Papers - Haruta, Junji

A Nationwide Survey on the Faculty Development for Simulation-Based Medical Education in Japan

T SHIGA, K FUJISAKI, H KOMATSU, T MAENO, K ABE, J HARUTA, ...

Medical Education, 245-250  2019

Joint Work

Development of an interprofessional competency framework for collaborative practice in Japan

Haruta J, Yoshida K, Goto M, Yoshimoto H, Ichikawa S, Mori Y, Yoshimi K, Otsuka M

Journal of Interprofessional Care (Journal of Interprofessional Care)  32 ( 4 ) 436 - 443 2018.07

Research paper (scientific journal), Joint Work,  ISSN  13561820

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© 2018, © 2018 Taylor & Francis. Rapid aging of the population necessitates improved collaboration among healthcare professionals. Unfortunately, interprofessional collaboration has yet to be implemented effectively in Japan. Therefore, we aimed to develop an interprofessional competency framework for Japanese healthcare professionals. The project was conducted as a four-step process, starting with initial categorization of potential competency domains, followed by guiding principle and prototype development, feedback on the prototype, and final consensus. First, authors (JH and MO) collected opinions about competency in interprofessional collaboration at two academic meetings of the Japan Association for Interprofessional Education (JAIPE) and then analyzed the data thematically. Second, a project team consisting of JAIPE and University representatives extracted the domains and statements as prototype 1. Third, seven representatives from professional organizations joined the project team and developed prototype 2. We then called for feedback on the revised prototype 2 at both an open symposium and via public comments. Following revision of prototype 2, a new project team including 20 university, professional organization and health practitioner representatives finally discussed prototype 3, developed the final draft and reached a consensus. In analysis after collecting the data, we extracted 11 themes. We developed four key principles which applied to six domains as prototype 1–3. Finally, our competency framework included two core domains of “Patient-/client-/family-/community-centered” and “Interprofessional communication”, and four peripheral domains of “Role contribution”, “Facilitation of relationships”, “Reflection” and “Understanding of others”. We developed an interprofessional competency framework in Japan which consists of two core and four peripheral domains. The interprofessional competency framework is likely to affect the understanding of “high-context” and “relationalism” in Japanese healthcare. We hope that our interprofessional competency framework will encourage the systematic implementation of interprofessional education and collaboration in Japan.

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Internet Survey Regarding Knowledge About the Common Cold in Japan

Sakamoto, N., Haruta, J., Goto, Ryohei., Yokoya, S., Madoka, T., Takayashiki, A., Maeno, T., Maeno, T.

Clinical Infection and Immunity 3 ( 2 ) 37 - 44 2018.06

Research paper (scientific journal), Joint Work, Accepted

Translation and cultural adaptation of the Japanese version of the interprofessional facilitation scale

Haruta J, Breugelmans R, Nishigori H

Journal of Interprofessional Care (Journal of Interprofessional Care)  32 ( 3 ) 321 - 328 2018.05

Research paper (scientific journal), Joint Work,  ISSN  13561820

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© 2018 Taylor & Francis. Effective interaction in interprofessional collaboration requires skills in interprofessional facilitation. The need for interprofessional learning and practice in Japan is highlighted by Japan’s status as one of the most rapidly aging societies because good care for elderly people with complex needs requires effective collaboration between different professional groups. The development of interprofessional facilitation skills (including management of the additional complexities) among learners or professionals enhances interprofessional learning and consensus building and empowers them to make appropriate commitments when faced with difficult challenges. The 18-item interprofessional facilitation scale (IPFS) can be used to enhance interprofessional facilitation skills. Here, we aimed to develop a Japanese adapted version of the IPFS and to validate it for use with Japanese healthcare professionals. Consistent with guidelines for cross-cultural adaptation, three translators translated the original IPFS from English into Japanese, and an expert and all authors confirmed its face and content validity. The translated items were amended during backtranslation and expert reviews. Exploratory factor analysis was performed with 167 healthcare professionals to explore the underlying structure of the items. This analysis revealed two factors with good internal consistency (Cronbach’s alpha > 0.8), which were labelled as: (1) encouraging interprofessional interaction and (2) respect for each professional. The original factor ‘Encouraging interprofessional interaction’ was divided into two factors in the study. One reason for this division might be related to the behaviour of Japanese health professionals, that is, most Japanese might understand that ‘facilitation’ encourages relationships as contextual belonging that are distinct from relationships based on respect for others. This mindset is likely based on the notion of ‘relationalism’, which is fundamental in Japanese culture. Further investigation of this Japanese version of the IPFS will strengthen factor construction and improve scrutiny of the relationships between factors.

