Itohetetal.；Educationalal.；EducationalEffects
Effects ofof Community-Participatory
Community-Participatory On-Site
Itoh
On-SiteTraining
Training《 Original Article 》

Educational Effects of Community-Participatory On-Site Training
Underpinned by Multidisciplinary Collaboration
Yoshimi Itoh1*, Youhei Ikemoto2, Takashi Kojima3, Misako Motoshuku4, Ino Takumi5,
Takeshi Aikawa5, Yachiyo Yamamoto5, Toshihito Nakamura2, Tsutomu Bandoh1
Even before its integration with Hokkaido University of Science, Hokkaido College of
Pharmacy (hereinafter, HCP) had, for a long time, aimed to nurture human resources capableof contributing to the local community. To this end, a three-day, community-participatory onsite training was conducted in Yubari City, Hokkaido, involving six departments of threeeducational institutions, including HCP Department of Pharmacy, Hokkaido University of
Science Departments of Nursing, Physical Therapy, and Clinical Engineering, and Tenshi
College Departments of Nursing and Nutrition, for the purpose of learning the importance ofmultidisciplinary collaboration in the context of community healthcare.
Participating students were organized into four groups and on-site training to acquire work
experience in visiting medical care, visiting nursing care, and visiting pharmacy care wasconducted. Before and after the on-site training, the degree of understanding and the degree ofawareness of the need for the work of each profession were surveyed. In addition, each student
was asked to come up with keywords related to community healthcare before and after the onsite training, and the number of keywords that matched those prepared in advance by faculty
members was counted.
With regard to the degree of understanding and the degree of awareness of the need for thework of each profession, significant increases in almost all survey items were observed after
the on-site training relative to before. Moreover, after the on-site training, there was a significant
increase in the number of keywords provided by each student that matched those prepared byfaculty members relative to before the training. These results objectively supported theeducational effects that the on-site training aimed to provide. Promoting multidisciplinary
collaborative education that transcends the boundaries of universities, academic disciplines, anddepartments is very useful in terms of understanding the necessity and importance ofmultidisciplinary collaboration, as well as understanding the role of each individual in thecontext of multidisciplinary collaboration.
Key words; multidisciplinary collaborative education, on-site training, community healthcare, home-care
Received March 29, 2020; Accepted June 19, 2020
1 Faculty of Pharmaceutical Sciences, Hokkaido University of Science
3 Division of Community-based Cooperation, AIN HOLDINGS, Inc.
5 Faculty of Health Sciences, Hokkaido University of Science

2 Yubari Municipal Clinic

4 Graduate School of Midwifery, Tenshi College*Corresponding author: Yoshimi Itoh, Faculty of Pharmaceutical Sciences, Hokkaido University of Science,
7-Jo 15-4-1 Maeda, Teine, Sapporo, Hokkaido 006-8585, Japan
Phone : +81 11-676-8721
Fax : +81 11-676-8666
E-mail : y_itoh@hus.ac.jp

6262

Japanese
JournalVol.8,
No.2,
62-77(2020)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.8,
No.2,
62-77
(2020)

students opportunities for actual experiences at
1． Introduction

multiple medical institutions, nursing care andwelfare facilities, and home-care sites in medically

As a result of the aging of society, medical care

underserved areas. This endeavor has been initiatedhas become far more complex, and the Ministry ofas part of the Good Practice Project of the Ministry

Health, Labour and Welfare of Japan has beenof Education, Culture, Sports, Science andpromoting the development of a comprehensive

Technology, with the full cooperation of Yubaricommunity care system1). This phenomenon has

Municipal Clinic in Yubari City, Hokkaido, sincealso increased the need for home-care in the20074).

community as well as for pharmacists to become

In addition, in our on-site training entitled,

involved in home-care in collaboration with

“Learn with multidisciplinary students! – Hands-on

physicians and nurses2). Six-year undergraduate

community healthcare,” which has been conductedpharmacy education was implemented in FY2006,

since 2009 in the same city (Yubari City), student

the aim of which was to train pharmacists who arevolunteers experienced home-care during springable to work as a member of team-based healthcare

vacation for the purpose of learning the importanceand contribute to patient medical care and treatmentof multidisciplinary collaboration in the community

as a specialist of pharmaceuticals. In FY2015, thehealthcare setting.

Model Core Curriculum for Pharmacy Education

Previously, HCP also jointly offered on-site

was revised3) to include an “outcome-based

training with the Department of Nursing and theeducation” system as a requirement for pharmacy

Department of Nutrition, Faculty of Nursing andeducation. Among the 10 “Professional Core

Nutrition at Tenshi College (Sapporo City;

Competencies for Pharmacists” specified in thishereinafter, Tenshi College Departments of Nursing

Core Curriculum are “inter-professional team care”

and Nutrition), which has concluded an inter-and “community health and medical care”, andinstitutional collaborative education and researchthese have become essential for future education.

agreement with HCP. The contents of the on-site

Hokkaido College of Pharmacy (HCP; presently

training as well as its educational effects have beenreported elsewhere5).

Hokkaido University of Science Faculty of
Pharmaceutical Sciences) had, for a long time,

This time, a total of six departments at threeoffered education aimed at nurturing humaneducational institutions, including HCP Department

resources capable of contributing to the localof Pharmacy, Tenshi College Departments ofcommunity. Even after its integration with

Nursing and Nutrition, and new participants,

Hokkaido University of Science (which, at that time,

namely, the Department of Nursing, the Department

was composed of the Faculty of Health Sciences,of Physical Therapy, and the Department of Clinicalthe Faculty of Engineering, and the Faculty ofEngineering of the Faculty of Health Sciences atFuture Design) in April 2018, this educational

Hokkaido University of Science (hereinafter,

policy has been upheld.

