Fig 1. A flowchart showing the selection of suitable participants for inclusion in this study.

To compile the derivation dataset, we collected responses from 2,640 Japanese medical students. Among the 2,640 respondents, 2,594 (98.3%) consented to participate in this study. Respondents with answers missing from their profile were excluded from the analysis (n = 127). In Japan, fifth- and sixth-year students are the equivalent years of practice, so we also excluded responses from students in years below the fifth year (n = 19). The next step was to categorize the responses according to the type of education the students received mid-COVID-19. Sixteen respondents were excluded for inappropriate responses. Of the 2,432 remaining respondents, 1,758 reported that they had experienced a face-to-face clerkship in a hospital pre-COVID-19 and then switched to an online clinical clerkship due to the COVID-19 crisis. Of the 1,758 respondents, those with missing responses regarding the content of the education to which they were exposed were excluded (n = 87). Finally, 1,671 responses were used for derivation analysis in this study.