Tokai National Higher Education and Research SystemNear-peer teaching in community oriented medical education based on Onsite and Virtual learning Integrated with Anthropology (NOVI+A)Establishing Bases for Fostering Medical Personnel in the Post-COVID Era Project

Research and Field Work

Medical anthropology is a subdiscipline of cultural anthropology, a study of cross-cultural communication and understanding. A key methodology in this curriculum is "field work," which is the hallmark of anthropology. Field work helps anthropologists communicate with local people, understand their worldviews, and identify the issues that matter to them. Medical anthropologists conduct their field work with a focus on the patients' challenges and clinical experiences.

Since medical anthropology emphasizes understanding people in their social and cultural context, it has traditionally focused on health care practices in local settings, such as primary health care, home-based care, and general medicine. This curriculum also emphasizes the following:

Cultural Relativism

Medical practice is a partnership between the physician and the patient, in which the patient shares their critical life challenges. The physician should assume that his or her frame of reference may differ from that of the patient. Though sometimes difficult to maintain, this assumption is important for grasping the meaning of the issues in the patient's life and identifying possible solutions through interactions with people having different value systems. The concept of cultural relativism assists anthropologists in their field work.

Anthropologists sometimes experience "culture shock" as they conduct field work in a sociocultural environment that is different from theirs. For example, local people may be annoyed by the anthropologists' kind deeds or become grateful for their misdirected actions. Then, the anthropologists will find that the idea of normalcy, rightness, masculinity, or femininity should not be taken for granted universally. In an effort to understand the sociocultural significance of a human behavior or action, medical anthropologists investigate the persons or matters they are directed to. Cultural relativism helps anthropologists realize that what they take for granted is not a matter of course for others.

Currently, "effective goal setting and achievement" is apparently the leading motto in medical practice. This motto may possibly create frictions with the way of life of a patient or their family. Cultural relativism allows anthropologists to explore possible solutions that are outside their value systems. Whereas effective goal setting and achievement is a powerful principle in education and other areas, this curriculum will encourage students to consider possible alternative options.

What does "local community" mean? What does a "community" represent to medical students? Some may think of administrative districts, while others may think of their beloved place. The term "community medicine" may connote a range of meanings. It may be regarded as clinical practices in rural areas or provided at places other than tertiary hospitals. Some students may feel community medicine has nothing to do with them.

This course will encourage students to revisit "community" at each locale where people live and carry out some kind of activity, regardless of whether it is in a city or a rural town. In order to achieve this, students will have the opportunity to meet a variety of people, including those involved in policy and administration, as well as medical professionals involved in rural and "community" healthcare, and learn about the many different perspectives on "community" and "community medicine." Even medical care in university hospitals will be interpreted as a "localized" activity created by the unique medical staff and patients at the particular place.

Considering community medicine not as a practice in areas with small populations, but as a localized practice whether it is in rural areas, urban cities, or at university hospitals, is an example of an anthropological perspective based on cultural relativism.

In our curriculum, medical students will be encouraged to apply cultural relativism to the "university-centric perspective" - the assumption that medical care provided in university hospitals is "the standard" and that medical care in non-university institutions is a kind of "deviation" from it - that medical students tend to unconsciously acquire in the conventional medical school education. Instead, students will be encouraged to take the viewpoint that each is a localized form of healthcare, whether it is in a university or a clinic, an urban or rural area.

Through relative and comparative examination, the curriculum aims to enable medical students to analyze the changes in the social environment surrounding medicine and to explore new medical practices and medical research.

Extended-reality technologies can have a great impact on medical education. In this curriculum, our extended-reality environment helps students acquire medical thinking skills (e.g., clinical reasoning and judgment, treatment planning) and physical examination techniques under the guidance of tutors.

The "Mixed-Reality Clinical Training" program enables advanced-year students to go beyond the limitations of in-person clinical training, in which students may not always encounter all of the educational cases. Whereas a medical examination in an office is a one-time event, this program allows students to examine the same conditions repeatedly.

Students will (i) have face-to-face contact with patients in remote communities, (ii) diagnose patients in the extended-reality space, and (iii) share their learning experience with peers and tutors in distant locations. Moreover, our extended-reality technologies equip students with medical English skills, allowing them to reach out to the communities of foreign residents. Using mixed-reality education tools and generative artificial intelligence (AI), early-year students will learn the art of medicine in local settings.

Nagoya Univ.

Gifu Univ.