Hokkaido University of Science Departments ofNursing,Previously, we reported the effects of providing

47
63

Physical

Therapy,andClinicalItohetetal.；Educationalal.；EducationalEffects
Effects ofof Community-Participatory
Community-Participatory On-Site
Itoh
On-SiteTraining
Training

Engineering), jointly conducted a three-day on-site

Municipal Clinic, a long-term healthcare facility

training targeting the students of these departments,

located in Yubari, and patients’ homes, andin collaboration with Yubari Municipal Clinic andconsisted of the following items: visiting medical

AIN Pharmaciez, Inc., both of which havecare, visiting nursing care, and physical andconcluded

occupational therapy (Yubari Municipal Clinic);acommunity-based

collaborationagreement (the agreement has been continued evenwatching

after the integration) with HCP. Herein we report theobservation (long-term healthcare facility); visiting

implementation of this community-participatory

pharmacy care (AIN Pharmaciez, Inc.); and clinicalon-site training.

engineering work.

4) Implementation method
2.

Methods

nutritionists

perform

foodintakePrior to the on-site training period, a 60-minute

introductory lecture was given at each educational

1. On-site training

institution. On the first day of the on-site training, a1) Participants

60-minute guidance was provided at Yubari

The participants were 28 first- to third-year

Municipal Clinic. The students were organized into

students (11 males and 17 females) from six

four groups of seven students each, in a manner thatdepartments at three educational institutions (i.e.,ensured an even distribution of students from

HCP

different departments/years to the extent possible,

Department

ofPharmacy;

Hokkaido

University of Science Departments of Nursing,and the training was conducted.

Physical Therapy, and Clinical Engineering; andThe outline of the on-site training is shown inTenshi College Departments of Nursing and

Figure 1.

Nutrition), who wished to attend the present training.
The

participants

included

14

The contents of the on-site training included thesecond-year

following: accompanying staff during visiting

students from HCP Department of Pharmacy; six

medicalfirst- and second-year students, three first-year

pharmacy care; experiencing the work of physicalstudents, and one first-year student from Hokkaido

or occupational therapists; watching nutritionists

University of Science Department of Nursing,

perform food intake observation; and experiencing

Department of Physical Therapy, and Department of

the work of clinical engineers (Table 1).

care/visiting

nursing

care/visiting

As for “accompanying staff during visiting

Clinical Engineering, respectively; and two secondyear students and two third-year students frommedicalTenshi College Department of Nursing andpharmacy care” and “experiencing the work of

Department of Nutrition, respectively.

physical or occupational therapists”, each of these2) Implementation period

was a three-hour on-site training and students

care/visiting

nursing

care/visiting

participated by rotation. Regarding “watching

The on-site training was performed for a threeday period spanning March 3 through 5, 2018.

nutritionists perform food intake observation”, this3) Implementation site

was carried out during lunchtime over the course of

The on-site training was conducted at Yubari

the three-day training period.
48
64

Japanese
JournalVol.8,
No.2,
62-77(2020)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.8,
No.2,
62-77
(2020)

am
9:00–
12:00

Visiting
medicalcare

Travelfrom
Sapporoto Yubari
Guidance

Visiting
nursing
care

Questionn aire
survey5th (Mon)
Lunch
pm
break
13:00–
16:00

Watch
nutritionists performfoodintakeobservation at thelong-term
healthcare
facility(Group 1)(15
minutes)

Other

C

16:00–
17:00

B

Visiting
pharmacycare(Occupational
therapy)

Occupational
therapy/
Experiencing homebased
oxygentherapyA
Visit
patient at
home

am
9:00–
12:00

Watch
"conference
video"(30
minutes)

B

Supplemen tarylectures:- Visiting
nurse- Physician

A

19:00–
20: 00Discussion/
Preparationforpresentation(60
minutes)D

6th (Tue)
Lunch
pm
break
13:00–
16:00

Watch
nutritionists
perform
foodintakeobservation at
the longterm
healthca refacility(Group 2)(15
minutes)(Occupational
therapy)AD

16:00–
17:15
Supplementarylectures:-Clinical
engineer-Hospital
pharmacist-Community
pharmacist-Dentist

am
9:00–
12:00

D

C

C

(Experiencing
homebased
oxygentherapy)C
Rehabilitation room

Other

19:00–
20:00
Discussion/
Preparationforpresentation(60
minutes)A・B

7th (Wed)
Lunch
pm
break
13:00–
15:30

Watch
nutritionists performfoodintakeobservation at thelong-term
healthcare
facility(Group3)(15
minutes)

Presentation/
Discussion/
Summary(60
minutes)
Questionn aire
survey15:30–
Travelfrom
Yubari to
SapporoB

D
Rehabilitation room

Figure 1 Outline of on-site training
Lecture contents:
Visiting nurse: Content of work in visiting nursing care setting, multidisciplinary collaboration (15 minutes）
Physician: Content of work in visiting medical care setting, multidisciplinary collaboration (15 minutes)
Clinical Engineer: Content of work in community healthcare setting (30 minutes)
Hospital pharmacist: Content of work in community healthcare setting, pharmacist-pharmacist collaboration (15 minutes)
Community pharmacist: Content of work in visiting pharmacy care setting, multidisciplinary collaboration, inter-facility
collaboration (15 minutes)
Dentist: Content of work in visiting dental care setting (15 minutes)
Groups: Group A, n = 7; Group B, n = 7; Group C, n = 7; Group D, n = 7(watch nutritionists perform food intake observation at long-term healthcare facility: Group 1, n = 9; Group 2, n = 9; Group 3,
n = 10)

