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  • 學位論文

臺灣醫學專業素養展現情形之初探

A Pilot Study of the Manifestation of Medical Professionalism In Taiwan

指導教授 : 邱瓊萱

摘要


醫學專業素養為指引醫師、醫學生態度與行為關鍵,故專業素養的構成應為醫學教育的重點之一。本研究之主要目的在於瞭解臺灣醫學專業素養展現情形之現況,以期發現其中問題,進而對醫學專業素養建構環境不足之處提出建議。本研究以五位不同年齡層之醫師與醫學生為研究對象,採質性研究方式,以半結構式訪談來蒐集研究資料,並以開放性編碼方式進行資料整理與分析。分析結果主要分為三大構面,分別為態度建構、個人實行以及環境支持,態度建構此一構面分「共同成長」、「內省」、「平等關係」、「陪伴」、「開放」、「學習苦難」、「關心」以及「利他主義」等八個次構面,其中「共同成長」與「學習苦難」是根據受訪者所說之詞彙為命名依據,其餘七個次構面則是以Cruess等人(2009)之醫治者與專業者的特質為理論依據;個人實行此一構面分為「溝通技巧」、「足夠的專業能力」、「值得信賴的」、「對專業的責任」、「對社會的責任」以及「尊重病人尊嚴與自主性」六個次構面,「溝通技巧」根據文獻回顧結果提出,其他五個次構面也是根據醫治者與專業者的特質而分;環境建構則以受訪者表達的方法為分類依據,共分「支持性的學習環境」、「團隊支持」與「典範學習」三個次構面。本研究之主要結果如下: 一、在態度建構此一構面,世代展現的程度是年長的世代優於年輕的世代,差異的分界在於60~69歲以及50~59歲兩代之間。 二、個人實行之構面則是年輕的世代展現重視程度優於年長的世代,差異的分界則是在50~59歲及40~49歲兩代間。 三、應建構支持性的教學環境,並且建議以團隊支持的機制及發展典範的方式協助學生。 根據研究結果,本研究提出下述建議:一、對於執業經驗豐富之年長世代提倡屬於professional之特質的重要性。二、對於較年輕的世代加強態度建構的部分。三、提升教學環境對於專業素養培育的助力。

並列摘要


Medical professionalism is the attitude and behavior guideline to physicians and medical students. The building of medical professionalism is one of the most important factor in medical education. The purposes of this study are to understand the manifestation of medical professionalism from one generation to another, hoping to see some problems in medical education environment now. The study is a qualitative design. The study samples consisted three physicians and two medical students. The data were collected by semistructured interviews, transcribed them, and analyzed based on the code and coding. The study result have three aggregate theoretical dimensions: Attitude, practice, and environment support. In attitude, there are eight theoretical categories: grow up together, insight, relations on an equal basis, presence/accompany, openness, learning sufferings, care/compassion, and altruism; In practice, there are six theoretical categories: communication skills, competpence, trustworthy, responsibility to profession, responsibility to society, and respect patient dignity autonomy; In environment support, there are three theoretical categories: supportive learning environment, team support, and role model. The major findings are: 1. In the attitude aspect, the older generation was better then younger. 2. In the personal behavior aspect, the younger generation was better then older.. 3. Supportive environment is necessary for medical education, “team support” and “role model” can help students. Based on the findings, there are four suggestions: (1) Advocate learning the factors of professional in older generation. (2) Enhance the attitude to medical professionalism in younger generation. (3) Enhance the support in education environment.

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