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Introduction: The Medical Emotion Scale has been translated into Japanese (J-MES) and validated for cross-cultural emotion research in medical education. However, its applicability for extracting Japanese cultural aspects of medical students' emotions has not been examined. This study aimed to explore the underlying latent constructs related to culture in the J-MES by conducting factor analyses.

Methods: In total, 41 medical students enrolled at a Japanese university participated in this study. The students completed the J-MES before, during, and after a computer-based clinical reasoning activity. Exploratory factor analysis (EFA) was conducted to examine the factor structure of the scale. Factor extraction was based on a scree plot investigation.

Results: The EFA for emotions before the task pointed to a four-factor structure explaining 56.70% of the total variance. The first factor accounted for 26.44% of the variance. Based on the seven items with the highest loadings on this factor (e.g., happiness), we interpreted the first factor as representing a positive valence dimension. The second factor explained 13.78% of the variance with four items of highest loadings (e.g., anger), which was interpreted as representing negative emotions toward the learning activity. The third factor explained 10.48% of the variance with three items (e.g., shame), interpreted as negative emotions related to self-performance. The fourth factor explained 6.00% of the variance with three items (e.g., confusion), which was interpreted as representing anxiety-related emotions.

Discussion: Negative emotions included multiple factors such as learning activity- and self-performance-related emotions, which could be associated with Japan's interdependent culture.

Supplementary information: The online version contains supplementary material available at 10.1007/s40670-025-02296-w.