstract":"<p>Designed and implemented over two decades ago, the Chronic Care Model is a well-established chronic disease management framework that has steered several healthcare systems in successfully improving the clinical outcomes of patients with type 2 diabetes mellitus. Research evidence cements the role of the Chronic Care Model (with its six key elements of organization of healthcare delivery system, self-management support, decision support, delivery system design, clinical information systems, and community resources and policies) as an integrated framework to revamp the type 2 diabetes mellitus-related clinical practice and care that betters the patient care and clinical outcomes. The current review is an evidence-lit summary of importance of use of Chronic Care Model in primary care and their impact on clinical outcomes for patients afflicted with one of the most debilitating metabolic diseases, type 2 diabetes mellitus.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"171-178"},"PeriodicalIF":1.8,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}