優良醫學教師特質量表編製暨差異研究

Development of Quality Scale for Outstanding Medical Educators and Analysis of Differences in Background Variables

朱紹盈(Shao-Yin Chu) ； 黃博聖(Po-Sheng Huang) ； 張景媛(Ching-Yuan Chang) ； 易烈瑜(Lieh-Yu Yi)

《教育心理學報》 51卷4期 (2020/06) Pp. 639-661

https://doi.org/10.6251/BEP.202006_51(4).0006

摘要

有鑑於臺灣醫學教育領域缺乏有效評估優良教師教學特質的工具。故此，本研究主要目的在編製一份醫學教師特質量表，並考驗其信、效度，以做為後續醫學教育評估優良教學教師的參考依據。本研究共編製了36道試題，分別包含教學計劃、教學活動、教學熱忱、學習輔導、教師支持、多元評量六大教學面向，請162位醫學院學生針對其醫學教師的特質，進行知覺重要性評量。藉由探索性因素分析與鑑別力分析之結果，最後共保留了26道作為正式量表試題。於信、效度的證據上，醫學教師特質量表之內部一致性係數介於 .79 ～ .89之間，同時二階驗證性因素分析亦具有可接受之整體適配度與內在品質，顯示本量表具有適當之信度與效度。此外，研究結果亦發現，（1）臺灣醫學生所知覺重要之教師教學特質，首要為教學熱忱、教學活動，其次為教學計劃、多元評量，之後才是學習輔導、教師支持。（2）不同性別醫學生對於各向度教學特質的知覺重要性無顯著差異。（3）高年級或繁星推薦等入學管道的醫學生，對於教師支持向度的知覺重要性，會顯著高於低年級或個人申請入學之醫學生。（4）未重考之醫學生對於教師的教學活動、教學熱忱、教師支持的知覺重要性，會顯著高於重考者。最後，針對研究結果之意涵進行討論。