Table 1 Items and contents of on-site training
Item

Content

Visiting medical care

Accompanying staff during visiting medical care in home-care setting

Visiting nursing care

Accompanying staff during visiting nursing care in home-care setting

Visiting pharmacy care

Accompanying staff during visiting pharmacy care in home-care setting

Physical and occupational therapy

Experiencing the work of physical or occupational therapists in home-care or
rehabilitation room settingWork of nutritionists

Watching nutritionists perform food intake observation at a long-term
healthcare facility

Clinical engineering work

Experiencing the work of clinical engineers in home-care setting (experiencehome-based oxygen therapy)

49
65

Itohetetal.；Educationalal.；EducationalEffects
Effects ofof Community-Participatory
Community-Participatory On-Site
Itoh
On-SiteTraining
Training

As regards “experiencing the work of clinicalthe afternoon of the 3rd day), regarding the degreeengineers”, only one group was able to participate;of understanding and the degree of awareness of thethus, a lecture and hands-on equipment experienceneed for each content on a 7-point scale (I don't

were provided to all students after completing thethink so at all → I strongly think so). In addition,

work experience on the 2nd day. After completingthe questionnaire also had a free comment section

the work experience on the 1st and 2nd days, aregarding community healthcare and home-care.

roughly 60-minute-long supplementary lecture ofMoreover, each student was asked to come up

the above contents was held, followed by awith keywords regarding community healthcare

discussion. In the supplementary lecture, the work

before and after the on-site training, and points were

content of each profession was explained from thecalculated for each student in the following manner:perspective of each department/unit involved inwhen a keyword the student came up with matchedcommunity healthcare and visiting care. After that,

one of those prepared in advance by two faculty

the students participated in a question and answer

members, one point was given. With regards to thesession and discussion to address questions arising

keywords, their validity was examined after theyfrom their experiences and share their experiences.

were presented by faculty members. The faculty

Furthermore,

after

completing

the

work

members referred to the literature when they foundexperience and the supplementary lecture on the 1st

it difficult to determine the validity of the keywords.

and 2nd days, each of the members of the four

These points were used as a measure of educationalgroups discussed what they had experienced byeffects.

group, and summarized their discussions at the

The questionnaire used before the on-site training

accommodation facility in Yubari City. Then, after

comprised seven questions pertaining to the degreecompleting their on-site training on the 3rd day, inof understanding and the degree of awareness offront of all participants, the students made aneed; four questions pertaining only to the degree ofpresentation of the results of their group discussion

understanding, and 13 other questions; theas well as their future academic goals andquestionnaire also contained a free comment section

aspirations when they become members of thefor three items and an entry column for keywords.

society in their respective professions.

The questionnaire used after the on-site training

Due to scheduling conflicts, it was difficult for allcomprised seven questions pertaining to the degreeof the students to participate in the on-site trainingof understanding and the degree of awareness ofheld at Yubari Municipal Clinic. Accordingly,

need; four questions pertaining only to the degree ofstudents watched the conference video.

understanding, and 15 other questions, with a freecomment section for seven items and an entry

2. Questionnaire survey

column for keywords.

1) Methods

The main items in the questionnaire were as

Questionnaire surveys were conducted before

follows:

and after the on-site training (after guidance in the-

About community healthcare and home-caremorning of the 1st day, and after the presentation in-

The role of each profession (physician, nurse,

50
66

Japanese
JournalVol.8,
No.2,
62-77(2020)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.8,
No.2,
62-77
(2020)-

pharmacist, occupational (physical) therapist,

A portion of the questionnaire used before the on-clinical engineer) in the community and home-site training is shown in Figure 2.

care settings2) Collection of questionnaires

Multidisciplinary collaboration (physician -All students answered the items in thenurse - nutritionist - pharmacist - occupationalquestionnaires for both before and after the on-site(physical) therapist - clinical engineer)training.

About "Practicing Community Healthcare" (before on-site training)
Please describe or rate your response on a 7-point scale(1: I don’t think so at all → 7: I strongly think so)
1. What motivated you to participate in this on-site training?
2. What is your idea of "community healthcare"?
3. What do you want to learn through this on-site training?
4. About community healthcare
I understand.

1 2 3 4 5 6 7

I think it is necessary.

1 2 3 4 5 6 7

I understand.

1 2 3 4 5 6 7

I think it is necessary.

1 2 3 4 5 6 7

I understand.

1 2 3 4 5 6 7

I think it is necessary.

1 2 3 4 5 6 7

5. About home-care- Visiting medical care (physician):- Visiting nursing care (nurse):- Visiting pharmacy care (pharmacist): I understand.  I think it is necessary.

1 2 3 4 5 6 71 2 3 4 5 6 7

6. About each profession in community healthcare- Role of each profession (physician, nurse, pharmacist, occupational (physical) therapist,
clinical engineer) in home-care setting:
I understand.

1 2 3 4 5 6 7

7. About intention to contribute- I would like to contribute to community healthcare.

1 2 3 4 5 6 7

- I would like to contribute to home-care.

