Haruta, Junji

写真a

Affiliation

School of Medicine, Medical Education Center (Shinanomachi)

Position

Professor

Contact Address

35 Shinanomachi Shinjukuku Tokyo,160-8582 Japan

Profile Summary 【 Display / hide

  • 地域の市中病院で総合診療医として研鑽し、医学教育領域で博士課程を取得し、現在Academic GP(General Practitioner)として多職種連携や総合的な視点を持った医療者教育などの研究に注力しております。また、領域横断的に、様々な領域の研究者・教育者の方々と協働しながら、慶應義塾大学の医療者教育をより良いものにし、さらに医療者教育や地域包括ケアに関わる研究を進めて参ります。総合大学としての義塾の強みを活かし、世界のどこよりも早く超高齢社会を迎える本邦の知見を臨床実践・教育・研究から発信していきたいと思っております。

Other Affiliation 【 Display / hide

  • 筑波大学医学医療系, 客員准教授

Career 【 Display / hide

  • 2004.04
    -
    2006.03

    東京ほくと王子生協病院, 初期研修医

  • 2004.04
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    2006.03

    東京ほくと王子生協病院, 初期研修医

  • 2006.04
    -
    2010.03

    東京ほくと王子生協病院, 後期研修医

  • 2010.04
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    2011.03

    Tokyo Hokuto Health Co-operative Ouji Seikyou Hospital, Medical Education Fellow / Ward Medical Director

  • 2011.04
    -
    2015.03

    東京大学大学院医学系研究科, 医学教育国際研究センター, 博士

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Academic Background 【 Display / hide

  • 1998.04
    -
    2004.03

    Asahikawa Medical College, 医学部, 医学科

    University, Graduated

  • 1998.04
    -
    2004.03

    Asahikawa Medical College, 医学部, 医学科

  • 2011.04
    -
    2015.03

    The University of Tokyo, 大学院医学系研究科内科学

    Graduate School, Graduated, Doctoral course

  • 2011.04
    -
    2015.03

    The University of Tokyo, 大学院医学系研究科内科学

Academic Degrees 【 Display / hide

  • Doctor (Medicine), The University of Tokyo, Coursework, 2015.03

    How do healthcare professionals and lay people in a community learn interactively? A case of trans-professional education

Licenses and Qualifications 【 Display / hide

  • 日本内科学会認定内科認定医, 2009.10

  • 日本プライマリ・ケア学会認定家庭医療専門医, 2010.04

  • 日本プライマリ・ケア学会認定家庭医療指導医, 2013.11

  • 医学教育学会認定医学教育専門家, 2016.07

  • Certificate in Measurement and Assessment in Medical Education in Iowa University, 2017.07

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Research Areas 【 Display / hide

  • Life Science / Medical management and medical sociology (総合診療、医学教育、多職種連携)

  • Life Science / Medical management and medical sociology (総合診療、医学教育、多職種連携)

 

Books 【 Display / hide

  • 実例から学ぶ!臨床研究はできないができるに変わる本

    2021.11,  Page: 237

    Scope: 4.質的研究の解説 ~主観的で、言語的で、動的かつ相互作用的なものが含まれる現象を明らかにする~,  Contact page: 206-215

  • 新型コロナウイルスと人類学 パンデミックともに考える

    飯田淳子, 木村周平, 濱雄亮, 堀口佐知子, 宮地純一郎, 照山絢子, 小曽根早知子, 金子惇, 後藤亮平, 春田淳志, 水声社, 2021.03

    Scope: パンデミック対策をローカライズする――日本におけるプライマリ・ケア医の実践,  Contact page: 340-365

  • 総合診療専門研公式テキストブック

    一般社団法人 日本専門医機構, 2020.12

    Scope: 多職種連携 総論、第8章考慮すべき社会情勢制,  Contact page: 312-314

  • 医療学総論、新体系 看護学全書 ,健康支援と社会保障制度

    春田淳志, 2020.12,  Page: 277

    Scope: Ⅱ.多職種連携、第2章 医療を担う専門職と連携、,  Contact page: 51-57

  • 地域における多職種連携、地域医療学入門

    春田淳志, 診断と治療社, 2019.08,  Page: 42-44

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Papers 【 Display / hide

  • Three-year evaluation of a program teaching social determinants of health in community-based medical education: a general inductive approach for qualitative data analysis

