Community Service-Learning and Cultivation of Humanity and Social Awareness in Medical Students

醫學教育除了傳授醫學知識與技巧外，更重要的是醫師素養的養成。醫學教育過程中，學生都集中在教學醫院或醫學中心，特殊的學習環境，使何醫學與社區脫節，結果是醫學成了一門技術，醫師成為一位醫療技術員，缺少了醫學中對人及社會的關懷。服務學習就是培養人性關懷、社會關懷與公民情操的一種學習方式。可以培養學生公民意識、社會責任、溝通能力、對多元性的了解、團隊合作、及主動學習精神。服務學習是一種透過體驗來學習的教育方法。學生在一個將過特別安排的學習環境下，從事與人及社區需求有關之工作，以增進學生的學習能力、自我成長、反思與互惠。服務學習的目的對學校來說，是提供學生學習與發展；對社區來說是滿足目前與將來的需求，因此服務學習必須要能同時滿足兩者的需求。服務學習的理論基礎是認知發展理論，包括Belenky等人之知曉方式理論、Baxter Magolda之智慧發展理論、Lawrence Kohlberg的道德發展理論、Kolb的經驗學習理論，及其他心理社會發展理論等。發展服務學習課程的困難在於學習環境的營造十分耗費資源，而且必須有社區的參與及人員投入；學校必須與社區建立良好的互惠關係，取得社區的信任；教師要與社區指導者有充分的溝通，社區指導者必須對學生的學習目標有足夠的了解，才能協助老師提供各種工作學習機會，並指導學生參與服務工作。評估是服務學習課程中十分重要的部份，應由學校與社區共同參與。評估的對象可分為課程及學生兩部分。課程評估包括：社區參與、狀況介紹與訓練、有意義的活動、自我反思及學習評估五部分。學生評估包括：對知識的了解與應用、對社區工作的投入、對社區問題的分析與理解、對社區的了解與關懷、思考範圍的擴大與觀念的改變、及社會公民意識的建立。

關鍵字

服務學習；醫師素養；醫學人文；社會關懷；體驗學習

並列摘要

Medical education suffered from overemphasis on technology and utilitarianism while leaving the humanistic care of patients untouched. Community service-learning is an educational strategy of learning through experience and self-reflection. Community service-learning emphasizes the balance between service and learning activities, community participation, self-reflection and reciprocity. It aims to meet both community needs and students' learning objectives. Service-learning can help foster civic attitude, social responsibility, communication skills, and respect for diversity. Moreover, it can also enhance teamwork, active learning attitude and skills, leadership ability, emotional growth, contextual learning, and knowledge application. Most important, service-learning can nurture humanity and social awareness. The notion of service-learning is developed from a number of developmental and cognitive theories, such as ”ways of knowing”, intellectual development theory, moral development theory, Kolb's experiential learning、and theories of psychological development. Although service-learning is theoretically sound and can provide a good learning experience to students, the implementation of a service-learning program is very complicated and logistically intensive. How to assess students and evaluate the program is another challenging issue. Students' assessment can be divided into following six categories: understanding and application of knowledge, participation in community work realization of community issues, understanding the community, attitude change, and social citizenship. On the other hand, program evaluation involves the following five components: community participation, orientation and training, meaningful activities, self-reflection and evaluation. Future research should focus on the development of evaluation tools with methodological vigor and applicability.

並列關鍵字

service-learning ； professionalism ； medical humanities ； social awareness ； experiential learning

參考文獻

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