{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:19:43Z","timestamp":1772165983771,"version":"3.50.1"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The excessive sub-divided or concrete pre-determined objectives found in the technological approach in contemporary medical education curricula may hinder the students\u2019 spontaneous learning about diverse needs and values in care. However, medical professionals must learn the diversity for care or a variety of social factors of the patients influencing decision making in daily practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We introduced a new method of curriculum development called the Rashomon approach. For testing the Rashomon approach, educational activities to teach the diversity in primary care were developed in four modules: 1) explication of the competency without specifying sub-objectives; 2) dialogue among multiple professional students; 3) visits and interviews of the patients; 4) dialogue with teachers\u2019 improvisation. The students\u2019 outcomes and responses were quantitatively and qualitatively analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 135 medical students joined this study in 2017. The descriptive data suggested that the key concepts of diversity in primary care were fully recognized and that the pre-determined general goals were achieved. Scores on the understanding of social factors in medicine, respect for other professionals, professional identity, and satisfaction with the course were very high.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Instead of the technological approach, the Rashomon approach, in which only a general goal guides educational activities was used in this research. Improvisation and dialogue fit the approach and were potentially effective activities to learn the multifaceted practice of medicine. In an era of competency-based education, the Rashomon approach could be a very useful framework in primary care education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-021-02570-6","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T08:03:43Z","timestamp":1614845023000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["What is the impact of the Rashomon approach in primary care education?: An educational case report of implementing dialogue and improvisation into medical education"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2734-9045","authenticated-orcid":false,"given":"Akiteru","family":"Takamura","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4740-2723","authenticated-orcid":false,"given":"Rintaro","family":"Imafuku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"key":"2570_CR1","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1097\/00001888-200205000-00003","volume":"5","author":"C Carraccio","year":"2002","unstructured":"Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting paradigms: from Flexner to competencies. Acad Med. 2002;5:361\u20137. https:\/\/doi.org\/10.1097\/00001888-200205000-00003 PMID 12010689.","journal-title":"Acad Med"},{"key":"2570_CR2","doi-asserted-by":"publisher","first-page":"646","DOI":"10.3109\/0142159X.2010.500703","volume":"8","author":"P Harris","year":"2010","unstructured":"Harris P, Snell L, Talbot M, Harden RM. Competency-based medical education: implications for undergraduate programs. Med Teach. 2010;8:646\u201350. https:\/\/doi.org\/10.3109\/0142159X.2010.500703 PMID 20662575.","journal-title":"Med Teach"},{"key":"2570_CR3","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1111\/medu.12831","volume":"11","author":"RE Hawkins","year":"2015","unstructured":"Hawkins RE, Welcher CM, Holmboe ES, Kirk LM, Norcini JJ, Simons KB, et al. Implementation of competency-based medical education: are we addressing the concerns and challenges? Med Educ. 2015;11:1086\u2013102. https:\/\/doi.org\/10.1111\/medu.12831 PMID 26494062.","journal-title":"Med Educ"},{"key":"2570_CR4","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1080\/01421590701746983","volume":"7","author":"JR Frank","year":"2007","unstructured":"Frank JR, Danoff D. The CanMEDS initiative: implementing an outcomes-based framework of physician competencies. Med Teach. 