1 2 3 4 5 6 7

Figure 2 Example of questionnaire used before on-site training

51
67

Itohetetal.；Educationalal.；EducationalEffects
Effects ofof Community-Participatory
Community-Participatory On-Site
Itoh
On-SiteTraining
Training

3) Data analysis

protection were explained, and the study was

Questionnaire scores are presented as means ±conducted after obtaining informed consent.

standard error (S.E.). Comparisons of scores before
and after the on-site training were performed using

3.

Results

the paired t-test, and p < 0.05 was considered
statistically significant.

1. Work of each profession in home-care setting

It should be noted that because some departments

Before the on-site training, the scores for the

had a small number of students, when performing

degree of understanding of “visiting medical care”,

data analyses by department, the total number of“visiting nursing care”, and “visiting pharmacy care”

students from the Department of Nursing and thewere low at 3.82 ± 1.19, 3.89 ± 1.20, and 3.93 ± 1.33,

Department of Nutrition was used for Tenshi

respectively. On the other hand, the scores for theCollege,

Clinicalawareness of the need for each of those were highEngineering at Hokkaido University of Science wasat 6.18 ± 1.02, 6.29 ± 1.05, and 6.07 ± 1.12,

excluded.

respectively.

and

the

Departmentof4) Ethical considerations

After the on-site training, the scores for theThis study was conducted after receiving

degree of understanding of each of the above items

approval that no application to the Ethics

significantly increased (5.46 ± 0.84, 5.61 ± 0.99,

Committee of Yubari Municipal Clinic wasand 5.71 ± 1.08, respectively). Similarly, the scoresnecessary.

for the degree of awareness of the need for each ofWith regard to informed consent, the purpose,

the above items also increased (6.75 ± 0.59, 6.75 ±methods, consent by free will, and privacy

0.59, and 6.71 ± 0.60, respectively) (Table 2).

Table 2 Changes in degree of understanding and degree of awareness of need
before and after on-site training
Survey item
(Question contents in the questionnaire)

I understand.

I think it is necessary.

Before onsite training

After on- Significant Before on- After on- Significant
site training difference site training site training difference

Visiting medical care

3.82 ± 1.19

5.46 ± 0.84*

6.18 ± 1.02

6.75 ± 0.59*

Visiting nursing care

3.89 ± 1.20

5.61 ± 0.99*

6.29 ± 1.05

6.75 ± 0.59*

Visiting pharmacy care*

3.93 ± 1.33

5.71 ± 1.08*

6.07 ± 1.12

6.71 ± 0.60

Role of each profession (physician, nurse, pharmacist,
occupational (physical) therapist, clinical engineer) 3.89 ± 1.34
in home-care setting

5.64 ± 0.95

*

－

－

Multidisciplinary collaboration (physician - nurse nutritionist - pharmacist - occupational (physical) 4.46 ± 1.32
therapist - clinical engineer)

5.82 ± 0.86*

6.54 ± 0.79

6.64 ± 0.73

N.S.

Information sharing in multidisciplinary collaboration 4.29 ± 1.18
(e.g., conferences)

5.68 ± 1.02*

6.50 ± 0.79

6.82 ± 0.61*

Community healthcare

4.14 ± 1.15

5.46 ± 0.88*

6.39 ± 1.07

6.75 ± 0.52*

Home-care (as a whole）

4.36 ± 1.16

5.32 ± 1.06*

6.43 ± 0.92

6.64 ± 0.73

N.S.

Mean ± S.E., n = 28,*: p < 0.05 (before on-site training vs. after on-site training), N.S.: not significant

52
68

Japanese
JournalVol.8,
No.2,
62-77(2020)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.8,
No.2,
62-77
(2020)

With respect to “visiting pharmacy care”, we
Degree of awareness of needplotted the degree of understanding against thedegree of awareness of the need for such care.
Before the on-site training, the degree ofunderstanding was low, whereas the degree ofawareness of need was high. After the on-sitetraining, both the degree of understanding and thedegree of awareness of need increased (Figure 3).
Although data are not shown, similar trends wereobserved for “visiting medical care” and “visiting
y = 0.2087x + 5.3864
R² = 0.1097



nursing care.”

The score for the degree of understanding of thepharmacist,(physical)

therapist,

clinicaloccupational

engineer)”

before on-site training,
after on-site training, n = 28
Each point may contain duplicates“role of each profession in home-care setting
nurse,



Figure 3 Degree of understanding vs. degree of  awareness of need for visiting pharmacy care

2. Role of each profession in home-care setting(physician,

Degree of understanding

With

was

respectto“information

sharinginmultidisciplinary collaboration (e.g., conferences)”,significantly increased after the on-site training

before the on-site training, the score for the degree

relative to before, from 3.89 ± 1.34 to 5.64 ± 0.95

of understanding was low (4.29 ± 1.18) compared(Table 2).

with the score for the degree of awareness of need
(6.50 ± 0.79), but after the on-site training, the3. Multidisciplinary collaboration and information

scores for both were significantly increased (5.68 ±sharing among various professions

1.02 and 6.82 ± 0.61, respectively) (Table 2).

With respect to “multidisciplinary collaboration

We also analyzed by department the scores for the(physician - nurse - nutritionist - pharmacist -degree of understanding of “multidisciplinary

occupational (physical) therapist - clinical engineer)”collaboration (physician - nurse - nutritionist -among various professions, before the on-site

pharmacist - occupational (physical) therapist -training, the score for the degree of understanding

clinical engineer)” among various professions.

was low (4.46 ± 1.32) compared with the score for

Significant increases were observed after the on-site

the degree of awareness of need (6.54 ± 0.79), but

training relative to before for all departments except

after the on-site training, the score for the degree of

Hokkaido University of Science Department ofunderstanding was significantly increased (5.82 ±Nursing (Figure 4).