    S Ozone, J Haruta, A Takayashiki, T Maeno, T Maeno

    BMC Medical Education 23 (1), 1-9 (BMC Medical Education)  23 ( 1 ) 332 2023.12

     View Summary

    Background: Social determinants of health (SDH) are intricately intertwined with various social and economic factors. Reflection is essential for learning about SDH. However, only a few reports have focused on reflection in SDH programs; most were cross-sectional studies. We aimed to longitudinally evaluate a SDH program in a community-based medical education (CBME) curriculum that we introduced in 2018 based on the level of reflection and content on SDH in students’ reports. Methods: Study design: General inductive approach for qualitative data analysis. Education program: A 4-week mandatory clinical clerkship in general medicine and primary care at the University of Tsukuba School of Medicine in Japan was provided to all fifth- and sixth-year medical students. Students underwent a 3-week rotation in community clinics and hospitals in suburban and rural areas of Ibaraki Prefecture. After a lecture on SDH on the first day, students were instructed to prepare a structural case description based on encounters during the curriculum. On the final day, students shared their experiences in a small group session and submitted a report on SDH. The program was continuously improved and faculty development was provided. Study participants: Students who completed the program during October 2018–June 2021. Analysis: Levels of reflection were categorized as reflective, analytical, or descriptive. The content was analyzed based on the Solid Facts framework. Results: We analyzed 118 reports from 2018–19, 101 reports from 2019–20, and 142 reports from 2020–21. There were 2 (1.7%), 6 (5.9%), and 7 (4.8%) reflective reports; 9 (7.6%), 24 (23.8%), and 52 (35.9%) analytical reports; and 36 (30.5%), 48 (47.5%), and 79 (54.5%) descriptive reports, respectively. The others were not evaluable. The number of Solid Facts framework items in reports were 2.0 ± 1.2, 2.6 ± 1.3, and 3.3 ± 1.4, respectively. Conclusions: Students’ understanding of SDH deepened as the SDH program in the CBME curriculum improved. Faculty development might have contributed to the results. Reflective understanding of SDH might require more faculty development and integrated education of social science and medicine.

  • How do medical students learn in an online community diagnostics program?

    Junji Haruta, Takayuki Ando, Seitaro Fujishima

    BMC medical education (BMC Medical Education)  23 ( 1 ) 15 - 15 2023.12

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    BACKGROUND: The need to engage medical students in understanding the social and environmental determinants of health in disparate communities is increasing. However, previous reviews have noted the limited community diagnosis programs and program evaluation. Given the feasibility of the programs, it is expected to be widely available online. Therefore, this study used a realist approach to identify learning patterns through an online community diagnosis program, namely context (C), mechanism (M), and outcomes (O) patterns. METHODS: A 2-week general medicine clinical practice program was conducted for 4th- and 5th-year medical students at a medical university in Japan. The program included a one-hour zoom-based lecture, feedback for students on their presentations on community diagnosis, and a structural report on community diagnosis. We developed the program based on variation theory, which views discernment and variation in situations having time, space, and social dimensions as core learning. The students' reflections on their learning through the program were thematically analyzed through CMO perspectives. The realist approach used in the online diagnosis program evaluation allows us to explore, test, and refine what mechanisms work under what conditions (context) and with what interventions (including opportunities and resources), from which we can describe iteratively explainable results. RESULTS: First, the medical students, who spent most of their time in the limited residential areas they lived in, discovered the characteristics of their own community by discovery learning and comparison among peers. Second, they increased their intrinsic interest in the community by discerning specific issues in their familiar community through community diagnosis. Third, they valued community diagnosis by identifying relationships between local data on health issues under their learning responsibility. Fourth, they become more flexible in their thinking and created new knowledge that would fit the local community, and their reflection on themselves was encouraged. CONCLUSION: In this online community diagnosis program, medical students learned about the community through four types of learning patterns. Medical students may develop an understanding of community with interest using variation theory as a program development perspective and cognitive flexibility theory surrounding the essential ambiguity and abstraction of community.