2007;7:642\u20137. https:\/\/doi.org\/10.1080\/01421590701746983 PMID 18236250.","journal-title":"Med Teach."},{"key":"2570_CR5","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1080\/01421590220120713","volume":"2","author":"JG Simpson","year":"2002","unstructured":"Simpson JG, Furnace J, Crosby J, Cumming AD, Evans PA, Friedman Ben David M, et al. The Scottish doctor--learning outcomes for the medical undergraduate in Scotland: a foundation for competent and reflective practitioners. Med Teach. 2002;2:136\u201343. https:\/\/doi.org\/10.1080\/01421590220120713 PMID 12098432.","journal-title":"Med Teach"},{"key":"2570_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4300\/JGME-D-13-00445.1","volume":"1","author":"G Norman","year":"2014","unstructured":"Norman G, Norcini J, Bordage G. Competency-based education: milestones or millstones? J Grad Med Educ. 2014;1:1\u20136. https:\/\/doi.org\/10.4300\/JGME-D-13-00445.1 PMID 24701301.","journal-title":"J Grad Med Educ"},{"key":"2570_CR7","doi-asserted-by":"publisher","first-page":"638","DOI":"10.3109\/0142159X.2010.501190","volume":"8","author":"JR Frank","year":"2010","unstructured":"Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice. Med Teach. 2010;8:638\u201345. https:\/\/doi.org\/10.3109\/0142159X.2010.501190 PMID 20662574.","journal-title":"Med Teach."},{"key":"2570_CR8","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/1-4020-4451-8_7","volume-title":"The Roots of Educational Change","author":"M Skilbeck","year":"2005","unstructured":"Skilbeck M. School-Based Curriculum Development. In: Lieberman A, editor. The Roots of Educational Change. Dordrecht: Springer; 2005. p. 109\u201332. https:\/\/doi.org\/10.1007\/1-4020-4451-8_7."},{"key":"2570_CR9","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/BF00596229","volume":"1","author":"CPM Van der Vleuten","year":"1996","unstructured":"Van der Vleuten CPM. The assessment of professional competence: developments, research and practical implications. Adv Health Sci Educ. 1996;1:41\u201367. https:\/\/doi.org\/10.1007\/BF00596229 PMID 24178994.","journal-title":"Adv Health Sci Educ"},{"key":"2570_CR10","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/j.1365-2929.2005.02094.x","volume":"3","author":"CPM Van der Vleuten","year":"2005","unstructured":"Van der Vleuten CPM, Schuwirth LWT. Assessing professional competence: from methods to programmes. Med Educ. 2005;3:309\u201317.","journal-title":"Med Educ"},{"key":"2570_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1365-2929.2005.02094.x","volume":"20","author":"CP van der Vleuten","year":"2014","unstructured":"van der Vleuten CP, Schuwirth LW, Driessen EW, Govaerts MJ, Heeneman S. 12 tips for programmatic assessment. Med Teach. 2014;20:1\u20136. https:\/\/doi.org\/10.1111\/j.1365-2929.2005.02094.x PMID 15733167.","journal-title":"Med Teach."},{"issue":"5","key":"2570_CR12","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1097\/ACM.0000000000000571","volume":"90","author":"M Westerhaus","year":"2015","unstructured":"Westerhaus M, Finnegan A, Haidar M, Kleinman A, Mukherjee J, Farmer P. The necessity of social medicine in medical education. Acad Med. 2015;90(5):565\u20138. https:\/\/doi.org\/10.1097\/ACM.0000000000000571.","journal-title":"Acad Med"},{"key":"2570_CR13","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1136\/jech.2009.093914","volume":"8","author":"K Rasanathan","year":"2011","unstructured":"Rasanathan K, Montesinos EV, Matheson D, Etienne C, Evans T. Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health. J Epidemiol Community Health. 