DEAR EDITOR,

We accept and mentor many Taiwanese medical students every year, and most of them have pointed out the importance of being able to learn medicine from real patients in clinical settings. We read an interesting article by Chang et al1 that had similar results to ours. Chang et al1 administered a questionnaire survey to medical students who participated in a 2-week summer camp; they concluded that early clinical exposure is important for medical professionalism and interprofessional collaboration.1 Our research consisted of interviews with medical professionals working in the field in local communities in Japan. This study was conducted with the approval of the appropriate ethical committee (approval #22-001) and informed consent was obtained both verbally and in writing from all participants.

We interviewed 10 nurses, social workers, care managers, and care workers with extensive experience in teaching interprofessional collaboration in rural parts of Japan in 2022. The main topic of the interview was what Japanese medical students should learn about interprofessional collaboration as future leaders of their healthcare teams. We identified the following four categories: (1) understanding the importance of clinical experience (early exposure), (2) understanding the roles of other professions, (3) cultivating professionalism, and (4) understanding the importance of nonmedical solutions. The Table 1 depicts examples of interviewees’ comments. Despite the significant differences in methodology and participants between our study and that of Chang et al,1 the results of both studies (as well as the Taiwanese students’ comments) show a common recognition that professionalism and communication with patients, families, and other people with different occupations are important. This suggests that the message about the significance of early clinical exposure conveyed by Chang et al1 may transcend national and cultural differences.

Table 1 - Categories and examples of interviewees’ comments Categories Examples of interviewees’ comments 1. Understanding the importance of clinical experience (early exposure) “It’s not really okay if I go to some other clinical setting and do the same thing as the text [book] or guidelines. The answer depends on the real world we’re facing, and if the person changes, then the answer might change too. There’s never just one correct answer.” 2. Understanding the roles of other professions “[Different healthcare professionals] come together for in-person meetings to discuss their respective challenges and objectives from their unique perspectives. Even though a hierarchy exists, wherein medical professionals and doctors hold a higher social status, the order of importance needs to be determined when conflicting priorities arise among the various professions.” 3. Cultivating professionalism “We work with older individuals—folks who are our seniors. These people diligently rebuilt Japan after the war. I often share with my students that we’re able to lead fulfilling and joyful lives thanks to their contributions. It’s essential that we show older adults the utmost respect and consideration.” 4. Understanding the importance of nonmedical solutions “It would be great to have a system that takes a holistic approach and focuses on lifestyle aspects. [Omitted] For instance, if some older adults are prescribed sleeping pills owing to medical necessity, it directly impacts their activities of daily living. This not only makes it easier for them to fall but also influences their dietary habits and increases the risk of developing aspiration pneumonia.”

As for interprofessional learning, some interesting topics have recently been reported on in Asian countries, including the impact of the hierarchy between medical and nursing/midwifery students2 and the importance of facilitating team-based learning in a real community setting.3 Another study suggested that teamwork and communication skills are improved and responsibility as a doctor is acquired through interprofessional education.4 Furthermore, behavioral changes and shifts in attitude and perception can be expected.5 Among these, Chang et al’s1 research may be positioned as a pioneering study on educating interprofessional collaborators in Asia.

We are grateful to the Taiwanese exchange students who shared details on their current medical education in their country for the research related to this letter. Taiwanese medical students seem to prefer to come to Hokkaido, Japan’s northernmost island, to study. As the global Coronavirus disease (COVID-19) situation gradually resolves, we hope that cooperation between Taiwan and Japan will continue to strengthen the field of medical education.

ACKNOWLEDGMENTS

This study was supported in part by JSPS KAKENHI (grant #22K10356).

We thank all the health professionals who participated in our research.

REFERENCES 1. Chang CC, Huang HC, Lee WS, Chuang CL, Huang LJ, Lu DY, et al. Early clinical exposure improves medical students’ recognition of the need for professionalism and interprofessional collaboration. J Chin Med Assoc. 2021;84:778–82. 2. Lestari E, Stalmeijer RE, Widyandana D, Scherpbier A. Understanding students’ readiness for interprofessional learning in an Asian context: a mixed-methods study. BMC Med Educ. 2016;16:179. 3. Wang J, Guo J, Wang Y, Yan D, Liu J, Zhang Y, et al. Use of profession-role exchange in an interprofessional student team-based community health service-learning experience. BMC Med Educ. 2020;20:212. 4. Alzamil H, Meo. SA. Medical students’ readiness and perceptions about interprofessional education: a cross sectional study. Pak J Med Sci. 2020;36:693–8. 5. Spaulding EM, Marvel FA, Jacob E, Rahman A, Hansen BR, Hanyok LA, et al. Interprofessional education and collaboration among healthcare students and professionals: a systematic review and call for action. J Interprof Care. 2021;35:612–21.