  • Precision engineered peptide targeting leukocyte extracellular traps mitigate acute kidney injury in Crush syndrome

    K Okubo, K Takayama, H Kawakami, K Iida, H Miyauchi, Y Roppongi, ...

    Biochemical and Biophysical Research Communications (Biochemical and Biophysical Research Communications)  671   173 - 182 2023.09

    ISSN  0006291X

     View Summary

    Crush syndrome induced by skeletal muscle compression causes fatal rhabdomyolysis-induced acute kidney injury (RIAKI) that requires intensive care, including hemodialysis. However, access to crucial medical supplies is highly limited while treating earthquake victims trapped under fallen buildings, lowering their chances of survival. Developing a compact, portable, and simple treatment method for RIAKI remains an important challenge. Based on our previous finding that RIAKI depends on leukocyte extracellular traps (ETs), we aimed to develop a novel medium-molecular-weight peptide to provide clinical treatment of Crush syndrome. We conducted a structure-activity relationship study to develop a new therapeutic peptide. Using human peripheral polymorphonuclear neutrophils, we identified a 12-amino acid peptide sequence (FK-12) that strongly inhibited neutrophil extracellular trap (NET) release in vitro and further modified it by alanine scanning to construct multiple peptide analogs that were screened for their NET inhibition ability. The clinical applicability and renal-protective effects of these analogs were evaluated in vivo using the rhabdomyolysis-induced AKI mouse model. One candidate drug [M10Hse(Me)], wherein the sulfur of Met10 is substituted by oxygen, exhibited excellent renal-protective effects and completely inhibited fatality in the RIAKI mouse model. Furthermore, we observed that both therapeutic and prophylactic administration of M10Hse(Me) markedly protected the renal function during the acute and chronic phases of RIAKI. In conclusion, we developed a novel medium-molecular-weight peptide that could potentially treat patients with rhabdomyolysis and protect their renal function, thereby increasing the survival rate of victims affected by Crush syndrome.

  • Association between family caregivers' primary care experience when they report as patients and their stress related to caregiving: A pilot cross-sectional study

    Nakayama G., Masumoto S., Haruta J., Maeno T.

    Journal of General and Family Medicine (Journal of General and Family Medicine)  24 ( 4 ) 231 - 239 2023.07

    ISSN  2189-6577

     View Summary

    Background: Few studies have examined whether family caregivers' own primary care providers can affect caregiving-specific well-being, such as caregiver stress. In this pilot study, we explored whether primary care experiences when family caregivers report as patients were associated with the stress of caregiving. Methods: We used cross-sectional data from a survey conducted in Japan between November and December 2020. We recruited family caregivers aged 40–74 years who were caring for community-dwelling adults with chronic conditions. We assessed primary care experience using the Japanese version of the Primary Care Assessment Tool Short Form (JPCAT-SF) and caregiver stress using the Japanese short version of the Zarit Caregiver Burden Interview. Results: In total, 406 family caregivers were included in the analysis. The mean JPCAT-SF total score was 42.1 out of 100 points. The proportion of caregivers who had higher caregiver stress was 48.8%. After adjusting for possible confounders, the JPCAT-SF score was found to be significantly associated with caregiver stress (lower stress = 0 vs. higher stress = 1; adjusted prevalence ratio per 1 SD increase in JPCAT-SF score = 0.89; 95% CI 0.80–0.98). Among the subscales of the JPCAT-SF, longitudinality, and comprehensiveness (services available) were associated with caregiver stress. Conclusions: Better primary care experiences when family caregivers reported as patients were associated with lower caregiver stress. Longitudinality, which includes focusing attention on the individual as a whole person, and comprehensiveness in the context of building provider-patient relationships that make consultation easier when needed, were associated with lower stress.

