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Table 3 Resident, nurse, and medical assistant reports during semistructured interviews regarding skill proficiency, relevance of gender, sexual health discussions, and potential for SPIs in Japan

From: The cultural context of teaching and learning sexual health care examinations in Japan: a mixed methods case study assessing the use of standardized patient instructors among Japanese family physician trainees of the Shizuoka Family Medicine Program

Topic Residents in year 1 (n = 6) Residents in year 2 (n = 3) Nurses and medical assistants (n = 7)
Examination proficiency
 Have performed pelvic exams many times 3 1
 Unsure if able to find abnormalities/diagnose in pelvic exams 4 1
 Does not get to perform breast exams often 5 2
 Does not get to perform male genital exams often 6 3
 Patient(s) seemed uncomfortable during male genital exam 2 1
 Can properly feel the prostate during digital rectal exam 4 3
Gender concordance/discordance
 No issues with gender concordance 4 2 7
 No issues with gender discordance 1 1 2
 Prefers gender match 2 1 3
 Female patients tend to request female physicians 1 1 5
 Difficult to talk about sexual health when gender discordant 4 1 3
 Able to ask appropriate questions regardless of concordance 1 3
Women’s and men’s health
 Discusses sexual health and vaccinations with female patients 3 1 3
 Recommends contraception for female patients 3 2
 Recommends pap smears for female patients 3 2
 Recommends smoking cessation outpatient services for male patients 2 3
 Cannot think of any issues specific to men’s health 1 3
 Should improve on screening male patients for erectile dysfunction 2 2
SPI training
 It was a great experience 3 2
 Allows for learning that would not otherwise be possible in Japan 2 2
 Would prefer more practice either at University of Michigan or in Japan 4 1
 Would be difficult to have in Japan 2 4
 Would be difficult to find people willing to become SPIs 2 1 1
 Would like to have an SPI program in Japan 5 3 3
  1. SPI standardized patient instructor