Assessing Core Clinical Competencies Required of Medical Graduates in Taiwan

醫學生在畢業時理應具備獨立提供基本病人照護的能力，然而，他們應該學習的能力與實際學到的能力之間確實有落差。這可能是因為缺乏明確定義的學習目標、仔細規劃的課程、以及適當實施的評量所致。本研究以三階段的方式來處裡這個問題：首先訂定醫學生畢業時必須具備的核心臨床能力，接著將這些能力整合到新課程當中，最後找出評量每一種臨床能力的最適當方式。我們在2004年訂定出一套醫學生必須具備的基本臨床能力，當中包括92項臨床技巧，4項溝通技巧、與7項態度。為了讓三、四年級學生能及早熟悉未來的臨床工作，醫學系課程委員會將核心臨床技巧的教學與評量整合進新課程中相關的器官系統學組。為了找出評量每一種臨床能力的最適當方式，我們以美國畢業後醫學教育評鑑委員會出版的Toolbox of Assessment Methods以及Sottish Deans' Medical Curriculum Group出版的The Scottish Doctor所提出的評量工具為基礎來設計問卷，並且以40位臨床教師為對象進行調查。研究結果顯示模擬與模型測驗、標準化病人測驗、以及客觀結構式臨床測驗適用於評量三分之二的核心臨床技巧，這些評量方法目前亦廣用於歐美醫學院。我們認為本校所實施的新課程，以及伴隨使用上述評量工具與其他新的教學和評量方式，將有助於讓醫學生為未來的臨床工作做好準備。

關鍵字

評量方法；臨床能力；課程；醫學教育；醫學生

並列摘要

Medical students are assumed to be competent to provide basic patient care independently on graduation. However, there is a gap between what students are expected to learn and what they have actually learned. This may be due to the lack of clearly defined learning objectives, well-organized curriculum, and properly administered assessment. In an attempt to tackle this problem, we conducted a three-step study. Firstly, we identified the core clinical competencies required of medical graduates in Taiwan. Secondly, we incorporated these clinical competencies into a new medical curriculum. Finally, we identified the most appropriate assessment methods for each clinical competency. In 2004, a set of minimally required clinical competencies for medical undergraduates in Taiwan was developed, which included 92 clinical skills, four communication skills, and seven kinds of attitudes. In order to prepare 3(superscript rd) and 4(superscript th) year medical students at Kaohsiung Medical University (KMU) for later clinical work, the medical curriculum committee integrated the teaching and assessment of the core clinical skills identified previously into relevant organ-system blocks of the new curriculum. To identify appropriate assessment methods for each clinical skill, a structured questionnaire of assessment methods based on the Toolbox of Assessment Methods (Accreditation Council for Graduate Medical Education) and The Scottish Doctor (Scottish Deans' Medical Curriculum Group) was developed and distributed to 40 senior clinical faculty members at KMU. Simulations and Models, Standardized Patient Examination (SP), and Objective Structured Clinical Examination (OSCE) were suggested to be most suitable to assess two-thirds of the core clinical skills. These assessment methods are commonly used in American and European medical schools. We believe that the implementation of the new curriculum at KMU accompanied by the use of Simulations and Models, SP, OSCE, and other teaching and assessment methods will help 3(superscript rd) and 4(superscript th) year students to prepare better for clinical practice in clerkships.

並列關鍵字

assessment method ； clinical competence ； curriculum ； medical education ； medical students

國際替代計量

Assessing Core Clinical Competencies Required of Medical Graduates in Taiwan

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