批判思維融入臺灣醫學生醫學人文教育：醫病關係多元文化感知量表之編製與驗證

Critical Thinking Integrating to Medical Humanity: Development and Validation of a Multicultural Perception Scale of Physician-Patient Relationship in Medical Professionalism for Medical Students in Taiwan

林育志(Yu-Chih Lin) ； 何文譽(Wen-Yu Ho) ； 陳偉權(Wei-Chuan Chen)

《科學教育學刊》 30卷S期 (2022/12) Pp. 425-447

https://doi.org/10.6173/CJSE.202212/SP_30.0003

摘要

臺灣現今是一個多元文化的社會，醫學生未來成為醫師後將面對具有不同文化背景的病人。醫學人文教育目的是培育醫學生醫學人文思維，以便在醫病互動中能以「人」為中心、與病人進行良好的溝通，進而傳遞有效的醫療服務治療病人。然而，人文教育課程中多半著重人文主義，從批判性多元文化主體性、權力／知識、以及尊重差異觀點來看，病人賦權力仍是不夠。發展具有批判性的多元文化感知量表，作為評量批判性人文思維的工具與指標，反映醫師對醫病關係的反思批判思維程度，是醫學人文教育的一個新議題。本研究以批判性多元文化主義作為方法論，編製醫學生的多元文化感知量表，並驗證信度、效度，蒐集有效研究對象為2021年12月至2022年2月間在學醫學生151名。量表項目以同質性考驗法分析，結果顯示每一項目與總分的相關達顯著（>.40）。探索式因素分析萃取出多元文化感知因素三構面：主體性、權力／知識、責任與關懷倫理，結果顯示量表具有收斂效度與區別效度。構面信度Cronbach's α係數皆在.80以上，整體信度為.94，內部一致性佳。從批判性人文思維的視角看，此量表可作為評量醫學生醫學人文教育之多元文化教育學習成效的工具與指標。

關鍵字

多元文化主義 ； 量表 ； 醫病關係 ； 醫學人文教育

並列摘要

Taiwan nowadays is a multicultural society. Medical students who will become physicians must face patients with diverse cultural backgrounds. The purpose of medical humanities education (MHE) is to cultivate physicians' humanistic thinking to deliver patient-centered medical service. However, MHE is only inclusive humanistic, but patient empowerment is still not enough from the perspective of subjectivity, power/knowledge, and respect for differences of critical multiculturism. The development of a critical multicultural perception instrument (MCPI), as a tool and indicator is to evaluate critical reflective thinking of physician patient relationship (PPR), and is a new topic in MHE. Taking critical multiculturalism as a methodology, MCPI was developed and validated. From December 2021 to February 2022, 151 medical students were enrolled in this study. The test of item homogeneity was significantly corrected (> .40). Principal component method extracted 3 domains which were divided as subjectivity, power/knowledge, and responsibility and care ethics. The convergent validity and discriminant validity were good (both composite reliability > .60, both average variance extracted > .50). The reliability of each domain determined by Cronbach's α was more than .80, and the overall reliability is .94, indicating good internal consistency. In short, from the perspective of critical humanistic thinking, MCPI can be used as a tool and an indicator to measure the effectiveness of multicultural education in MHE for medical students in Taiwan.

並列關鍵字

Multiculturalism ； Scale ； Patient-Physician Relationship ； Medical Humanity

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