  • Association between experience of interprofessional care and self-medication among family caregivers: A cross-sectional study.

    Shoichi Masumoto, Gen Nakayama, Junji Haruta, Tetsuhiro Maeno

    Research in social & administrative pharmacy : RSAP (Research in Social and Administrative Pharmacy)  19 ( 5 ) 773 - 777 2023.05

    ISSN  15517411

     View Summary

    BACKGROUND: Although healthcare professionals pay attention to the drugs prescribed by physicians, few studies have assessed self-medication by family caregivers. Family caregivers' experience of interprofessional care in the care of patients can influence caregivers' health behaviors. OBJECTIVES: This study aimed to describe self-medication among family caregivers of community-dwelling adult patients, and to assess association between family caregivers' experience of interprofessional care and their self-medication, adjusting for possible confounding factors. METHODS: We conducted a cross-sectional survey from November to December 2020 in Ibaraki Prefecture, Japan. Family caregivers between 40 and 74 years old and caring for community-dwelling adult patients with chronic conditions were recruited. The use of any self-medication in the last 2 weeks by family caregivers was the outcome variable. The explanatory variable was family caregivers' experience of interprofessional care in the care of patients, using the Japanese version of the Caregivers' Experience Instrument (J-IEXPAC CAREGIVERS). Adjusted covariates were age, gender, educational attainment, annual household income, self-rated health, and caregiving time of family caregivers. RESULTS: Of 1091 recruited family caregivers, 750 were included in the analysis. A total of 258 (34.4%) family caregivers reported having used self-medication in the past 2 weeks. Logistic regression analysis showed that having a higher score on the J-IEXPAC CAREGIVERS (odds ratio 0.80 per 1 standard deviation increase) was associated with less use of self-medication by caregivers. CONCLUSIONS: This study revealed that about one-third of family caregivers self-medicate, and this practice is associated with a less positive experience of interprofessional care. These results suggest that it is important for healthcare professionals to be aware of the health condition of family caregivers and to provide appropriate advice regarding self-medication.

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Reviews, Commentaries, etc. 【 Display / hide

  • 【Making of医学教育モデル・コア・カリキュラム】方略とGood Practice(1)

    松島 加代子, 淺田 義和, 野村 理, 春田 淳志, 山口 久美子, 近藤 猛, 錦織 宏, 小西 靖彦

    医学教育 ((一社)日本医学教育学会)  54 ( 2 ) 177 - 181 2023.04

    ISSN  0386-9644

     View Summary

    令和4年改訂版医学教育モデル・コア・カリキュラム(以下,コアカリ)では,アウトカム基盤型教育において,さらなる展開として,新たに『学修方略・評価』の章が追加された.カリキュラムの重要な要素である方略・評価の章を加え,資質・能力に紐づけることで,学修者や指導者にコアカリを活用していただけるよう工夫した.また,教育現場ですぐに実践していただけるように11の方略・評価事例をGood Practiceとして紹介した.ただし,これらのGood Practiceは,各施設での実施を必須とするものではなく,あくまで参考例として掲載している.各大学の特徴を生かした独自の方略・評価が策定され,本章がさらに発展していくことを期待する.(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

    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 ((一社)日本医学教育学会)  54 ( 2 ) 142 - 148 2023.04

    ISSN  0386-9644

     View Summary

    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)

