山本 祐

PURPOSE: Patient care ownership (PCO) is a critical component of medical professionalism. Despite the mounting global recognition of its importance, there is little knowledge regarding what kind of learning environment is associated with greater PCO among medical residents. Therefore, the aim of the study was to examine the association between hospital type and PCO among residents throughout Japan. METHODS: This cross-sectional study was conducted from 17 January to 31 March 2024, as part of PCO research projects. Participants were residents who took the General Medicine In-Training Examination. We used the Japanese version of the PCO Scale, comprising the four subscales of assertiveness, sense of ownership, diligence and being the 'go-to' person, and treated hospital type (community hospital [reference category], university hospital or university branch hospital) as an explanatory variable. RESULTS: Data were analysed for 1836 residents. After adjustment for possible confounders, university hospitals were associated with lower PCO than community hospitals (adjusted mean difference -0.19, 95% confidence intervals -0.36 to -0.03). Among PCO subscales, university hospitals were significantly associated with lower assertiveness and diligence. Conversely, there were no statistically significant differences between residents in university branch hospitals and community hospitals, either in overall PCO or subscale scores. CONCLUSIONS: This study identified differences in residents' PCO between university and community hospitals. Resident autonomy support and/or collaborative educational strategies between these hospitals would aid in cultivating PCO. Given recent reports advocating the importance of PCO, these findings may provide international medical educators and policymakers with in-depth insights into PCO education strategies.