2011;8:656\u201360. https:\/\/doi.org\/10.1136\/jech.2009.093914 PMID 19933684.","journal-title":"J Epidemiol Community Health"},{"key":"2570_CR14","volume-title":"Behavioral and Social Science Foundations for Future Physicians","author":"Association of American Medical Colleges","year":"2011","unstructured":"Association of American Medical Colleges. Behavioral and Social Science Foundations for Future Physicians. Washington, DC: Association of American Medical Colleges; 2011. https:\/\/www.aamc.org\/download\/271020\/data\/behavioralandsocialsciencefoundationsforfuturephysicians.pdf. Updated August 19, 2109. Assessed November 24"},{"key":"2570_CR15","doi-asserted-by":"publisher","first-page":"243","DOI":"10.3928\/01484834-20170323-11","volume":"4","author":"DS Cantey","year":"2017","unstructured":"Cantey DS, Randolph SD, Molloy MA, Carter B, Cary MP. Student-developed simulations: enhancing cultural awareness and understanding social determinants of health. J Nurs Educ. 2017;4:243\u20136. https:\/\/doi.org\/10.3928\/01484834-20170323-11 PMID 28383751.","journal-title":"J Nurs Educ"},{"key":"2570_CR16","doi-asserted-by":"publisher","first-page":"673","DOI":"10.3109\/0142159X.2011.590253","volume":"8","author":"S Leinster","year":"2011","unstructured":"Leinster S. Evaluation and assessment of social accountability in medical schools. Med Teach. 2011;8:673\u20136. https:\/\/doi.org\/10.3109\/0142159X.2011.590253 PMID 21774656.","journal-title":"Med Teach."},{"key":"2570_CR17","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1097\/ACM.0000000000001689","volume":"1","author":"M Sharma","year":"2018","unstructured":"Sharma M, Pinto AD, Kumagai AK. Teaching the social determinants of health: a path to equity or a road to nowhere? Acad Med. 2018;1:25\u201330. https:\/\/doi.org\/10.1097\/ACM.0000000000001689 PMID 28445214.","journal-title":"Acad Med"},{"key":"2570_CR18","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3946\/kjme.2018.92","volume":"3","author":"K Kim","year":"2018","unstructured":"Kim K, Lee YM. Understanding uncertainty in medicine: concepts and implications in medical education. Korean J Med Educ. 2018;3:181\u20138. https:\/\/doi.org\/10.3946\/kjme.2018.92 PMID 30180505.","journal-title":"Korean J Med Educ"},{"key":"2570_CR19","doi-asserted-by":"publisher","unstructured":"Fox RC. Medical Uncertainty Revisited. Chapter 26. In: Handbook of social studies in health and medicine: SAGE Publications Ltd; 2000. p. 409\u201325. https:\/\/doi.org\/10.4135\/9781848608412.n26.","DOI":"10.4135\/9781848608412.n26"},{"key":"2570_CR20","doi-asserted-by":"publisher","first-page":"28","DOI":"10.29060\/TAPS.2017-2-3\/LE1045","volume":"3","author":"PK Rajesh","year":"2017","unstructured":"Rajesh PK, Bharathi S. The Kurusowa approach to teaching learning. Asia Pacific Scholar. 2017;3:28. https:\/\/doi.org\/10.29060\/TAPS.2017-2-3\/LE1045.","journal-title":"Asia Pacific Scholar"},{"key":"2570_CR21","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1111\/j.1741-5446.2000.00321.x","volume":"3","author":"DC Phillips","year":"2000","unstructured":"Phillips DC. Interpreting the seventies, or, Rashomon meets educational theory. Educ Theory. 2000;3:321\u201338.","journal-title":"Educ Theory"},{"issue":"2","key":"2570_CR22","first-page":"205","volume":"32","author":"MP Cotler","year":"2013","unstructured":"Cotler MP. Bioethics consultation: the Rashomon effect. Med Law. 2013;32(2):205\u201312.","journal-title":"Med Law"},{"key":"2570_CR23","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1097\/00001888-199411000-00001","volume":"11","author":"FW Hafferty","year":"1994","unstructured":"Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med. 1994;11:861\u201371. https:\/\/doi.org\/10.1097\/00001888-199411000-00001 PMID 7945681.","journal-title":"Acad Med"},{"key":"2570_CR24","volume-title":"The professor of education: an assessment of conditions","author":"JM Atkin","year":"1975","unstructured":"Atkin JM. A new evaluator perspective for professors of education. In: Bagley A, editor. The professor of education: an assessment of conditions. Minneapolis: Society of Professors of education, College of Education, University of Minnesota; 1975. Retrieved from https:\/\/societyofprofessorsofeducation.files.wordpress.com\/2013\/07\/profed_atkins.pdf. Accessed November 25, 2019."