  • 【令和時代の医学教育】日本の医学部教育の歴史,現在,そして,これから

    百武 美沙, 春田 淳志

    臨床麻酔 ((株)シービーアール)  47 ( 3 ) 439 - 446 2023.03

    ISSN  0387-3668

     View Summary

    我が国における医学部教育の歴史,現状,そして今後の展望について解説する.具体的には,江戸時代からの医学部の変遷をたどり,医学教育モデル・コア・カリキュラムを元にこの20~30年のカリキュラム改革を紐解いた上で,現在どのような入学者選抜,教養・基礎医学・臨床医学の教育が行われており,昨今話題のプロフェッショナリズム教育や共用試験の公的化に触れる.最後に,コロナ禍や国際化など変わりゆく社会での卒前医学教育の展望を述べる.(著者抄録)

  • 臨床現場でどのように多職種連携コンピテンシーを活用するのか?

    春田 淳志

    日本消化器病学会雑誌 ((一財)日本消化器病学会)  119 ( 臨増大会 ) A429 - A429 2022.10

    ISSN  0446-6586

  • 臨床現場でどのように多職種連携コンピテンシーを活用するのか?

    春田 淳志

    日本消化器がん検診学会雑誌 ((一社)日本消化器がん検診学会)  60 ( Suppl大会 ) 1047 - 1047 2022.10

    ISSN  1880-7666

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Research Projects of Competitive Funds, etc. 【 Display / hide

  • Exploring interprofessional collaborative patterns among professionals, organizations, patients, and communities that fit complex issues

    2022.04
    -
    2026.03

    Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), No Setting

     View Summary

    本研究の概要は、地域包括ケアシステムの中核になる病院・診療所・介護施設等の現場で生起する複雑な課題に適合する専門職(医療専門職を目指す学生を含む)・組織・患者・地域が協創する最適な協働(Good collaboration)のパターンを明らかにするため、専門職と組織との実態や関係を考慮した視察・アンケート調査をはじめ、ネットワーク分析、マインドライン、リアリスト分析の方法論的トライアンギュレーションを用い、領域横断的協働による創造的知見を創出することにある。

  • プライマリ・ケア医の仕事の意味にはどのような要因が関係するか?

    2021.04
    -
    2024.03

    University of Tsukuba, Grant-in-Aid for Scientific Research (C), No Setting

     View Summary

    日本では少子高齢化などに伴いプライマリ・ケア(PC)への需要が高まっているが、PC医の数は不足している。PC医にとって、どのような仕事との関わりが「仕事の意味(Meaning of work)」と関連するかを明らかにすることで、PC医が仕事の意義を感じる契機を見つけ、活き活きと働くロールモデルとなり、PC医が増える可能性がある。本研究の目的は、PC医の仕事の意味に関連する要因を探索することである。

  • Curriculum development on social determinants of health for medical students and assessment on its educational effect.

    2019.04
    -
    2022.03

    University of Tsukuba, Grant-in-Aid for Scientific Research (C), Research grant, Coinvestigator(s)

     View Summary

    医療者は、健康に影響を与える貧困や労働・社会格差などの社会的要因(Social Determinants of Health, 以下SDH)を正しく理解し、アプローチを行う役割を担う。先行研究の蓄積が乏しいこの分野の卒前医学教育の現状を踏まえて、我が国で先駆的に医学生のSDH教育プログラムを導入した筑波大学および国内外の先行事例をあわせて、量的研究と質的研究(教員・学生インタビュー、文献調査)を複合的に行うアクションリサーチの研究デザインを用いて教育効果の検証を行い、SDHの教育推進に活用できる汎用可能なFaculty Developmentプログラムの開発を行う。

  • Development and analysis of system dynamic evaluation models in community-based integrated care system

    2019.04
    -
    2022.03

    University of Tsukuba, Grant-in-Aid for Early-Career Scientists, Research grant, Principal investigator