0.86). However, there was no significant differencein scores for the degree of awareness of need before

4. Regarding community healthcare and home-care

and after the on-site training (6.54 ± 0.79 and 6.64

With respect to “community healthcare”, before± 0.73, respectively) (Table 2).

the on-site training, the score for the degree of5369Itohetetal.；Educationalal.；EducationalEffects
Effects ofof Community-Participatory
Community-Participatory On-Site
Itoh
On-SiteTraining
Training

B)
8

＊
Score

Score

6
4
2
0

8

8

6

6

4
2

Before

0

After

＊

4
2

Before0

After

Before

After

E)

D)

8

8

＊

4
2
0

＊

6

Score

6

Score

C)

Score

A)

4
2

Before0

After

BeforeAfter

Figure 4 Changes in degree of understanding of multidisciplinary collaboration before and after on-site training
A: Hokkaido College of Pharmacy (before integration) (Department of Pharmacy), n = 14;
B: Hokkaido University of Science (Department of Nursing), n = 6;
C: Hokkaido University of Science (Department of Physical Therapy), n = 3;
D: Tenshi College (Departments of Nursing and Nutrition), n = 4;
E: three educational institutions/six departments (include one student at Hokkaido University of Science Department of ClinicalEngineering), overall, n = 28;
Mean ± S.E., n = 28, *: p < 0.05 (before on-site training vs. after on-site training)

Table 3 Changes before and after on-site training
Survey item
(Question contents in the questionnaire)

Before on-sitetraining

After on-sitetraining

Significant
difference

I would like to contribute to community healthcare.

5.46 ± 1.29

6.11 ± 1.17*

I would like to contribute to home-care.

5.39 ± 1.37

5.96 ± 1.20*

It is meaningful to learn with students other than pharmacy students(or nursing/nutrition students, or health sciences students).

5.89 ± 1.20

6.64 ± 0.78*

I think it will be useful in the future (when I become a pharmacist, nurse, nutritionist,
physical therapist, or clinical engineer).

6.14 ± 1.04

6.64 ± 0.78*

Hands-on, on-site training is meaningful as it offers an opportunity to learn things
that are otherwise not available through university classes.

6.18 ± 0.90

6.68 ± 0.72*

It increases motivation for future study.

5.96 ± 1.10

6.43 ± 0.84*

About intention to contribute

Mean ± S.E., n = 28,*: p < 0.05 (before on-site training vs. after on-site training）

54
70

Japanese
JournalVol.8,
No.2,
62-77(2020)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.8,
No.2,
62-77
(2020)

awareness of the need was originally high at 6.39 ±like to contribute to home-care”, significant

1.07, whereas the score for the degree ofincreases were observed after the on-site training

understanding was low at 4.14 ± 1.15. However, therelative to before (from 5.46 ± 1.29 to 6.11 ± 1.17,scores for both were significantly increased after theand from 5.39 ± 1.37 to 5.96 ± 1.20, respectively)

on-site training (6.75 ± 0.52 and 5.46 ± 0.88,(Table 3).

respectively) (Table 2).

AnalysisWith respect to “home-care”, before the on-siteofscoresforthedegreeofunderstanding of “community healthcare” bytraining, the score for the degree of understanding

department

was low (4.36 ± 1.16) compared with the score for

University of Science Department of Nursing, all

the degree of awareness of need (6.43 ± 0.92), but

departments showed a significant increase after theafter the on-site training, the score for the degree ofon-site training relative to before (Figure 5).

understanding was significantly increased (5.32 ±Analysis of scores for the degree of understanding

1.06). However, there was no significant differenceof “home-care” by department revealed that except

in scores for the degree of awareness of need before

Hokkaido University of Science Department ofand after the on-site training (6.43 ± 0.92 and 6.64

Nursing and Physical Therapy, all departments± 0.73, respectively) (Table 2).

showed a significant increase after the on-site

Moreover, with respect to “I would like torevealed

that

exceptHokkaido

training relative to before (Figure 6).

contribute to community healthcare” and “I would
B)
8

＊
Score

Score

6
4
2
0

8

8

6

6

4

Before

0

After

＊

4
2

2

0

BeforeAfter

Before

After

E)

D)

8

8

＊

4

4
2

2
0

＊

6

Score

6
Score

C)

Score

A)

BeforeAfter0

BeforeAfter

Figure 5 Changes in degree of understanding of community healthcare before and after on-site training
A: Hokkaido College of Pharmacy (before integration) (Department of Pharmacy), n = 14;
B: Hokkaido University of Science (Department of Nursing), n = 6;
C: Hokkaido University of Science (Department of Physical Therapy), n = 3;
D: Tenshi College (Departments of Nursing and Nutrition), n = 4;
E: three educational institutions/six departments (include one student at Hokkaido University of Science Department of ClinicalEngineering), overall, n = 28;
Mean ± S.E., n = 28, *: p < 0.05 (before on-site training vs. after on-site training)55
71

Itohetetal.；Educationalal.；EducationalEffects
Effects ofof Community-Participatory
Community-Participatory On-Site
Itoh
On-SiteTraining
Training

B)
8

＊
Score

Score

6
4

8

6

6

4
2

2
0

C)
8

Score

A)

Before

0

After

4
2

Before0

After

Before

After

E)

D)

