@article{10.22454/FamMed.2026.679774,
author = {Miyamoto, Yuda and Takenaka, Hiroaki and Wakabayashi, Hideki and Yamada, Ui and Sato, Juichi},
title = {Learning Family-Oriented Care in Residency: A Qualitative Portfolio Analysis},
journal = {Family Medicine},
volume = {58},
number = {6},
year = {2026},
month = {6},
pages = {419-426},
doi = {10.22454/FamMed.2026.679774},
abstract = {Background and Objectives: Family-oriented care is a core competency in family medicine, yet the educational processes through which residents develop this skill remain poorly understood. We examined how family physicians acquire family-oriented perspectives through clinical practice and reflective learning to inform curriculum development.
Methods: We conducted a qualitative descriptive study by purposively collecting residency evaluation portfolios from 15 physicians who were board-certified in family medicine in Japan between 2018 and 2023. Reflective narratives were analyzed by a five-member research team using Steps for Coding and Theorization (SCAT), referencing the “Action, Looking back on the action, Awareness of essential aspects, Creating alternative methods of action, and Trial” (ALACT) model and the Levels of Physician Involvement With Families framework.
Results: Residents’ reflections demonstrated progressive learning. They developed awareness of their emotions and communication, recognized circular perspectives, and viewed themselves as agents of change within family systems. They also linked family-oriented care with core principles of family medicine: continuity, comprehensiveness, and attention to social context. However, the depth of reflection varied. Practice descriptions emphasized empathic engagement, tailored advice, and information sharing or role negotiation, often through family conferences, whereas exploration of relational dynamics and emotional involvement was limited. Context-sensitive flexibility appeared crucial in shaping practice quality.
Conclusions: Family-oriented care acquisition involved knowledge, skills, and meaningful shifts in clinical attitudes and professional identity. Variation in reflective depth and relational insight suggests a need for structured reflective learning and targeted educational strategies to support family-oriented competencies.},
URL = {https://journals.stfm.org//familymedicine/2026/june/miyamoto-0500/},
eprint = {https://journals.stfm.org//media/finmx31p/fammed-58-419.pdf},
}