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A cross-sectional survey of interprofessional education across 13 healthcare

Goto Michiko., Haruta Junji., Oishi, Ai., Yoshida Kazue., Yoshimi Kenji, Yoshimoto Hisashi.

The Asia Pacific Scholar medical and healthcare professions education 3 ( 2 ) 38 - 46 2018.05

Research paper (scientific journal), Joint Work, Accepted

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Background: With the rapid aging of the population, collaboration among the various medical professions throughout the country is becoming increasingly indispensable in Japan. To promote collaboration in medical care, it is necessary to introduce the concept of collaboration to students at an early stage of their professional education. Despite this need, there are no core medical, healthcare and welfare education curricula in Japan that include interprofessional education (IPE). Therefore, the status of IPE in Japanese schools of medicine and other healthcare-related services is unclear.
Methods: We sent 3,430 questionnaires to 13 schools of medicine and related healthcare providers: doctors, nurses, physical therapists, registered dieticians, dentists, dental hygienists, social workers, pharmacists, occupational therapists, clinical psychologists, medical administrators, certified care workers, and speech therapists. The items addressed implementation rate of IPE, teaching methods and grading methods.
Results: Of the 3,430 surveys distributed, 572 completed surveys were returned (response rate 17%). Of the completed surveys, 493 qualified as valid, resulting in a final response rate of 14%. Only 19% (n = 93) of the analysed medical educational institutions included IPE instruction in their curricula.
Conclusion: While many educational institutions were conducting IPE, there were important inter-institutional differences with respect to attitudes towards IPE, teaching methods, and evaluation methods. This study was unprecedented in scale, and provides important basic information for the future development of IPE in Japan.

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Identification of prognostic factors for activities of daily living in elderly patients after hospitalization for acute infectious disease in Japan: A 6-month follow-up study

Goto R, Watanabe H, Haruta J, Tsutsumi M, Yokoya S, Maeno T

Geriatrics and Gerontology International (Geriatrics and Gerontology International)  18 ( 4 ) 615 - 622 2018.04

Joint Work,  ISSN  14441586

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© 2017 Japan Geriatrics Society Aim: We investigated factors that predict the prognosis of activities of daily living (ADL) in elderly patients who had undergone rehabilitation during hospitalization for acute infectious disease. Methods: The present prospective cohort study included 131 patients who were hospitalized due to acute infectious disease and who had undergone rehabilitation during hospitalization. Patient characteristics collected from medical records included age, sex and comorbidity score. The level of ADL 2 weeks before admission was assessed by interview at the start of rehabilitation. Grip strength testing, Short Physical Performance Battery as an assessment of lower limb function and the Mini-Mental State Examination as an assessment of cognitive status were carried out at the time of hospital discharge. The level of ADL at 6 months after discharge was assessed by telephone interview. Multivariate logistic regression analysis was used to identify factors that independently predict ADL dependence (defined as being dependent in one or more ADL items at 6 months after discharge). Results: The average age of participants was 81.5 years, and 52.7% were women. A total of 22.1% of patients showed dependence in an ADL at 6-month follow-up. Factors that predicted an ADL dependence were comorbidity score (OR 4.19, 95% CI 1.19–14.69) and lower limb function (OR 0.51, 95% CI 0.36–0.72) at discharge. Conclusions: The present findings have implications for the healthcare planning and well-being of elderly patients during hospitalization and after discharge. Geriatr Gerontol Int 2018; 18: 615–622.

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退院後のADLに関連する予測因子の探索 急性感染症で入院した高齢患者を対象にした前向き観察研究

後藤亮平, 春田淳志, 前野哲博

高齢者ケアリング学研究会誌 (日本高齢者ケアリング学研究会)  8 ( 2 ) 1 - 10 2018.01

Research paper (scientific journal), Joint Work, Accepted,  ISSN  2185-6753

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【目的】急性感染症で入院した高齢患者を対象に退院後のADL予後予測要因を明らかにすることを目的とした。【方法】急性感染症で入院した65歳以上の患者のうち、入院2週間前と比較して退院時にADL低下を認めた者を解析対象とした。データ収集は、リハビリテーション開始時(基本情報・入院前ADL等の収集)・退院時(身体機能等の評価)・退院後6ヵ月時(生活状況等の収集)の3時点で行った。対象者のうち、退院後6ヵ月時点のADLが、入院2週間前と同等まで回復した場合を「ADL回復群」、そうでない場合を「ADL低下群」と定義し、ADL回復を予測する要因を検討した。【結果】対象者(74例)の平均年齢は83.4±6.0歳、女性が43例(58.1%)であった。また、74例のうち40例(54.1%)が「ADL回復群」であり、その予測要因は、「退院時の下肢機能が高い」であった。【結論】退院時の下肢機能が高く保たれていることは、退院後のADL自立度に影響する可能性が考えられた。(著者抄録)

A cross-sectional survey of interprofessional education across 13 healthcare professions in Japan

M Goto, J Haruta, A Oishi, K Yoshida, K Yoshimi, Y Takemura, ...

