An action research study on the needs and perspectives of medical students and junior residents on peer physical examination guidelines to respect medical students' autonomy and privacy in Japan.

Abstract

Objectives: The purpose of this study is to develop and refine PPE guidelines that address students' needs and concerns for the Peer Physical Examination (PPE) guidelines and to assess the feasibility of a Japanese version of such guidelines for managing PPE classes.

Method: An action research approach was employed. Firstly, we sent a Questionnaire Survey 1 to the 5th and 6th year undergraduate medical students and junior residents to gather participants' expectations and suggested improvements for PPEs and their opinion about having a set of PPE guidelines. We drafted a set of PPE guidelines with reference to PPE policies overseas by reflecting participants' needs as identified through Questionnaire Survey 1. We then conducted interviews of 16 participants and revised our guidelines accordingly. Finally, we asked 632 medical students and 191 junior residents to fill out the form for obtaining informed consent (Questionnaire Survey 2) in order to check the feasibility of our PPE guidelines.

Result: The majority of the participants supported the development of the PPE guidelines. The interviews identified 5 themes relating to participants' needs and concerns. In a pilot survey, students' refusal rate for being a model patient varied depending on body region and 74.2% had a desire to be informed of any abnormal findings confidentially. Additionally, the need to take a balance between respecting students' autonomy and securing model patients was noted.

Conclusion: Medical students and junior residents generally supported the PPE guidelines. The right to refuse the model patient role and management of incidental findings should be included in the guidelines. In addition, informing students of educational benefits in being a model patient may be necessary to address the shortage of model patients.