應用英美醫學生臨床技能測驗模式落實台灣醫學生臨床技能測驗評估

Using the OSCE of British and American Medical Students to Implement the Clinical Skills Assessment of Taiwan Medical Students

劉克明(Keh-Min Liu) ； 黃裕勝(Yu-Sheng Huang)

《Journal of Medical Education》 7卷1期 (2003/03) Pp. 15-21

https://doi.org/10.6145/jme.200303_7(1).0003

摘要

醫學教育之目的在培育醫學生畢業時具有利他主義、知識淵博、臨床技術熟練、負責任等特質。各醫學院為達到這些目的而規劃課程、執行教學與評估教學成果。因此醫學生到醫院實習時應該具備之醫學的知識、臨床技能、態度與價值觀都有很清楚規定。在台灣，醫學生的基礎醫學與臨床醫學等知識的學習成果，可以經由筆試測驗出來，但在問診、身體檢查、臨床技術、儀器操作、推理決策、態度、溝通技巧與價值觀等臨床課程方面之學習成果，需要建立一套適當的評估方法，以判定醫學生臨床學習的表現是否有達到醫學教育的目的。筆者觀察英國及美國六所大學醫學院採用標準病人及客觀結構式臨床測驗評估醫學生之臨床技能。在台灣要實施醫學生臨床技能測驗之重點為：1.成立客觀結構式臨床技能測驗委員會，以擬定測驗目標、項目、評估及回饋方式；2.設置臨床技能中心（包括身體檢查室、面談室及觀察室）以執行醫學生之臨床技能測驗；3.建立標準病人制度；4.建立解剖等模型測驗室。

關鍵字

醫學教育 ； 臨床技能中心 ； 客觀結構式臨床測驗 ； 標準病人

並列摘要

The objective of medical education is to develop in medical students the attributes needed to practice medicine in a postgraduate setting. These attributes include altruism, a fund of basic and clinical science knowledge and various clinical skills. In order to achieve this objective, each medical school has designed a curriculum, implemented an educational program, and evaluated the outcome of the student's learning. The scope of medical knowledge, clinical skills, attitudes, and effective patient communication required during the program are set forth clearly.
In Taiwan, the medical student's achievements in the knowledge areas of the basic sciences and clinical medicine can be evaluated easily by written examination. However, clinical performance, such as history taking, physical examination, problem solving, attitudes, and communication skills have rarely been assessed objectively. Therefore, appropriate assessment methods are required for the evaluation of the clinical abilities of our medical students.
From our observations of several medical schools in United Kingdom and United States, we found that Standardized Patients (SPs) and Objective Structured Clinical Examinations (OSCEs) provide a uniform objectivity upon which student's clinical competencies can be evaluated. By the use of SPs and OSCEs, the outcome of medical student's clinical training can be assessed as part of a program that includes a list of the desirable behavior patterns that a physician should exhibit in practice. In order to implement the system of SPs and OSCEs for Taiwan medical students, the following major components should be organized: 1) An OSCE Committee; 2) A Clinical Skills Center (including rooms for physical examination, interviewing, and observation); 3) A Standardized Patient Program; 4) Examination sites with anatomical models.

並列關鍵字

medical education ； clinical skills center ； OSCE ； standardized patient

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