Tomoko Onoe
Department of Nursing, Ehime Prefectural University of Health Sciences, Japan.
Corresponding Author Details: Tomoko Onoe, Department of Nursing, Ehime Prefectural University of Health Sciences, Japan.
Received date: 30th November, 2023
Accepted date: 05th December, 2023
Published date: 07th December, 2023
Citation: Onoe, T., (2023). The Importance of Putting Yourself in Someone’s Shoes: A Case Study of a Workshop at a Medical University in Japan on Multicultural Understanding in Healthcare Services. J Comp Nurs Res Care 8(1):192.
Copyright:©2023, This is an open-access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
What criteria would you use when selecting a gift for your friend? Some of you might—while trying to keep a clear picture of your friend’s face in mind—choose something that they would love. Others, however, might choose something based on what they feel would be useful or beneficial to the friend. The former attitude is the one anthropologists take when conducting surveys and other research in their field; in other words, they try to understand and clarify how the individual informants and populations that they are researching understand their world. Incorporating such an attitude in medical education can be expected to enhance the education experience.
In 2022, the number of foreign residents in Japan reached a new record high [1], and, with the serious labor shortage that the country continues to face, this number is predicted to keep on rising. In response to this situation, some efforts are being made— in areas such as medicine, local government, and education— to make the society more multicultural and more amenable to foreign residents. The development of a support system in health and medical services for foreign patients and residents, however, remains quite lacking, and, therefore, going to see a doctor is still a major problem and poses many difficulties for them [2,3]. In fact, there are surveys indicating that many foreign residents will avoid, or put off, seeing a doctor unless there is an urgent need to do so [2,4]. In order to remove linguistic and cultural obstacles and thus provide a more barrier-free environment, specialists in Japanese language education, medical education, and medical anthropology have been attempting to incorporate an easy Japanese, Yasashi Nihongo, into the healthcare setting and to train healthcare professionals in how to work better in a multicultural environment.
However, we can still see reactions among healthcare providers that show that, in spite of these efforts being made by specialists, much work needs to be done yet. For example, Onoe [5] has noted responses such as the following from her informants, who were or had been healthcare professionals: “In any case, it’s just scary having to deal with foreign patients.” “I always use a translator app to interact with foreign patients, but it does not always work so well.” “I only do the bare minimum when attending to foreign patients.” There are also some cases reported by medical interpreters, which indicate unkind reactions among healthcare providers that the interpreters witnessed [6]. Reactions such as these suggest that many medical professionals often find themselves at a loss when dealing with foreign patients.
What then can instructors at medical schools and universities do to help make sure that the best healthcare service can be provided to everyone, including foreign patients?
When preparing classes and workshops related to living in a multicultural society, one effective method is to design exercises that can deepen a student’s understanding of the experiences and perspectives of foreign residents and include these exercises in the lesson plan.
Onoe [5] discusses how she incorporated such an activity into her workshop lesson entitled “Communication in an Intercultural Society” at a medical university in Japan. The activity allowed her students to experience what it would be like to be a foreign resident in Japan. She points out that such activities can help change the attitude of the students who have had no particular prior interest in what it takes to live in a multicultural society. Although many of the students had been indifferent toward foreign residents’ daily lives in Japan and perceived such matters as “someone else’s business” prior to the lesson, they were able to gain a more open perspective on what life in unfamiliar places was like once the activity had allowed them to experience something similar to what a foreigner who does not understand Japanese language may go through in Japan.
It should be pointed out that during this “Communication in an Intercultural Society” seminar that Onoe conducted for healthcare professionals in a prefecture in Japan, the participants were quite positive about the portions of the seminar where foreign residents in the community shared with them the hardships they had faced and in which the participants were able to interact with the foreign residents.
Activities that help the students or seminar participants in the workshops develop a better understanding of what happens to foreign residents and where they stand in the society provides them with a new viewpoint and leads them to want to improve the support system for the foreign patients and residents in health and medical service in the future.
An important thing to realize is that instructors need to keep in mind the perspective of their students when developing lesson plans in the same way that anthropologists attempt to understand the point of view of their informants when conducting research. Frequently, the instructors and their students are not of the same generation, and the students might have a different cultural background from that of the instructor.
In ethnography—a branch of cultural anthropology—researchers endeavor to understand and describe the world which their informants recognize, often leading to a feeling of friendship, or at least affinity, between the researchers and those they research through their long term interaction. In recent years, this approach has been incorporated into the training of professionals in a variety of fields. Integrating this anthropological approach to understanding those who have different cultural backgrounds into education in the classroom can prevent instructors from forcing their own values on their students. In other words, taking into consideration the students’ perceptions of and attitudes toward foreign residents in Japan or living in a multicultural society while developing and planning lessons will raise the quality of education.
As mentioned above, the development of a support system for foreigners in health and medical services in Japan is still in its beginning stages. Obviously, it is essential to listen to foreign residents when designing a system which will provide good healthcare to meet their particular needs. In medical education, it is also necessary for instructors to try to listen to their students and give consideration to their attitudes or viewpoints in order to make the educational experience more effective and fulfilling.
Immigration Services Agency (2023). Foreign resident statistics (End of December 2022) (https://www.moj.go.jp/isa/policies/ statistics/toukei_ichiran_touroku.html?hl=en) (accessed 10 November 2023).View
Takeda, Y., Iwata, K., Ni, M., (2021). Healthcare services for foreigners: Using not only English but also “easy Japanese”. Iryougenba no gaikokujin taiou: Eigo dakejanai “yasashi nihongo” (in Japanese). Nanzandou.
Ministry of Health, Labour and Welfare (2022). Report of survey on the acceptance of foreign patients at medical institutions, March 2022. Iryoukikan niokeru gaikokujin-kanja no ukeire ni kakawaru jittaichousa: Kekka houkokusho (Reiwa 4nen 3gatsu) (in Japanese). https://www.mhlw.go.jp/stf/seisakunitsuite/ bunya/0000202918_00022.html, (accessed 30 August 2022).View
Takeda, Y., (2020). Try to talk to patients in “easy Japanese” in medical site. Iryou, kango no ba de “yasashi nihongo” wo tsukattemiru (in Japanese). Nihon kangokyoukai kikanshi (Journal of the Japanese Nursing Association) 72(7): 80-85.
Onoe, T., (2022). Power of a simulated experience: A survey of Japanese college students’ perspectives on multicultural coexistence. Taikansurukoto no chikara: Tabunka-kyousei ni taisuru iryoukei-daigaku no gakusei no ishikichousa kara (in Japanese). Daigaku kyouiku kenkyu journal (Journal of college education and research) 20: 15-27.View
Morita, N., & Yoshitomi, S., (2020). 2-1 Expectations and Proposals from the Healthcare Interpreter’s Perspective. 2-1 Iryou-tsuyakusha no tachiba kara kitai to teigen (in Japanese). Igakukyouiku (Journal of medical education). 51(6): 643-649. https://doi.org/10.11307/mededjapan.51.6_643View