The Asia Pacific Scholar 3, 37-45  2018

Improving the workflow of nursing assistants at a general hospital in Japan

Isono Hiroki, Suzuki Sayuri, Ogura Jun, Haruta Junji, Maeno Tetsuhiro

BMJ Open Qual 6 ( 2 ) e000106 2017.11

Research paper (scientific journal), Joint Work, Accepted

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Transferring non-specialised tasks from registered nurses to nursing assistants may help registered nurses focus on specialised tasks. Optimising the workflow of nursing assistants by making their tasks more efficient may improve problems associated with the shortage of registered nurses. The nursing assistants at our hospital were stressed about referring inpatients to outpatient specialty clinics. Therefore, we initiated a project to optimise the referral process and reduce the time spent by nursing assistants on this task, with the collaboration of physicians, registered nurses and administrative assistants. The Training for Effective & Efficient Action in Medical Service–Better Process (TEAMS-BP) method, which was developed by modifying the Japanese Training Within Industry–Job Method, was used for the optimisation process. TEAMS-BP teaches users how to break each task down into its individual components, to scrutinise the details, and then to develop new processes by eliminating, combining, rearranging and simplifying tasks. At baseline, each referral took 10 min and was performed 39 times over 10 days in six wards. The first TEAMS-BP cycle did not yield satisfactory results for the nursing assistants. In the second TEAMS-BP cycle, participants included inpatient and outpatient physicians, registered nurses and administrative assistants. As a result, we changed the referral process from paper to electronic records and streamlined referrals that were ordered by inpatient physicians to outpatient physicians. The use of this method saved the equivalent of 175 hours of nursing assistants’ time per year at no additional cost. If we had been able to define the referral process as an interdisciplinary task and show the merits to each department from the beginning, we may have been able to form the interprofessional team in the first TEAMS-BP. Improving the efficiency of nursing assistants can allow other professionals to focus on their specialised tasks more effectively.

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How do healthcare professionals and lay people learn interactively? A case of transprofessional education.

Haruta Junji, Nishigori Hiroshi, Kitamura Kiyoshi,

The Asia Pacific Scholar medical and healthcare professions education. 2 ( 3 ) 1 - 7 2017.09

Research paper (scientific journal), Joint Work, Accepted

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Lay people without a body of specialty knowledge, like the professionals, have not been able to partake in interprofessional education (IPE). Transprofessional education (TPE), which was defined as IPE with non-professionals /lay people, is an important extension of (IPE). A TPE programme was developed to explore how health professionals and lay people learn with, from and about each other in a Japanese community. The present study was conducted in a hospital and the surrounding community in Japan. An ethnographic study design was adopted, and the study participants were six lay individuals from the community and five professionals working in the community-based hospital. During the health education classes, the first author acted as a facilitator and an observer. On reviewing interview data and field notes using a thematic analysis approach, findings showed that healthcare professionals and lay participants progressed through uniprofessional and interprofessional before achieving transprofessional learning. Both type of participants became to transcend boundaries after sharing their viewpoints in a series of classes and recognized that they were important partners in their local community step by step, which increased their sense of belonging to the community. The transformation was driven by dynamic interaction of the following four factors: reflection, dialogue, reinforcement of ties, and expanding roles. We believe this process led both groups to come to feel collective efficacy and inspire healthcare professionals to reflect on their transprofessional learning. We clarified how healthcare professionals and lay people achieved transprofessional learning in a TPE programme where participants advanced through uniprofessional, interprofessional stage before achieving transprofessional learning.

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Validity of medical history taken by pharmacists using a medical history taking tool

Matsushita Aya, Haruta Junji, Tsutumi Madoka, Sato Takuya, Maeno Tetsuhiro.

Journal of General and Family Medicine 18 ( 6 ) 403 - 408 2017.06

Research paper (scientific journal), Joint Work, Accepted

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Background
The progress in aging and the shortage of physicians is a significant problem in Japan. Hence, healthcare professionals including pharmacists should cooperate to provide medical services with limited resources. However, pharmacists might have inadequate skills in taking medical histories. Therefore, we developed an interview tool to collect accurate medical history. In this study, we aimed to validate the contents of medical histories taken by a pharmacist using the interview tool and investigate physician consultation length.
Methods
Setting intervention days alternately, adult outpatients of the Kitaibaraki Center for Family Medicine who had new symptoms had their medical histories taken by one of two pharmacists before their physician visit during the study period. The contents of the medical history taken by a pharmacist using text analysis were validated on other four days. All sentences collected by a pharmacist or five physicians were divided into segments, and six other physicians assessed each segment. Differences in length of the physician consultation between those with and without (intervention and control groups, respectively) medical history taken by a pharmacist were investigated.
Results
Of 23 patients’ medical histories taken by a pharmacist using the interview tool, 84.4% of segments were related to the clinical diagnosis. The mean consultation length was 10.1±8.4 minutes in the intervention group (n=104) and 13.0±10.4 minutes in the control group (n=96) (p=0.048).
Conclusions
Medical histories taken by a pharmacist using the interview tool had high content validity and might reduce physician consultation length.

