利用小組教學方式實施醫學倫理教學

The Teaching of Medical Ethics Using a Small-Group Tutorial Method

李明濱(Ming-Been Lee) ； 李宇宙(Yue-Joe Lee) ； 林信男(Hsin-Nan Lin) ； 謝博生(Bor-Shen Hsieh) ； 陳恒順(Heng-Shuen Chen)

《Journal of Medical Education》 1卷2期 (1997/06) Pp. 63-77

https://doi.org/10.6145/jme.199706_1(2).0008

摘要

本研究之目的在於探討利用啓發式小組敎學技巧實施醫學倫理學敎學的相關問題，及其短期成效評估；本研究以台大醫學院醫學系修習醫學倫理學課程之133位六年級學生為對象，學生分為六組，分六梯次進行，每梯次一組（約20-22人），修習時間每組六週，每週四小時。討論過程由同學主持，以問题為基礎及個案為中心，由2-4位跨科之導師指導，進行討論。在課程結束時，以自塡問卷評量方式由學生評估學習成效、團體氣氛及團體互動。經由本研究結果發現，討論式小組敎學適用於醫學倫理學之敎學；就整體評量而言，92％的學生認為醫學倫理教育對行醫生涯很重要，75.2％的學生認為醫學倫理學課程安排在五、六年級臨床見習時修習最為理想。大多數同學對課程內容安排(69.1％)及進行方式(56.7％)均表滿意；而多數學生覺得倫理知識(70.8％)有明顯的收穫，而對倫理思考能力(72.6％)亦有明顯的幫助。討論過程中團體互動與氣氛亦相當良好，大多數學生都非常能表達個人觀點、面對面解決問题而少有明顯之負面情緒或衝突表現；同學也能積極透過整理、分析資料，充分表達自己及經驗分享，而獲得知識與經驗之學習。有42位學生接受筆試測驗，其測驗結果提示倫理原則較易透過敎學而學習，但將倫理原則運用於特殊情境之推理，則仍有待在實習階段或畢業後之繼續敎育再持續加強。本研究並針對課程成績評定及同學對課程之建議進行分析，以做為課程改善之重要依據；同時經由本研究亦達成醫學倫理學之師資培養。

關鍵字

醫學倫理教育 ； 成效評估 ； 小組教學

並列摘要

The present study evaluated students' understanding of medical ethics and opinions about course content following completion of a course in medical ethics taught using a small-group tutorial method. The participants were 133 sixth-year students at the National Taiwan University College of Medicine in the 1995-1996 academic year. The course was conducted as weekly four-hour discussions for six consecutive weeks. The students were divided into six groups with approximately 20-22 members in each group. Each two-hour session was facilitated and coordinated by two senior psychiatric faculty members and one or two physicians in other specialties or allied professionals. During each session, four students in each group were assigned a special topic which was described on prepared handouts. Those students were then asked to give a brief presentation on the topic. One of the students was designated as the group leader. Following the presentation, all of the students were asked to give problem-based and case-centered examples as triggers for open discussion. A series of reliable questionnaires were developed to assess the teaching effectiveness, and to measure the group interaction and group climate. Post-course questionnaire surveys revealed that 92% of the students considered ethics education to be important for professional development, and 75.2% believed that ethics courses should be taught during clinical training (years 5 and 6). The majority of students were very satisfied with both the course content (69.1%) and the teaching format (56.7%). Regarding the effectiveness of the course, survey results indicated that 70.8% of the students reported to have significant gains on general knowledge of ethics and 72.6% in the ability to perform ethical reasoning. The results of students' ratings on group interaction showed that the students had learned how to express themselves, share personal achievement with others, and could actively dedicate themselves to self-directed study through the process of information collecting and analyzing. The group climate was generally rated by the students as highly cohesive and interactive without obvious emergence of avoidance, conflict or negative emotions.
In conclusion, the present study demonstrated that students were satisfied with the teaching methods and course content. They also believed that a significant learning process had occurred through use of the small-group tutorial method. The findings of the present study provide valuable information and empirical data about outcome evaluation in medical ethics training using a small-group tutorial method and may be useful in the training of faculty in this field.

並列關鍵字

medical ethics education ； small-group tutorial ； outcome evaluation