關鍵字

教學 ； 優良醫學教學教師 ； 醫學教育

並列摘要

Training by competent doctors is essential in medical education. Being taught by an outstanding medical educator not only provides medical students with access to clinical knowledge but also presents them with a role model for caring about patients and cooperating with other professionals, thus in turn facilitating the development of medical students into excellent doctors. Therefore, identifying the teaching qualities an outstanding medical educator should possess is integral to establishing an assessment criteria for evaluating outstanding teachers. A good medical educator can be evaluated as a physician, human, and teacher. As a physician, a good medical educator should have sufficient medical and clinical knowledge, enthusiasm for medicine, skills for treating patients, ability to maintain positive doctor-patient relationships, and academic research abilities, among other qualities. As a human, a good medical educator should prioritize the welfare of human beings and should be friendly, approachable, honest, respectful, humorous, empathetic, communicative, and reflective. As a teacher, a good medical educator should establish a learner-friendly teaching environment, show enthusiasm toward teaching, have good teaching skills, encourage students to actively participate in the learning process, carefully observe students and identify individual differences between them, have good relations with students, respond to students promptly, stimulate students' interest in learning, monitor students' progress, and make good use of constructive assessment and feedback. Kilukawa et al, (2013) adopted a focus group method to interview Japanese physicians on their perception of the characteristics of a good clinical educator. Of the 30 themes identified in the responses, 24 were categorized under the teacher perspective, including providing students with sufficient support, opportunities for thinking, feedback, indicators of required progress, and practice opportunities. The other six were categorized under the physician perspective, including enthusiasm for patient care, patience with patients, and emphasis on pathological reasoning. However, characteristics pertaining to the human perspective were not found. Studies have indicated that medical students in Eastern and Western countries may have varying perceptions of a good medical educator's characteristics. Medical students in Western countries emphasize on the physician and human characteristics of medical educators; however, medical students in Eastern countries are more likely to emphasize on the teaching practice of medical educators. Cultural differences heavily influence medical students' perception of the qualities medical educators should possess; hence, identifying the qualities recommended by different cultures is critical. In Taiwan, the lack of effective quantitative tools for assessing medical educators' qualities presents an obstacle. Therefore, development of the said tools is warranted. This study developed a quality scale for outstanding medical educators to serve as reference for medical education quality assessment. The reliability and validity of the scale were verified. The scale also investigated the possible difference in how medical students from different backgrounds perceive the qualities of good teachers. On the basis of the literature review on good teacher qualities in the general and medical domain, the authors identified six teaching dimensions to use as measuring items. The original scale comprised 36 items, encompassing six major teaching dimensions, namely teaching planning (five items, including curriculum planning and course organization), teaching activities (eight items, including learning activities and resource development), teaching passion (six items), learning guidance (six items, including student coaching, mentoring, and providing constructive feedback), teacher support (five items, including teaching support and professional development), and multiple assessment (six items). In total, 162 medical students (79 men, 82 women, and 1 gender unknown) in Eastern Taiwan were invited to rate the perceived importance of the six items in reference to their teachers' qualities. According to the results of the exploratory factor analysis and discrimination analysis [indicators of corrected item-total correlation and critical ratio (CR)], the authors removed the items in which factor loading and corrected item-total correlation were ＜.40 and those with a CR of ＜3. Finally, 26 items were retained for the final scale. Five, six, four, five, three, and three items were assigned to each teaching dimension, respectively. Furthermore, reliability testing demonstrated that the internal consistency coefficients of teaching planning, teaching activities, teaching enthusiasm, learning guidance, teacher support, and multiple assessment subscales were .877, .887, .853, .892, .818, and .794, respectively. During validity testing, a second-order confirmatory factor analysis revealed that the scale exhibited acceptable statistical fit and internal quality. This indicated the proposed scale's validity and reliability. Moreover, the study results suggested the following: (1) Medical students perceived teaching passion and teaching activities as the most important dimensions, followed by teaching planning, multiple assessment, learning guidance, and teacher support, F(5, 805) = 31.98, p ＜ .05, ɳ^2 = .166. The authors speculated that the differences in perceived importance between different dimensions could be attributed to the learning environment and expectations of medical educators. Medical students in Taiwan believe that it is difficult for educators to provide additional assistance to facilitate students' learning and guidance when they have to be a teacher and a clinician simultaneously. Therefore, medical students perceived learning guidance and teacher support as less important. Instead, they placed more importance on educators providing good teaching quality in their teaching process. (2) Male and female medical students differed nonsignificantly in terms of their perceived importance of the six teaching dimensions, ts (159) ＜ 1.12, ps ＞ .05. (3) Medical students who were admitted through the Star Plan [t (160) = 2.45, p ＜ .05] and those in higher grade levels [F(3, 158) = 3.00, p ＜ .05, ɳ^2 = .054] perceived teacher support to be significantly more important compared with medical students who were admitted through personal applications or those in lower grade levels. The authors speculated that the difference between grades could be attributed to the medical curriculum planning. Senior medical students acquire more medical knowledge and require more practical clinical experience. Hence, teacher support is more critical to the learning process of higher grade students than that of lower grade students. Moreover, medical students who are enrolled through the Star Plan have a clear path for their medical career. They are more eager to obtain resources provided by educators and gain advanced medical knowledge and clinical technology than those enrolled through personal applications. Therefore, teacher support is essential for them. (4) Medical students who did not retake the entrance examination perceived teaching activities, teaching passion, and teacher support to be significantly more important compared with those who retook the entrance examination, ts (160) = 2.78, 2.54, and 2.55, respectively; all ps ＜ .05. The authors speculated that previous unsuccessful experience of re-examination could be responsible for this. These students may attribute their learning success or failure in medical courses to their own ability or lack of effort instead of viewing it as a reflection of the educators' qualities. Therefore, students who retook the entrance examination placed less emphasis on teaching activities, teaching passion, and teacher support. Finally, the implications and limitations of the study results were discussed.

並列關鍵字

teaching ； outstanding medical educator ； medical education

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