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Cross-cultural adaptation of the professional version of the Readiness for Interprofessional Learning Scale (RIPLS) in Japanese

Oishi Ai., Haruta Junji., Yoshimi Kenji., Goto Michiko., Yoshida Kazue, Yoshimoto Hisashi

Journal of Interprofessional Care (Taylor & Francis)  31 ( 1 ) 85 - 90 2016.12

Research paper (scientific journal), Joint Work, Accepted

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Interprofessional education (IPE) for healthcare professionals is important in Japan because of its rapidlyaging population and increasingly complex healthcare needs. However, no tools have been validated inthe Japanese context to evaluate healthcare professionals’attitudes towards, or readiness for, IPE. Theprofessional version of the Readiness for Interprofessional Learning Scale (RIPLS) with 23 items wasselected for cross-cultural adaptation because it has been widely used internationally and a Japaneseedition of the student version has already been developed. We followed a guideline for cross-culturaladaptation and subsequently conducted factor analysis with 368 responses from over 16 professions.Face and content validity was confirmed through the translation process. We obtained four factors withgood internal consistency (Cronbach’s alpha > 0.7). These results were similar to those of the original UKstudy, apart from one factor being divided into two different factors in this study. Studies are required tofurther confirm the rigor and generalisability of the results; however, the Japanese RIPLS can be used toevaluate healthcare professionals’attitudes towards IPE, which can eventually lead to a better IPEdevelopment for healthcare professionals in Japan.

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Development of an interprofessional competency framework in Japan

Haruta Junji., Sakai Ikuko, Otsuka Mariko., Yoshimoto Hisashi, Yoshida Kazue, Goto Michiko, Shimoi Toshimichi

Journal of Interprofessional Care 30 ( 5 ) 675 - 677 2016.09

Research paper (scientific journal), Joint Work, Accepted

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This article presents a project that aimed to identify a set of competencies (domains and statements) to prepare Japanese students and healthcare practitioners for collaborative practice. The Japan Association for Interprofessional Education (JAIPE) has started a government-funded project to formulate its interprofessional competency framework, in cooperation with professional organisations (e.g. Japan Society for Medical Education) in healthcare and social sciences. This three-year project is underway as part of the Initiative to Build up the Core Healthcare Personnel programme of Mie University. This project consists of five stages: literature review, data collection, prototype development, consensus formation, and finalisation. Our efforts will culminate in Japan's first interprofessional competency framework, with consensus from relevant academic societies and other stakeholders. We hope that the involvement of stakeholder participation will improve the usability of the final interprofessional competency framework.

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専門職連携コンピテンシー 1. 多職種連携コンピテンシーの国際比較

J HARUTA

保健医療福祉連携 9 (2), 106-115  2016

Relationship between Nurses'“Social Skills” and the Degree of Knowledge Regarding the Professions of other Co-medicals, in Japan: 68

K Yoshida, M Goto, J Haruta, A Oishi, K Yoshimi, H Yoshimoto

Medical Education 49  2015

A Survey of Interprofessional Education in Japan: A Cross Sectional Study of Schools of Medicine and Other Health Care Services: 66

M Goto, A Oishi, J Haruta, K Yoshida, K Yoshimi, H Yoshimoto

Medical Education 49  2015

第4回日本プライマリ・ケア連合学会ワークショップ『ジェネラリストに必要な緩和ケアのスキルとは？』報告

大石 愛, 浜野 淳, 春田 淳志, 木村 洋輔, 菅野 哲也, 田中 久也

日本プライマリ・ケア連合学会誌 37 ( 4 ) 366 - 368 2014.12

Research paper (scientific journal), Accepted

医療専門職の多職種連携に関する理論について

春田淳志、錦織宏

医学教育 45 ( 3 ) 121 - 134 2014.05

Research paper (scientific journal), Accepted

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�T An overview of theories about interprofessional education and work

J Haruta, H Nishigori

Medical Education 45 (3), 121-134  2014

�T 医療専門職の多職種連携に関する理論について

春田淳志， 錦織宏

医学教育 45 (3), 121-134  2014