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    本研究は2025年までに地域包括ケアシステムを評価する方法は確立するため、効果的な地域包括ケアの実態を可視化することを目的とする。研究方法は、ネットワーク分析とリアリスト分析を用い、3年で3つのフィールドで調査する予定である。八戸や神栖は目的型、笠間は地縁型コミュニティ構築の戦略を取り、他に転用可能なモデルとなり得る先進的な地域であるため、目的的に研究のフィールドとして選択した。本研究で地域包括ケアにおけるネットワークとその構築プロセスが可視化され、効果的なネットワークを構築できれば、本邦だけでなく、今後高齢社会を迎える先進国にむけても一つのEvidenceとなる。

  • 地域包括ケア病棟に入院する認知症高齢者を支援する多職種専従チームの開発

    2017.04
    -
    2020.03

    Jichi Medical University, Grant-in-Aid for Scientific Research (C), Research grant, Coinvestigator(s)

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    質問紙調査を行うため、1年目に作成した質問紙を用いて医療機関でパイロットスタディを実施した。質問紙の項目には、前年度検討した属性(筋骨格系疾患、呼吸器疾患、外傷・熱傷・中毒、消化器疾患(肝臓、胆道、膵臓疾患等)を設定したが、複合的に疾患を持つ患者が多く単一的な疾患に分類することが困難であった。また、退院時の行き先を自宅と介護施設と想定したが、転院せざるを得ないケース等も散見された。質問項目の多職種による連携内容では、BPSDの対応、サルコペニア、リハビリ栄養、服薬の指導などを想定していたが、退院支援そのものが連携の中心であるとの回答も見られた。さらに、質問紙項目の認知症高齢者の実状についてもBPSD等による困難さはあまり目立たず、認知症に関する多職種の関わりでも現状把握は難しかった。特に、限定された職種が関わることで多職種の関わりが限局され、本来は関わったほうが良いと推測される職種がその場におらず連携の実状が限定されていた。このことから、多職種の関わりについてはそれぞれの医療機関に属している職種でモデルを考える必要に迫られた。これらから、現時点での質問紙では地域包括ケア病棟の現状を把握することが難しいことが分かった。そこで、本研究の目的を北海道・東北エリアの2病院に説明し、フォーカスグループにて地域包括ケア病棟の多職種の実状を尋ねた。現在、分析中ではあるが、この結果を基に再度質問紙の修正を行っている。
    1年目は本研究に関連する文献検討から、質問紙項目の属性と多職種に関する内容を整理した。それに従って質問紙を作成し、パイロットスタディを行ってみたところ、本研究の目的を明らかにするには質問紙が不十分であることが分かった。そこで、質問紙調査を行う前に、現場の実際を尋ねるフォーカスグループを実施することとした。現在、データを分析中ではあるが、その内容を踏まえ再度質問紙を検討している。そのため、今年度に予定されていた質問紙調査を行うことができなかった。
    現在、分析している質的データ結果を踏まえ、質問紙を修正して調査を実施する。質問紙調査の結果については、早急に集計する。集計した結果を踏まえ、1~2病院でフォーカスグループを実施し、多職種連専従チームを検討する。

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Awards 【 Display / hide

  • 医学教育賞 懸田賞

    2020.08, 日本医学教育学会, Realist approach to evaluating an interprofessional education program for medical students in clinical practice at a community hospital

    Type of Award: Honored in official journal of a scientific society, scientific journal

  • 医学教育賞 懸田賞

    2020.08, 日本医学教育学会, Realist approach to evaluating an interprofessional education program for medical students in clinical practice at a community hospital

    Type of Award: Honored in official journal of a scientific society, scientific journal

 

Courses Taught 【 Display / hide

  • ADVANCED MEDICAL PEDAGOGY

    2023

  • BEHAVIORAL SCIENCE 2

    2023

  • RESEARCH FRONTIERS IN BIOMEDICAL SCIENCE

    2023

  • MEDICAL PEDAGOGY: SEMINAR

    2023

  • MEDICAL PEDAGOGY: PRACTICE

    2023

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