接受醫學課程整合教育的醫學系三年級和學士後醫學系一年級學生焦慮和憂鬱程度之比較

A Comparison of Anxiety and Depression between Medical Students from Graduate-entry and Undergraduate-entry Medical Programs Who Were Experiencing Educational Reform

顏正芳(Cheng-Fang Yen) ； 劉克明(Keh-Min Liu) ； 賴春生(Chung-Sheng Lai) ； 黃俊雄(Chun-Hsiung Huang) ； 黃尚志(Shang-Jyh Hwang) ； 黃尹亭(In-Ting Huang)

《Journal of Medical Education》 10卷4期 (2006/12) Pp. 283-290

https://doi.org/10.6145/jme.200612_10(4).0004

摘要

高雄醫學大學醫學院是目前台灣唯一具有七年制醫學系和學士後醫學系兩種入學管道的學校，自2005年開始，高醫醫學院進行課程改革，整合基礎和臨床醫學教育課程，並強調問題導向學習。本調查性研究的目的在於：評估和比較接受醫學課程整合教育第一學期的醫學系三年級和學士後醫學系一年級醫學生之焦慮和憂鬱程度；檢驗兩系醫學生在兩次評估中焦慮和憂鬱程度是否有所變化。本研究以前後相隔一個半月時間，邀請兩系醫學生填寫兩次「曾氏心理健康量表(Zung's Anxiety and Depression Scale)」以了解其焦慮和憂鬱的程度，以焦慮和憂鬱分量表的原始總分，和依照常模轉換為百分等級後列於焦慮和憂鬱最嚴重的前百分之十（定義為具有高度焦慮／憂鬱）的人數比例，來比較兩系醫學生在接受醫學課程整合教育第一學期時焦慮和憂鬱程度的差異，以及前後兩次評估嚴重程度的變化。兩次評估結果發現：無論是原始總分或具有高度焦慮/憂鬱的人數比例，皆顯示醫三同學比後醫一同學具有較嚴重的焦慮和憂鬱程度；無論醫三或後醫一同學，前後兩次的焦慮和憂鬱分數皆未有明顯的變化；高比例第一次評估為高焦慮和高憂鬱的醫學生，在第二次評估中仍維持高程度的焦慮和憂鬱。對於醫三和後醫一醫學生接受醫學課程整合教育時焦慮和憂鬱程度的差異，研究者提出可能的解釋，並建議針對接受醫學課程整合教育的醫學生，提供他們所特別需要的輔導計畫。

關鍵字

醫學課程整合教育 ； 焦慮 ； 憂鬱 ； 壓力適應

並列摘要

Kaohsiung Medical University (KMU) is the only university undertaking the training of medical students in Taiwan that has both graduate-entry and undergraduate-entry medical programs. Since 2005, KMU has established an educational reform program for medical students, which has been characterized as integrating basic and clinical teaching and emphasizing problem-based learning. This study aimed to compare the levels of anxiety and depression between the medical students from the graduate-entry and undergraduate-entry medical programs who were experiencing educational reform. Grade 1 students from the graduate-entry program and grade 3 students from undergraduate-entry program, both in their first semester of educational reform, were recruited to complete the Zung's Anxiety and Depression Scale in order to examine their psychological well-being. This was carried out twice separated by a time interval. The results revealed that although the students were experiencing the educational reform program together, the medical students from undergraduate-entry program were more anxious and more depressed than those from graduate-entry program. The level of anxiety and depression did not change between the two assessments. Among the students who showed extreme anxiety and depression at their first assessment, 66.7% and 73% still had extreme anxiety and depression, respectively, at their second assessment. The results of this study indicate that medical students from the undergraduate-entry program displayed poorer psychological well-being than those from the graduate-entry program. The possible explanations for this difference will be discussed.
(Full text in Chinese)

並列關鍵字

anxiety ； depression ； medical curriculum innovation ； psychological adjustment

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