以個案為導向社區醫學課程之評估

Evaluation of Case-oriented Community Medicine Clerkship Course

陳慶馀(Ching-Yu Chen) ； 郭斐然(Fei-Ran Guo) ； 劉文俊(Wen-Jing Liu) ； 梁繼權(Kai-Kuen Leung) ； 李宇芬(Esther Y. F. Lee)

《Journal of Medical Education》 2卷3期 (1998/09) Pp. 255-263

https://doi.org/10.6145/jme.199809_2(3).0005

摘要

家庭醫學與社區醫學為台大醫學院醫學系必修的核心課程，以小班敎學方式實施，為期三週。課程內容係以個案為中心，以家庭為導向。本研究採用結構式問卷，評估學習過程和成效。結果顯示：學生對於主要學習目標的認知較為分歧，對於將來行醫生涯的幫助看法則頗為一致，對課程各項目進行完整性的評量結果顯示接受程度的完整性尚可。在訪視前準備工作方面：「熟習量血壓及血糖等技術」、「借閱訪視個案的病歷」接受度較高。在訪視過程評估方面：以「個案目前疾病治療情況」、「個案過去病史」接受度最高。在訪視後評估方面：以「歸納出心理及社會問题」接受度較高。在討論教學評估方面：以「分析資料並發現問題」、「瞭解個案的健康照顧模式」接受度較高。在勝任程度評量方面：以「家庭或社區因素對患者的影響」接受度較高。進一步對未來行醫生涯幫助的影響評項分析，顯示所有對課程整體評價的各個項目皆有統計學上的差異性。其中以「學生與學生之間討論互動的過程」、「對學習重點的掌握」、「課堂中疑問的解答」三項最相關。對整體學習收穫滿意度的複迴歸分析，發現以「擬定解決問題方案」、「個案遵醫囑性」、「熟習量血壓血糖技術」三項解釋量達60.4%。

關鍵字

家庭醫學 ； 社區醫學 ； 個案導向學習 ； 家庭訪視

並列摘要

Since 1993,family medicine and community medicine has been a part of the medical curriculum at National Taiwan University Medical College. The course is taught to fifth year medical students in small groups. Each group has about 12 students in 3 week rotations. The students are assigned to the Kin-Sun Community Medicine Training Center at Taipei County. In the 1996 school year the course was designed as a case-centered family-oriented community practice course. The study used a questionnaire designed to evaluate student performance and satisfaction in order to further improve the training program. Results showed variations in opinion on the main course objectives but similar opinions on impact on future medical practice. Mean scores ranged between 5.33 and 7.38 out a full score of 10.The overall evaluation of all related course items was mild to moderate acceptable. Items in the learning process category with a mean score over 7.0 were ”review past history of case” ”review current situation of case” ”individual compliance” and ”evaluation of the impact of family and community on health”. The only item with mean score below 6.0 was ”ask the nurse or the doctor information” in the category of previsit preparation. A significant variation between satisfaction with the whole course and help in student's future medical practice was revealed. The whole course satisfaction was able to be explained by three items, i.e. ”draft problem-solving plan” ”individual compliance” and ”familiar with blood pressure and blood sugar check technique”, up to 60.4% in multiple regression. The study highlighted the importance of community medicine teaching and furthermore efforts to improve in future. (Full Text in Chinese)

並列關鍵字

family medicine ； community medicine ； case-oriented learning ； home visit