[Clinical clerkship of home care for medical students]

A clinical clerkship of home care has been introduced in our program for third-year medical students since 1998 at this university. In our clinical clerkship of home care, medical students are not only dispatched to visiting nursing stations, but they also participate in home care service activities with visiting nursing people at patients' homes. Through these experiences the students have an opportunity to study the policy of community medicine and home care, and to gain the knowledge of teamwork.

The clerkship of home care (1 week program) was introduced to all of the third-year medical students. The students were dispatched to visiting nursing stations and they had to take part in home care service activities at patients' homes with community care visiting nurses. After this program was finished, questionnaires were given to all the students and visiting nurses to examine the necessity and scheduling of this program and to evaluate the students by the visiting nurses, etc.

A total of 621 students participated in our program for the past 6 years since 1998, and 90 visiting nurses from 30 visiting nursing stations gave actual trainings to our students every year at patients' homes. 98% of the students as well as 97% of the home care nurses returned questionnaires. After the program, 95.1% of the students and 97.8% of the visiting nurses agreed that this program was meaningful for both sides and it should be continued. Furthermore, regarding a question of the suitability of the third-year medical students to be in the program, 70% of the students and 48% of the visiting nurses agreed. As to a question of the training duration, 80% of the students and 87% of the visiting nurses also agreed. Both students and visiting nurses were in agreement that this home care clerkship was important. Meanwhile, both students and visiting nurses also expressed a degree of some difficulty for this clinical clerkship training. These results suggested that there were some factors to be resolved in order to carry out the clinical clerkship as a success. The clinical trainings for community-based home care are not carried out sufficiently under present medical education because clinical clerkships are always performed at a bedside of a university hospital. It is hard for the students to learn community-based home care and the time related progression of a patient's disease. Therefore, clinical clerkship of home care is a good and effective method to educate the students in those areas.