Objective This cross-sectional national study determined which educational approaches are associated with the effectiveness of online clerkship for medical students.
Method A survey was conducted for medical students at 78 medical schools in Japan from May 29 to June 14, 2020. It comprised the following aspects: (a) participants' profiles, (b) number of opportunities to learn from each educational approach (lecture, medical quiz, assignment, oral presentation, observation of a physician's practice, clinical skill practice, participation in interprofessional meetings, and interactive discussions with physicians) in online clerkship, (c) frequency of technical problems, and (d) educational outcome measurement (satisfaction, motivation, knowledge acquisition, skill acquisition, change in self-study time, and understanding of the importance of medical care team).
Results Of the 2,640 respondents, 2,594 (98.3%) agreed to cooperate. Ultimately, 1,711 matched our inclusion criteria. All educational approaches but assignments were positively associated with satisfaction and motivation. All educational approaches excluding assignment submission and interprofessional meeting were positively associated with knowledge acquisition. Observation, practice, and interprofessional meeting were positively associated with skill acquisition. Only assignment submission was positively associated with the change in self-study time. Educational approaches excluding medical quizzes were positively associated with understanding the importance of the medical care team. Technical problems were negatively associated with motivation, knowledge acquisition, and skill acquisition.
Conclusions Educators should implement various educational approaches, especially observation and practice, even in online clinical clerkship. They also need to minimize the technical problems associated with the Internet, as they reduce the effectiveness of online clerkship.
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410285300182480256","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000409880717"},{"@type":"NRID","@value":"9000411566832"},{"@type":"NRID","@value":"9000410269511"},{"@type":"NRID","@value":"9000398963286"},{"@type":"NRID","@value":"9000396162208"},{"@type":"NRID","@value":"9000411566762"},{"@type":"NRID","@value":"9000411566775"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/naoto_kuroda_wayne"}],"foaf:name":[{"@language":"en","@value":"Kuroda Naoto"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Pediatrics, Wayne State University, USA"},{"@language":"en","@value":"Department of Epileptology, Tohoku University Graduate School of Medicine, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702851","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Suzuki Anna"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Kyushu University School of Medicine, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702724","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Ozawa Kai"}],"jpcoar:affiliationName":[{"@language":"en","@value":"The Jikei University School of Medicine, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702850","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Nagai Nobuhiro"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Faculty of Medicine, Shimane University, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702723","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Okuyama Yurika"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Akita University School of Medicine, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702722","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Koshiishi Kana"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Asahikawa Medical University, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702848","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Yamada Masafumi"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Faculty of Medicine, Shimane University, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702852","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Raita Yoshihiko"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Nephrology, Okinawa Chubu Hospital, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702849","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Kakisaka Yosuke"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Epileptology, Tohoku University Graduate School of