台灣未來醫學系教育改革方向

Future Direction of Medical Education Reform in Taiwan

何善台(Shung-Tai Ho) ； 徐建鵬(Chien-Peng Hsu) ； 王如娥(Carol Ju-O Wang) ； 謝正源(Jane-Yane Shieh) ； 陳震寰(Chen-Huan Chen) ； 林其和(Chyi-Her Lin) ； 張聖原(Sun-Yran Chang)

《Journal of Medical Education》 8卷1期 (2004/03) Pp. 18-30

https://doi.org/10.6145/jme.200403_8(1).0003

摘要

自1950年代起美國各醫學院校紛紛提出適合各校發展的醫學教育改革方案，而國內也自1990年代起以國外經驗為借鏡，開始進行一連串的改革活動。本文意旨即藉觀察國內公立醫學院與美加六所醫學院醫學教改趨勢及內容後，探討及分析台灣醫學教育未來將邁向的境界，並討論其具體可行之作法，進而提供未來各校教改之參考。經過觀察與比較，發現台灣未來醫學系修業年限可能縮短為六年制，一、二年為大學教（醫預科），三至六年級為醫學教育。課程方面，基礎與臨床相互支援的教學方式被廣為採用。教學方式除大班教學外並增加小班教學及問題導向學習的方式融入，以培養醫學生主動及終身學習的觀念。從各校教育目標中可以看出醫學倫理與醫學人文素養逐漸被動視。而國外醫學院教育則強調：讓醫學生提早接觸臨床、給予學生更多自我學習時間、著重小班教學方式、課程整合以「系統」為主軸、大量運用資訊輔助教學。在臨床技能評估時則藉重標準病人、臨床模擬情境等方式了解醫學生實際臨床診斷能力。綜合各校改革現況觀察結果，其教育目標雖可能因科技的進步、資訊的發達，而隨著時代變遷轉化，但是強調在知識、態度、技能三者的均衡發展，卻仍是不變的重點。

關鍵字

醫學教育改革(meducal education reform)

並列摘要

The purpose of this study is to examine the trends and content of reform in Taiwan’s public medical schools, and in six institutions in America and Canada. It is our hope that this study may serve as a reference point for future discussions of medical education reform.
After observation and comparison, we found that future student recruiting in Taiwan will probably move gradually toward ”screening examinations” and individual applications, in order to select the most appropriate students for medical training. The term of study will probably shrink to six years, with the first two years consisting of regular college work (the pre-med programs), and with the last four years consisting of purely medical training. In term of the curriculum, basic and clinical training will no longer be rigidly separated; instead, instructional methods, which support both, will be widely applied, so that students faced with clinical instruction will be able to make skillful use of the basic sciences. Instruction will change to open medical student discussions, combining small classes with problem-based learning. This will produce students with a active, lifelong learning orientation in the future. In the future development of medical school curriculum, we may anticipate that humanities and ethics courses will be increasingly important. Medical students must learn to interact with their patients, show interpersonal respect, and have a more humanistic background. In addition to evaluation of the knowledge acquired, there will also be more attention paid to clinical skills. Such evaluations will rely on standardized patient simulations, in order to better measure student clinical abilities. (Full text in Chinese)

並列關鍵字

medical educatoin ； reform

參考文獻

何善台(2002)。醫然記得－國防大學國防醫學院醫學系百年紀念特刊。台北:國防大學國防醫學院。

賴明亮(2002)。要成良醫，先爲病者－由要成良醫先爲君子談起。醫學教育。6(1)，1-3。

賴明亮(2002)。以問題導向學習方式實施病態生理學之教學評估。醫學教育。2(6)，147-158。

(1998)。台大醫學院小班教學指導老師研習會摘要。醫學教育。2(3)，354-360。

AAMC(1998).Report-Learning Objectives for Medical Student Education-Guidelines for Medical Schools, Medical School Objective Project.Washington DC:AAMC.