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Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary care clinicians frequently struggle to apply the International Classification of Functioning, Disability, and Health (ICF) in clinical decision-making, despite its relevance for holistic and community-oriented care. To address this gap, we used an educational action research approach informed by participatory principles to iteratively develop an educational program that enables primary care physicians and trainees to understand and apply the ICF in real clinical contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We employed a multi-cycle educational action research design integrating both quantitative and qualitative data. Each cycle involved an educational session, structured observation, and collaborative reflection. Data sources included questionnaires assessing satisfaction and perceived understanding, open-ended written responses, and follow-up semi-structured interviews with a subset of participants selected based on their open-ended responses. Informants comprised family medicine residents, attending primary care physicians, and medical students. Program materials were refined across cycles by incorporating multimodal resources, including video-recorded patient scenarios and interviews with rehabilitation professionals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across three iterative action research cycles (2019\u20132022), five residents participated in Cycle 1, 38 learners (residents, attending physicians, and medical students) in Cycle 2, and 51 residents in Cycle 3. Lecture-only sessions improved recognition of individual ICF components but did not support understanding of how these elements relate to each other. Introducing video-based patient cases and rehabilitation-therapist interviews helped participants better appreciate the interconnections among environmental factors, activities, and participation. Qualitative feedback indicated that multimodal materials enabled learners to visualize patients\u2019 lived contexts more clearly. In the final iteration, physician-led explanations of clinical observation points made the content feel more applicable to routine clinical practice. Across sessions, 75\u201390% of respondents reported high satisfaction and greater confidence in using the ICF framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Through an iterative educational action research process, we developed a multimodal education program that supported primary care clinicians in understanding the ICF framework and recognizing its relevance to clinical practice, addressing gaps left by lecture-only training. Multimodal and contextually grounded educational materials could potentially foster the application of ICF perspectives in primary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12875-026-03299-1","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T06:22:02Z","timestamp":1774851722000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a collaborative rehabilitation education program for primary care: an educational action research approach"],"prefix":"10.1186","volume":"27","author":[{"given":"Ryohei","family":"Goto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junji","family":"Haruta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"3299_CR1","doi-asserted-by":"publisher","first-page":"2005","DOI":"10.1016\/S0140-6736(17)30873-5","volume":"389","author":"Global Burden of Disease Health Financing Collaborator Network","year":"2017","unstructured":"Global Burden of Disease Health Financing Collaborator Network. 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The Ethics Committee of the Institute of Medicine, University of Tsukuba, Japan waived the requirement for written informed consent, as the study involved minimal risk and was conducted as part of routine educational activities. Instead, an opt-out consent procedure was implemented. Detailed information about the study was publicly disclosed on the institution\u2019s website and bulletin board, and participants were provided with the opportunity to decline participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"184"}}