},{"key":"2570_CR25","first-page":"23","volume-title":"National Research Council","author":"JM Atkin","year":"2001","unstructured":"Atkin JM, Black PJ, Coffey JE, Assessment in the classroom. Classroom Assessment and the National Science Education Standards. In: National Research Council. Washington DC: National Acedemiy Press; 2001. p. 23\u201358."},{"key":"2570_CR26","first-page":"49","volume-title":"Karikyuramukaihatsu no kadai","author":"Ministry of Education","year":"1975","unstructured":"Ministry of Education. Karikyuramukaihatsu no kadai. Tokyo: Ministry of Finance Press; 1975. p. 49\u201355. (Japanese)"},{"key":"2570_CR27","doi-asserted-by":"publisher","first-page":"40","DOI":"10.11307\/mededjapan1970.12.40","volume":"12","author":"K Nakayama","year":"1981","unstructured":"Nakayama K. A Fundamental Consideration on the Curriculum Development in Medical Schools. Med Educ. 1981;12:40\u20134. https:\/\/doi.org\/10.11307\/mededjapan1970.12.40 (Japanese).","journal-title":"Med Educ"},{"key":"2570_CR28","doi-asserted-by":"publisher","first-page":"54","DOI":"10.29060\/TAPS.2018-3-2\/LE2032","volume":"2","author":"J Tanaka","year":"2018","unstructured":"Tanaka J. Rashomon approach as educational method. Asia Pacific Scholar. 2018;2:54. https:\/\/doi.org\/10.29060\/TAPS.2018-3-2\/LE2032.","journal-title":"Asia Pacific Scholar"},{"key":"2570_CR29","unstructured":"Model Core Curriculum for Medical Education in Japan. http:\/\/www.mext.go.jp\/component\/a_menu\/education\/detail\/__icsFiles\/afieldfile\/2018\/06\/18\/1325989_30.pdf. Updated in 2016. Accessed 9 August 2018."},{"issue":"Suppl 1","key":"2570_CR30","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1111\/ijn.12018","volume":"19","author":"M Cleary","year":"2013","unstructured":"Cleary M, Happell B, Lau ST, Mackey S. Student feedback on teaching: some issues for consideration for nurse educators. Int J Nurs Pract. 2013;19(Suppl 1):62\u20136. https:\/\/doi.org\/10.1111\/ijn.12018 PMID 23425381.","journal-title":"Int J Nurs Pract"},{"key":"2570_CR31","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1097\/ACM.0000000000000103","volume":"2","author":"S Goldfarb","year":"2014","unstructured":"Goldfarb S, Morrison G. Continuous curricular feedback: a formative evaluation approach to curricular improvement. Acad Med. 2014;2:264\u20139. https:\/\/doi.org\/10.1097\/ACM.0000000000000103 PMID 24362392.","journal-title":"Acad Med"},{"key":"2570_CR32","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"2","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;2:77\u2013101. https:\/\/doi.org\/10.1191\/1478088706qp063oa.","journal-title":"Qual Res Psychol"},{"key":"2570_CR33","doi-asserted-by":"publisher","first-page":"29","DOI":"10.15256\/joc.2015.5.51","volume":"5","author":"C Sinnott","year":"2015","unstructured":"Sinnott C, Bradley CP. Multimorbidity or polypharmacy: two sides of the same coin? J Comorb. 2015;5:29\u201331. https:\/\/doi.org\/10.15256\/joc.2015.5.51 PMID 29090158.","journal-title":"J Comorb"},{"key":"2570_CR34","doi-asserted-by":"publisher","DOI":"10.5041\/RMMJ.10085","volume":"3","author":"AK Agarwal","year":"2012","unstructured":"Agarwal AK, Murinson BB. New dimensions in patient-physician interaction: values, autonomy, and medical information in the patient-centered clinical encounter. Rambam Maimonides Med J. 2012;3:e0017. https:\/\/doi.org\/10.5041\/RMMJ.10085 PMID 23908841.","journal-title":"Rambam Maimonides Med J"},{"key":"2570_CR35","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1080\/17564905.2013.10820070","volume":"1\u20132","author":"N Redfern","year":"2013","unstructured":"Redfern N. Film style and narration in Rashomon. J Japanese Korean Cinema. 2013;1\u20132:21\u201336. https:\/\/doi.org\/10.1080\/17564905.2013.10820070.","journal-title":"J Japanese Korean Cinema"},{"key":"2570_CR36","doi-asserted-by":"publisher","first-page":"20224","DOI":"10.3402\/rlt.v21i3.20224","volume":"21","author":"D Persico","year":"2013","unstructured":"Persico D, Pozzi F, Anastopoulou S, Conole G, Craft B, Dimitriadis Y, et al. Learning design Rashomon I - supporting the design of one lesson through different approaches. Research in Learning Technology. Special Suppl Art Sci Learn Design. 