Medicine, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1420001326213493760","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"80207753"},{"@type":"NRID","@value":"1000080207753"},{"@type":"CINII_AUTHOR_ID","@value":"DA18408419"},{"@type":"URI","@value":"https://ci.nii.ac.jp/author/DA18408419#entity"},{"@type":"URI","@value":"https://viaf.org/viaf/NII%7CDA18408419"},{"@type":"NRID","@value":"9000003608083"},{"@type":"NRID","@value":"9000405062447"},{"@type":"NRID","@value":"9000258060079"},{"@type":"NRID","@value":"9000258291272"},{"@type":"NRID","@value":"9000404674796"},{"@type":"NRID","@value":"9000399217719"},{"@type":"NRID","@value":"9000006072743"},{"@type":"NRID","@value":"9000003595321"},{"@type":"NRID","@value":"9000405080721"},{"@type":"NRID","@value":"9000405078150"},{"@type":"NRID","@value":"9000405656367"},{"@type":"NRID","@value":"9000283611262"},{"@type":"NRID","@value":"9000367421625"},{"@type":"NRID","@value":"9000406229182"},{"@type":"NRID","@value":"9000405684773"},{"@type":"NRID","@value":"9000408414511"},{"@type":"NRID","@value":"9000006498779"},{"@type":"NRID","@value":"9000345250019"},{"@type":"NRID","@value":"9000257874608"},{"@type":"NRID","@value":"9000001963610"},{"@type":"NRID","@value":"9000003606306"},{"@type":"NRID","@value":"9000403693855"},{"@type":"NRID","@value":"9000405052656"},{"@type":"NRID","@value":"9000405037044"},{"@type":"NRID","@value":"9000345298957"},{"@type":"NRID","@value":"9000414076940"},{"@type":"NRID","@value":"9000257755953"},{"@type":"NRID","@value":"9000001900289"},{"@type":"NRID","@value":"9000248207917"},{"@type":"NRID","@value":"9000345425452"},{"@type":"NRID","@value":"9000414075620"},{"@type":"NRID","@value":"9000414075197"},{"@type":"NRID","@value":"9000414076948"},{"@type":"NRID","@value":"9000399519985"},{"@type":"NRID","@value":"9000272994124"},{"@type":"NRID","@value":"9000401503062"},{"@type":"NRID","@value":"9000405070760"},{"@type":"NRID","@value":"9000412664550"},{"@type":"NRID","@value":"9000405095350"},{"@type":"NRID","@value":"9000414076414"},{"@type":"NRID","@value":"9000405095339"},{"@type":"NRID","@value":"9000257871148"},{"@type":"NRID","@value":"9000405684806"},{"@type":"NRID","@value":"9000344126097"},{"@type":"NRID","@value":"9000003619850"},{"@type":"NRID","@value":"9000406036203"},{"@type":"NRID","@value":"9000405684940"},{"@type":"NRID","@value":"9000261036815"},{"@type":"NRID","@value":"9000405091139"},{"@type":"NRID","@value":"9000405048511"},{"@type":"NRID","@value":"9000405062175"},{"@type":"NRID","@value":"9000243571479"},{"@type":"NRID","@value":"9000405048914"},{"@type":"NRID","@value":"9000405042760"},{"@type":"NRID","@value":"9000414075637"},{"@type":"NRID","@value":"9000414077033"},{"@type":"NRID","@value":"9000257867807"},{"@type":"NRID","@value":"9000411379392"},{"@type":"NRID","@value":"9000404150144"},{"@type":"NRID","@value":"9000405095224"},{"@type":"NRID","@value":"9000405070578"},{"@type":"NRID","@value":"9000414250784"},{"@type":"NRID","@value":"9000401982326"},{"@type":"NRID","@value":"9000363873196"},{"@type":"NRID","@value":"9000363152563"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/nakasato"}],"foaf:name":[{"@language":"en","@value":"Nakasato Nobukazu"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Epileptology, Tohoku University Graduate School of Medicine, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1410856045100702853","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Kikukawa Makoto"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Medical Education, Kyushu University, Japan"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"09182918"},{"@type":"EISSN","@value":"13497235"}],"prism:publicationName":[{"@language":"en","@value":"Internal Medicine"},{"@language":"en","@value":"Intern. Med."}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society of Internal Medicine"},{"@language":"ja","@value":"一般社団法人 日本内科学会"}],"prism:publicationDate":"2022-08-15","prism:volume":"61","prism:number":"16","prism:startingPage":"2431","prism:endingPage":"2440"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"https://www.jstage.jst.go.jp/article/internalmedicine/61/16/61_9291-21/_pdf"},{"@id":"https://search.jamas.or.jp/link/ui/2023195017"}],"availableAt":"2022-08-15","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=COVID-19","dc:title":"COVID-19"},{"@id":"https://cir.nii.ac.jp/all?q=clinical%20clerkship","dc:title":"clinical clerkship"},{"@id":"https://cir.nii.ac.jp/all?q=tele-education","dc:title":"tele-education"},{"@id":"https://cir.nii.ac.jp/all?q=online","dc:title":"online"},{"@id":"https://cir.nii.ac.jp/all?q=medical%20education","dc:title":"medical education"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360013276945591808","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Medical Student Education in the Time of COVID-19"}]},{"@id":"https://cir.nii.ac.jp/crid/1360016867515235200","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Twelve tips for teaching medical students online under COVID-19"}]},{"@id":"https://cir.nii.ac.jp/crid/1360016868164357248","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Creation of an Interactive Virtual Surgical Rotation for Undergraduate Medical Education During the COVID-19 Pandemic"}]},{"@id":"https://cir.nii.ac.jp/crid/1360016868175162496","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Orthopaedic Education During the COVID-19 Pandemic"}]},{"@id":"https://cir.nii.ac.jp/crid/1360016869790925696","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Impact of the COVID-19 pandemic on medical education: Medical students’ knowledge, attitudes, and practices regarding electronic learning"}]},{"@id":"https://cir.nii.ac.jp/crid/1360016870122702720","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"COVID-19 