Yokohama City University

Deep End Placements and Social Empathy: Single Centered Before–After Study in Japan

2026.10.08

Abstract
Purpose

Medical education in socioeconomically deprived areas may help prepare future physicians to better understand the needs of these communities. However, educational outcomes associated with programmes delivered in such settings remain insufficiently studied. The aim of this study was to describe the educational programme within the deprived area in Japan and assess short-term changes in social empathy.

Methods
This single-site, uncontrolled before–after study targeted all individuals who participated in clinical placements at single clinic over a 1-year period in the Japanese deprived area, Kotobuki district, Yokohama. The programme offered structured exposure to the social context of health by combining community-based activities, clinical experience, and reflective practice. Pre- and post-placement changes were evaluated using the Social Empathy Index (SEI) immediately after placement.

Results
At 1 year, 49 individuals underwent clinical placement, and 43 consented to participate (median age, 26.0 years; female participants, 58.1%). Medical students and interns (postgraduate physicians at 1 or 2 years) constituted 55.8% of the participants (46.5% and 9.3%, respectively). The median clinical placement duration was 1 day (maximum: 20 days). The mean SEI score was 167.2 (standard deviation [SD]: 20.3) before placement, which increased to 175.1 (SD: 22.2) after placement. Sensitivity analysis restricted to participants with 1-day placement revealed similar trends.

Conclusion
This study reports a clinical placement programme in a Japanese socially deprived setting and shows that participation was associated with improvements in learners’ social empathy.

For inquiries regarding this article

Makoto Kaneko
Visiting Professor
Department of Health Data Science, Yokohama City University, Yokohama, Japan