2013;21:20224. https:\/\/doi.org\/10.3402\/rlt.v21i3.20224.","journal-title":"Special Suppl Art Sci Learn Design"},{"key":"2570_CR37","doi-asserted-by":"publisher","first-page":"20057","DOI":"10.3402\/rlt.v21i3.20057","volume":"21","author":"LP Prieto","year":"2013","unstructured":"Prieto LP, Dimitriadis Y, Craft B, Michael D, Emin V, Katsamani M, et al. Learning design Rashomon II - exploring one lesson through multiple tools. Res Learn Technol. 2013;21:20057. https:\/\/doi.org\/10.3402\/rlt.v21i3.20057.","journal-title":"Res Learn Technol"},{"key":"2570_CR38","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1111\/j.1365-2923.2012.04310.x","volume":"9","author":"KW Eva","year":"2012","unstructured":"Eva KW, Hodges BD. Scylla or Charybdis? Can we navigate between objectification and judgement in assessment? Med Educ. 2012;9:914\u20139. https:\/\/doi.org\/10.1111\/j.1365-2923.2012.04310.x PMID 22891912.","journal-title":"Med Educ"},{"key":"2570_CR39","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1111\/j.1365-2923.2012.04326.x","volume":"9","author":"KW Eva","year":"2012","unstructured":"Eva KW. Dialogue in medical education: enabling the academic voyeur that lurks inside us all. Med Educ. 2012;9:826\u20137. https:\/\/doi.org\/10.1111\/j.1365-2923.2012.04326.x PMID 22891901.","journal-title":"Med Educ"},{"key":"2570_CR40","unstructured":"Bohm D, factor D, Garrett P. dialogue\u2013a proposal. http:\/\/www.david-bohm.net\/dialogue\/dialogue_proposal.html. Updated December 31, 2018. Accessed 9 August 2018."},{"key":"2570_CR41","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1177\/004912402237292","volume":"2","author":"WD Roth","year":"2002","unstructured":"Roth WD, Mehta JD. The Rashomon effect combining positivist and Interpretivist approaches in the analysis of contested events. Sociol Methods Res. 2002;2:131\u201373. https:\/\/doi.org\/10.1177\/004912402237292.","journal-title":"Sociol Methods Res"},{"key":"2570_CR42","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1207\/s15516709cog1202_4","volume":"2","author":"J Sweller","year":"1988","unstructured":"Sweller J. Cognitive load during problem solving: effects on learning. Cogn Sci. 1988;2:257\u201385. https:\/\/doi.org\/10.1207\/s15516709cog1202_4.","journal-title":"Cogn Sci"},{"key":"2570_CR43","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511815355","volume-title":"Situated learning: legitimate peripheral participation","author":"J Lave","year":"1991","unstructured":"Lave J, Wenger E. Situated learning: legitimate peripheral participation. Cambridge: Cambridge University Press; 1991."},{"key":"2570_CR44","first-page":"517","volume":"8","author":"N Whitman","year":"1993","unstructured":"Whitman N. A review of constructivism: understanding and using a relatively new theory. Fam Med. 1993;8:517\u201321 PMID 8405799.","journal-title":"Fam Med"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-021-02570-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12909-021-02570-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-021-02570-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T08:04:10Z","timestamp":1614845050000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmededuc.biomedcentral.com\/articles\/10.1186\/s12909-021-02570-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,4]]},"references-count":44,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2570"],"URL":"https:\/\/doi.org\/10.1186\/s12909-021-02570-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-58058\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-58058\/v1","asserted-by":"object"}]},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,4]]},"assertion":[{"value":"12 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Kanazawa Medical University Review Board. IRB number is I-090. The participants filled out and signed a consent form for participating in the study, and permitting publication of the relevant data in the form of an article.","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 that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"143"}}