學習歷程檔案於醫學生基本臨床技能之教、學與評量之應用

The Design and Application of a Medical Student Portfolio for Teaching, Learning, and Assessment of Basic Clinical Skills

王維典(Wei-Dean Wang)

《Journal of Medical Education》 5卷2期 (2001/06) Pp. 107-123

https://doi.org/10.6145/jme.200106_5(2).0003

摘要

在真實情境中進行教、學與評量，是指導醫學生學習基本臨床技能的理想作法，但是在實際執行過中，常常受到主、客觀因素的影響，使教學成效大打折扣。學習歷程檔案是科學教育在實境教、學及評量中，發現及促成學習者成長之有效方法。本研究的主要目的在基本臨床技能的學習課程中，設計及應用學習歷程檔案於醫學生的學習，使具有實境教、學與評量的效果，以促進學習成效。本研究採用行動研究法，以在台大醫院家庭醫學部學習臨床醫學之醫學生為研究對象，由指導教師設計適用卡及教學模式，指導教師與醫學生共同參與進行學習項目修改，使足以促進基本臨床技能之教、學與評量，再以半結構式問卷探討此模式的適用情形。本研究所設計之教、學及評量模式，採用教師指導、小組討論、多媒體學習及建立學習歷程檔案等方法，協助醫學生進行包括自我評量的主動學習，使在基本臨床技能學習過程中，能熟悉使用學習歷程檔案。四階段臨床技能教學過程分為課堂講述、錄影帶教學、臨床演練及獨立作業四個階段，著者共開發出五種學習歷程檔案紀錄卡及四項用於評鑑檔案內容的基準。醫學生所建立的學習歷程檔案包括紀錄卡與錄影帶。研究結果顯示使用學習歷程檔案於基本臨床技能的教、學及評量，可以引導醫學生進行主動學習，具體紀錄醫學生的學習經過及改變，具有實境教、學與評量的效果。著者正在進一步研究建立各項基本臨床技能的實作基準，以及使用此模式之教、學與評量成果的效度與信度。

關鍵字

學習歷程檔案 ； 四階段臨床教學 ； 基本臨床技能

並列摘要

The ideal way for medical students to learn basic clinical skills is to have teaching, learning and assessment conducted in an authentic situation. In reality, however, this is usually impossible owing to various subjective and objective factors. Therefore, the outcome of teaching is usually compromised. A portfolio can be an effective tool to facilitate and monitor the learner during the process of teaching, learning and assessment in an authentic context. This study involved the development of a teaching, learning and assessment model, which used medical student portfolios during the acquisition of basic clinical skills. This research was an action research, the study objects were senior medical students on family medicine clinical rotation. Teacher and students worked together on the recording chart and the study model designed by the teacher in advance. Necessary changes were made and their applicability was assessed by a semi-structured questionnaire. The created portfolio study model involves a format which combines instruction, discussion and multimedia learning methods. Students were motivated to conduct active learning including self-evaluation and were able to use the portfolio as a means of learning basic clinical skills. The four-step clinical skill teaching includes lecturing, videotape teaching, supervised practice and independent practice. Five recording charts and four kinds of content evaluation criteria were developed to facilitate the portfolio construction. The student portfolio includes record charts and videotapes. The research results indicate that the use of the portfolio approach in teaching, learning and for the assessment of basic clinical skills is able to motivate medical students to conduct active learning, to record the learning process and it results in an improvement in their skills. Thus, it fulfills the purpose of authentic learning. A further study is underway to develop the performance criteria for each of the basic clinical skills and to establish the validity and reliability of this study model. (Full text in Chinese)

並列關鍵字

portfolio ； four-step clinical skill teaching ； basic clinical skills