8

8

＊

4

4
2

2
0

＊

6

Score

Score

6

Before0

After

BeforeAfter

Figure 6 Changes in degree of understanding of home-care before and after on-site training
A: Hokkaido College of Pharmacy (before integration) (Department of Pharmacy), n = 14;
B: Hokkaido University of Science (Department of Nursing), n = 6;
C: Hokkaido University of Science (Department of Physical Therapy), n = 3;
D: Tenshi College (Departments of Nursing and Nutrition), n = 4;
E: three educational institutions/six departments (include one student at Hokkaido University of Science Department of ClinicalEngineering), overall, n = 28;
Mean ± S.E., n = 28, *: p < 0.05 (before on-site training vs. after on-site training)
B)

A)
15

＊

5

Before

10
5
0

After

Score

Score

Score

15

15

＊

10

0

C)

Before

After

10

＊

5
0

Before

After

E)

D)
20

15

＊
Score

Score

15
10
5
0

Before

After

＊

10
5
0

BeforeAfter

Figure 7 Educational effects before and after on-site training by keyword presentation
A: Hokkaido College of Pharmacy (before integration) (Department of Pharmacy), n = 14;
B: Hokkaido University of Science (Department of Nursing), n = 6;
C: Hokkaido University of Science (Department of Physical Therapy), n = 3;
D: Tenshi College (Departments of Nursing and Nutrition), n = 4;
E: three educational institutions/six departments (include one student at Hokkaido University of Science Department of ClinicalEngineering), overall, n = 28;
Mean ± S.E., n = 28, *: p < 0.05 (before on-site training vs. after on-site training)

56
72

Japanese
JournalVol.8,
No.2,
62-77(2020)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.8,
No.2,
62-77
(2020)

5. About on-site training with students fromcare” was plotted, a characteristic trend was

different academic disciplines

observed, namely, whereas the scores for the degree

With regard to “It is meaningful to learn withstudents

other

than

pharmacy

students

of awareness of need were high even before the on-(orsite training, those for the degree of understanding

nursing/nutrition students, or health scienceswere low. On the other hand, after the on-site

students)”, a significant increase in score wastraining, both scores for the degree of understanding

observed after the on-site training relative to before,

and the degree of awareness of need were high.

from 5.89 ± 1.20 to 6.64 ± 0.78 (Table 3).

Moreover, given that there was a further increase inMoreover, with regard to “It increases motivation

score for the awareness of need, which wasfor future study”, a significant increase in score wasoriginally high, relative to before the on-site

observed after the on-site training relative to before,

training, we presumed that the degree of awarenessfrom 5.96 ± 1.10 to 6.43 ± 0.84 (Table 3).

of need increased even more after the on-sitetraining because of the increase in the degree of

6. Keywords related to community healthcare

understanding relative to before. Similar trends

In terms of the number of keywords that students

were noted in the scores for “visiting medical care”

came up with as relating to community healthcare,and “visiting nursing care”, suggesting that similarsignificant increases were observed after the on-site

factors to those related to “visiting pharmacy care”

training relative to before in HCP Department ofmight have been involved.

Pharmacy,

Hokkaido

Universityof

Science

With regard to the role of each profession, theDepartments of Nursing and Physical Therapy, andscore for the degree of understanding of the “role ofTenshi College Departments of Nursing andeach profession (physician, nurse, pharmacist,

Nutrition. Among the six departments of the threeoccupational (physical) therapist, clinical engineer)

educational institutions, overall, the score was 3.32

in the home-care setting” showed a significant± 0.80 before the on-site training and 8.96 ± 1.25

increase after the on-site training relative to before.

after, showing a significant increase (Figure 7).

In addition to experiencing the work of eachprofession, supplementary lectures were provided

4. Discussion

afterwards, and in some cases, discussions evolved
into those related to the importance within

The results of the questionnaire survey of thecommunities. This likely helped students better

work of each profession in the home-care setting

understand the role of each profession.

indicated significant increases in scores for theAfter the on-site training, the score for the

degree of understanding as well as the degree ofawareness of the need for “multidisciplinaryawareness of the need for “visiting medical care”,

collaboration (physician - nurse - nutritionist -“visiting nursing care”, and “visiting pharmacy care”

pharmacist - occupational (physical) therapist -after the on-site training. When the relationshipclinical engineer)” was 6.64 ± 0.73, and that for

between the degree of understanding and the degree“informationof awareness of the need for “visiting pharmacy

collaboration (e.g., conferences)” was 6.82 ± 0.61,

57
73

sharinginmultidisciplinary

Itohetetal.；Educationalal.；EducationalEffects
Effects ofof Community-Participatory
Community-Participatory On-Site
Itoh
On-SiteTraining
Training

which was the highest of all scores in the on-site

discussions with students from different academic

training.

thedisciplines might have further increased theirmultidisciplinary work experience contributed to anunderstanding of different professions as well as

increased

their awareness of the need for multidisciplinary

In

the

on-siteunderstandingoftraining,

multidisciplinary

collaboration. This likely resulted in the increased

collaboration.

scores after the on-site training, suggesting that theWith regard to “community healthcare”, which

training is useful for learning hands-on the necessity

includes the present on-site training, there wereof multidisciplinary collaboration.

significant increases in scores for the degree ofIn the present study, whereas a significant
difference

was

to

Significant increases in scores were also observed

multidisciplinary

for the degree of understanding of “home-care”, “I

collaboration (e.g., conferences)”, no significant

would like to contribute to home-care”, and “Idifference was observed with respect to thewould like to contribute to community healthcare”

awareness of the need for “multidisciplinary

after the on-site training. However, there was no

collaboration (physician - nurse - nutritionist -significant difference in the degree of awareness ofpharmacist - occupational (physical) therapist -the need for “home-care”. This may be because aclinical engineer)”. As a related factor, we notedhigh score of 6.43 ± 0.92 was originally notedthat the original score (i.e., before the on-site

before the on-site training and the difference wastraining) for “multidisciplinary collaboration” wasnot statistically significant even though the score

6.54 ± 0.79, which was the highest of all scores; thisincreased to 6.64 ± 0.73 after.

