客觀結構式臨床觀察應用於職能治療教育之專題報導

A Topic Report of the Objective Structured Clinical Examination in Occupational Therapy Education

傅中珮(Chung-Pei Fu) ； 蘇佳廷(Chia-Ting Su) ； 王志嘉(Chih-Chia Wang) ； 張婉嫈(Wan-Ying Chang) ； 劉倩秀(Chien-Hsiou Liu)

《臺灣職能治療研究與實務雜誌》 12卷2期 (2016/12) Pp. 136-150

https://doi.org/10.6534/jtotrp.2016.12(2).136

摘要

職能治療系教育宗旨在培育具備專業知能的臨床職能治療人員，而客觀結構式臨床觀察(objective structured clinical examination, OSCE)是醫學教育中被認為較有效、且全面能夠評估出臨床技能的方式，亦為醫師國考第二階段之應考資格。以OSCE作為職能治療教育的評量方式，是醫療專業的趨勢，亦有助於職能治療品質提升。故本文希望藉OSCE簡介、回顧國內外職能治療OSCE在學校及在職教育的研究現況、與兒童標準化病人(standardized patient, SP)之研究現況等文獻回顧，增加對OSCE的了解與應用，並建議未來執行職能治療OSCE的步驟。回顧職能治療OSCE文獻，僅日本、印度和台灣在學校教育及在職教育有執行經驗。研究結果皆支持OSCE對職能治療學校教育及在職教育之成效。惟目前職能治療OSCE相關研究大多應用在生理及精神疾病領域，對於「兒童疾病職能治療領域」的研究，則付之闕如，推測主要原因可能為兒童SP建立困難。執行OSCE可依照下列步驟：(1)組成職能治療OSCE專家小組；(2)訂定職能治療核心能力；(3)依據核心能力、測驗目標撰寫教案；(4)舉辦考官共識會議；(5)舉辦成人SP及兒童SP訓練；(6)考場人員訓練；(7)執行OSCE測驗；(8)依據OSCE測驗結果，進行教案品質分析，並修改教案；(9)重複執行OSCE測驗。建議未來應針對生理、精神、及兒童疾病職能治療三大領域進行OSCE相關研究，以證明OSCE在台灣職能治療教育上之可行性，亦可作為未來建議考選部是否將OSCE納入職能治療師國考科目之參考。

關鍵字

客觀結構式臨床觀察 ； 職能治療 ； 專題報導

並列摘要

The aim of the department of occupational therapy (OT) is to train professional and qualified occupational therapists. The objective structured clinical examination (OSCE) is regarded as the most effective, and holistic test method in examining the clinical competencies in medical education. Using the OSCE in OT education is a trend, and it is also helpful to improve the quality of OT. Therefore, we reviewed the introduction of the OSCE, the researches of the OSCE in school education and post-graduate education in OT, and the researches of the pediatric standardized patients (SP). We hoped to make suggestions for how to administer the OSCE in OT education in the future. The OSCEs were administered in OT education in Japan, India, and Taiwan. All the results supported using the OSCE in both OT school education and post-graduate education. However, the OSCEs were only administered in the physical and psychiatric OT rather than in the pediatric OT. The possible explanation may be that establishing the pediatric SP is difficult. The steps of administering the OSCE in OT education are as follows: (1) to form a panel of experts; (2) to set the core skills of OT; (3) to write OSCE assessment forms; (4) to hold examiners meetings; (5) to hold SP trainings; (6) to hold examination workers trainings; (7) to administer the OSCE; (8) to revise the assessment forms according to the reliability and validity of the assessment forms; (9) to administer the OSCE again. We recommended that using the OSCE in three fields of OT education to examine the feasibility of OSCE in Taiwan. The results of the studies could give the Ministry of Examination some suggestions of whether it is practical to use the OSCE in the National Occupational Therapy Certification Examination.

並列關鍵字

objective structured clinical examination ； occupational therapy ； topic report