and the mental well-being of Australian medical students: impact, concerns and coping strategies used"}]},{"@id":"https://cir.nii.ac.jp/crid/1360016870128638208","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"A Multimodal Multi‐institutional Solution to Remote Medical Student Education for Otolaryngology During COVID‐19"}]},{"@id":"https://cir.nii.ac.jp/crid/1360298343005180800","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Peer-Facilitated Virtual Action Learning: Reflecting on Critical Incidents During a Pediatric Clerkship"}]},{"@id":"https://cir.nii.ac.jp/crid/1360298344780676608","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"The Covid-19 pandemic: Provoking thought and encouraging change"}]},{"@id":"https://cir.nii.ac.jp/crid/1360298345093112192","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Perceptions of medical students towards online teaching during the COVID-19 pandemic: a national cross-sectional survey of 2721 UK medical students"}]},{"@id":"https://cir.nii.ac.jp/crid/1360298345101745024","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"The knowledge level and perceptions toward COVID-19 among Turkish final year medical students"}]},{"@id":"https://cir.nii.ac.jp/crid/1360298345455081600","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"A meta-analysis of continuing medical education effectiveness"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574094481385728","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Clinical Characteristics of Coronavirus Disease 2019 in China"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574095206395392","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"The value of reflective journaling in undergraduate nursing education: A literature review"}]},{"@id":"https://cir.nii.ac.jp/crid/1360576226945060096","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Preparedness of medical education in China: Lessons from the COVID-19 outbreak"}]},{"@id":"https://cir.nii.ac.jp/crid/1360579815711400192","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"The effectiveness of self-assessment on the identification of learner needs, learner activity, and impact on clinical practice: BEME Guide no. 10"}]},{"@id":"https://cir.nii.ac.jp/crid/1360579817453858688","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Satisfaction with online learning in the new normal: perspective of students and faculty at medical and health sciences colleges"}]},{"@id":"https://cir.nii.ac.jp/crid/1360579817483595136","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Medical education: COVID-19 and surgery"}]},{"@id":"https://cir.nii.ac.jp/crid/1360579818094500992","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Effects of realistic e-learning cases on students’ learning motivation during COVID-19"}]},{"@id":"https://cir.nii.ac.jp/crid/1360579818115753216","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Live-Streaming Surgery for Medical Student Education - Educational Solutions in Neurosurgery During the COVID-19 Pandemic"}]},{"@id":"https://cir.nii.ac.jp/crid/1360579818126307712","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"COVID-19 – Considerations and Implications for Surgical Learners"}]},{"@id":"https://cir.nii.ac.jp/crid/1360579818910526080","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Simulation-Based Mastery Learning Improves Medical Student Performance and Retention of Core Clinical Skills"}]},{"@id":"https://cir.nii.ac.jp/crid/1360855569382074752","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Repeated testing improves long‐term retention relative to repeated study: a randomised controlled trial"}]},{"@id":"https://cir.nii.ac.jp/crid/1360857595698337280","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Medical Student Concerns Relating to Neurosurgery Education During COVID-19"}]},{"@id":"https://cir.nii.ac.jp/crid/1360857701882059648","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"How we make choices and sacrifices in medical education during the COVID-19 pandemic"}]},{"@id":"https://cir.nii.ac.jp/crid/1360857702246926848","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Developments in medical education in response to the COVID-19 pandemic: A rapid BEME systematic review: BEME Guide No. 63"}]},{"@id":"https://cir.nii.ac.jp/crid/1360861292616920320","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Interprofessional education for students of the health professions: The “Seamless Care” model"}]},{"@id":"https://cir.nii.ac.jp/crid/1360861292966026496","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Team Training of Medical Students in the 21st Century: Would Flexner Approve?"}]},{"@id":"https://cir.nii.ac.jp/crid/1360861294714152064","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"An update on developments in medical education in response to the COVID-19 pandemic: A BEME scoping review: BEME Guide No. 64"}]},{"@id":"https://cir.nii.ac.jp/crid/1360861294734831744","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Distant surgical teaching during