“information

observed

sharinginwithrespect

understanding and the degree of awareness of need.

might explain why there was no significant

When

the

analyses

wereperformedbydifference. Another possibility was that because it

department (Figures 4 to 6), Hokkaido University of

was rare to have people of other professions present

Science Department of Nursing showed noduring work experience particularly in a patient's

significant differences in scores for the degree of

home, significant differences might not have been

understanding of “multidisciplinary collaboration

detected.

(physician - nurse - nutritionist - pharmacist -As for the items “it is meaningful to learn withoccupational (physical) therapist - clinical engineer,(orFigure 4B)”, “community healthcare (Figure 5B)”,

nursing/nutrition students, or health sciencesand “home-care (Figure 6B)”, after the on-site

students)” and “it increases motivation for future

training relative to before. This might be because

study”, the scores were significantly increased after

four of the six students had participated in the samethe on-site training relative to before. In addition,

on-site training in the previous school year, and also,

during the on-site training, students from different

their scores before the on-site training were high.

students

other

than

pharmacy

students

departments acted together in groups, and at the

Hokkaido University of Science Department oftime of discussion as well, they were able to carry

Physical Therapy also showed no significant

out discussions from their respective knowledge

difference when scores for the degree ofbases and perspectives. As such, learning andunderstanding of “home-care” before and after the
58
74

Japanese
JournalVol.8,
No.2,
62-77(2020)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.8,
No.2,
62-77
(2020)

on-sitetraining

werecompared.

Hokkaido

keywords related to community healthcare, namely,

University of Science Department of Physicalthe mean value for all students before the on-site

Therapy offers a requisite lecture course entitledtraining was 3.32 ± 0.80, whereas that after was 8.96

“Theory of team medical care” in the first semester± 1.25. That a significant increase was observed inof the first year, where students learn about team-scores across all the three institutions suggested thatbased healthcare as well as the roles of otherobjective evaluation was feasible.

professions. It was thus likely that because all

In addition, the number of keywords presented

students of this Department who participated in the

before and after the on-site training by students ofpresent on-site training were first-year students andTenshi College was larger than that by students of

had taken the above-mentioned course, their scores

the other institutions. This could be attributed to thewere high before the on-site training. This mightfact that one of the four students of Tenshi College

explain the observed trend.

had a deep interest in community healthcare and did

The results of the questionnaire surveys revealed

self-study prior to the training. The fact that thisthat many students felt the need for most items, evenstudent’s scores before and after the on-site training

though their levels of understanding of those items

were extremely high at 20 and 29, respectively, waswere low before participating in the on-site training.

considered one of the factors contributing to the

As for the cause, we presumed that because thelarge number of keywords. The scores before andstudents have learned about community healthcare

after the on-site training for only the other three

and contents related to home-care in other lectures

students were 3.00 ± 3.00 and 7.00 ± 3.61,

and courses, they might have felt that community

respectively, and were almost the same as thehealthcarenecessary;

average scores for all students of 3.32 ± 0.80 andmeanwhile, they have not yet acquired a sufficient

8.96 ± 1.25, respectively. The above-mentioned

understanding of the contents due to lack ofpossibility was further inferred on the basis of theseexperience.

findings.

andhome-carewereTeshima et al. reported that among the three

Currently,

multidisciplinary

collaborativeeducational institutions, a survey targeting students

education has been introduced as part of

who had taken inter-university credit-exchangeable

undergraduate

courses in fields related to home-care anduniversities, as well as in universities that have acommunity healthcare revealed that the educational

faculty of pharmaceutical sciences7–10). There are

effects of each specialized education wereseveral learning methods for multidisciplinary

significantly increased in the “lecture plus exercise

collaborative education and in many cases,or practical training group” compared with the

problem-based learning (PBL)11–13), case study9),“lecture-only group”6).

and role play14) are used; however, on-site training

education

in

many

medical

We presumed that through participation in the on-

is rarely offered10). Moreover, there are few

site training, the students were able to gain awarenessinstances in which multidisciplinary collaborativeof the need accompanied by understanding.

educationisofferedwith

theFacultyofPharmaceutical Sciences at the core, and only a few

This was also reflected in the presentation of59
75

Itohetetal.；Educationalal.；EducationalEffects
Effects ofof Community-Participatory
Community-Participatory On-Site
Itoh
On-SiteTraining
Training

cases have examined its educational effects9, 11, 14).

who are capable of playing a key role in

Ogura et al. showed that in first-year professional

collaboration with society, through comprehensive

collaborative education using the PBL style,learning of team-based healthcare centered onorganizing groups among students from fourhome-care. In terms of contribution to community

faculties

healthcare, we would like to enhance the awareness(Faculties

ofMedicine,

Dentistry,

Pharmaceutical Sciences, and Health Sciences) andof the need in future learning.

six departments was effective in promoting mutual
understanding among students13).

References

In our present study as well, we showed that
conducting hands-on practical training of students1) Ministry of Health, Labour and Welfare:from six departments by organizing them into

Integrated Community Care System．

groups had valid educational effects.

<https://www.mhlw.go.jp/stf/seisakunitsuite/

We think that a comprehensive understanding of

bunya/hukushi_kaigo/kaigo_koureisha/chiiki-

community healthcare was gained through thehoukatsu/>, cited 16 March, 2020.

following approaches. First, in order to deepen2)  Ministry of Health, Labour and Welfare:

understanding of the local community, on-site

Promotion of the Team Approach in Medical

training was conducted with focus on home-care,

Care by Collaboration and Cooperation of thewhich involved visiting various homes rather than

Medical Staff

limiting training to only a single facility. Second,<http://www.mhlw.go.jp/shingi/2010/05/dl/s0

students not only learned the contents of work of

512-6h.pdf>, cited 16 March, 2020.

respective

professions

but

also

experienced3) Model Co re Curriculu m for P harmac ymultidisciplinary collaboration. Third, in addition

Education, FY2013 revised version．

to on-site training, a pre-training lecture, post-<https://www.mext.go.jp/a_menu/01_d/08091

experience supplementary lectures, and discussions

815.htm>, cited 16 March, 2020.

were carried out, which might have enabled

4)  Itoh Y, Bandoh T, Ikemoto Y, Kojima T,

students to learn while retaining knowledge they

Yamaguchi S, Yokota K, Yonai M, Ono M,

have acquired.

Satoh K, Matsuhira T, Sasaki M, Anzai N, ItohThe

resultsandM, Ikeda K, Yamaguchi T, Satoh H, Sudou T,questionnaire surveys suggested that students were

Narumi S, Okazaki M, Shimamori Y,

able

of

Watanabe K, Hayase Y, Hiura M, Hiura Y,

through

Morita H, Hatta M, Nagamori K, Murakami T,

community

Introduction and Evaluation of the Efficacy of

toofthe on-siteunderstandmultidisciplinary
comprehensive

theimportancecollaboration
experience

trainingofhealthcare involving multiple departments in Yubari

Community-based

City, where community healthcare has been

Pharmacy Services, Jpn. J. Pharm. Health Care

proactively implemented.

Sci., 2013; 39: 413-422.

On-siteLearningof

It is considered that by conducting the on-site5) Bandoh T, Community Home Healthcare in 6-

training, it may be possible to develop professionals

Year Pharmacy Education, Yakugaku Zasshi,
60
76

Japanese
JournalVol.8,
No.2,
62-77(2020)
Japanese
JournalofofCommunity
Community Pharmacy
Pharmacy Vol.8,
No.2,
62-77
(2020)

2013; 133: 343-348.

Pharmacist Education, Yakugaku Zasshi,6)  Teshima M, Takeshima J, Yoshihara R,

2013; 133: 231-241.

Matsumoto S, Iwashita J, Sakakibara R,11) Tomoda S, Suzuki K, Sugimoto T, Watanabe

Matsuzaka N, Hoshino Y, Kuroda Naotaka,N, Tsunekawa Y, Nakata K, Senda A, Report

Nakashima M, Tracking by a Questionnarie forof the First IPE Even for 5th-year Students at

Interprofessional Education Taking Persons by

the School of Dentistry and Pharmacy, Aichi

Consortium for Home Care in Nagasaki, J.

Gakuin University, Aichi-Gakuin J. dent. sci.,

Kyushu Pharm., 2018; 72: 69-75.

2018; 56: 57-64.

7)  Noda Y, Uchida M, Hanya M, Practice of12) Enokida M, Kataoka R, Suzuki H, Imafuku R,

interprofessional education in the faculty of

Ogura H, Osakabe K, Matsuki E, Geshi E,

pharmacyfaculties:

Kiuchi Y, Takagi Y, Evaluation of problem-

collaboration with other medical faculties, Jpn.

based learning tutorial curriculum focused to

J. Pharm. Edu., 2019; 3: 1-7.

interprofessional

without

medical8)  Sakai I, Asahina M, Maeda T, Sekine Y,
Kurokochi

K,

YamadaK,

education,

J.

Interprof.

Collabo. Health Social Care, 2015; 8: 10-19.

Program-13) Goto A, Hanya M, Yoshimi A, Uchida M,

improvement progress and future task of

Takeuchi S, Aida N, Suematsu M, Abe K,

Inohana Interprofessional Education, Medical

Yasui H, Kamei H, Noda Y, Usefulness of

Education, 2014; 45: 153-162.

Interprofessional Education (Tsurumai-Meijo

9)  Ino Y, MatsuyamaT, Tachi T, Noguchi Y,

IPE) in Program Collaborating with Simulated

Teramachi H, Effect of Multidisciplinary

Patients, Yakugaku Zasshi, 2017; 137: 733-

Medical CareTeam Education on Pharmacy

744.

Students - Short-term Effect Focused on
RIPLS(Readinessfor14) Ogura H, Osakabe K, Kataoka R, Suzuki H,

Interprofessional

Imafuku R, Enokida M, Kiuchi Y, Tanaka K,

Learning Scale) and IEPS(Interdisciplinary

KurataEducation Perception Scale) -, Jpn. J. Pharm.

education for the first-year students in a

Health Care Sci., 2018; 44: 191-202.

medical univwrsity, J. Interprof. Collabo.

10) Kiuchi Y, Masuda Y, Kamei D, Kogo M,

T,Effectsofinterprofessional

Health Social Care, 2016; 9: 29-38.

Nakamura A, Advanced Curriculum for
Clinical Assessment and Skill in New Age

6177