摘 要 本研究旨在實驗角色扮演的教育介入方式對醫學院學生個人死亡建構的影響,以作為往後醫學教育中死亡學課程的設計參考。 本研究以89學年度某私立醫學大學選修「醫學與戲劇」並自願配合實驗研究者為實驗組,有33位。同校同期選修「助人的歷程與技巧」課程,且願意配合前、後測者為對照組,有21位。實驗組之教育介入為兩天密集的「面對臨終病人之角色扮演練習」的課程,對照組不做任何介入。實驗及對照兩組均在實驗組之教育介入前一個月,施以前測,教育介入後之同一週內,施以後測。本研究並運用以個人建構心理學為基礎的編碼系統來分析醫學院學生對死亡之自由表述文,作為前、後測的評量工具。所得資料再以次數分配、百分比、平均數等描述性統計,及線性迴歸方式之階層迴歸分析來驗證研究假設。研究結果支持了本研究的假設:「實驗組的個人死亡建構向度數與總數平均數,在後測時比前測時有明顯的增加,而且顯著地高於對照組的」。在控制了個人變項及前測之後的迴歸分析,發現新投入的教育介入變項為後測的個人死亡建構向度數、總數,以及正向認知、正向情意與負向情意等核心建構的顯著預測因子。 本研究並針對研究對象在教育介入前後建構的消長及其意義、本研究之教育介入方式如何對研究對象的個人死亡建構產生效果以及後續發展適合國人使用之死亡態度量表應考慮的方向等加以討論。 關鍵字:個人建構、死亡教育、角色扮演、醫學院學生
Abstract The present study aimed to investigate the influence of role-playing end-of-life care to the changes of medical school undergraduates' personal death constructs. Personal constructs of free-response narratives were analyzed and compared before and after completion of a course on role-playing end-of life care (N = 33) or a course on helping process and techniques (N = 21). The hypothesis of the present study was supported by the results, the quantities of personal death constructs dimensions and frequencies of the role-playing class in the post test significantly more than that of pretest and of the helping process and techniques class. Regression analyses found that role-playing intervention is the predictor of posttest quantities of personal death constructs total dimensions, total frequencies, as well as that of dimensions and frequencies of the following core constructs : positive cognition , positive affect and negative affect. The meaning of construct changes, how role-playing intervention is effective and its practical implication for medical education and possible direction for future research were discussed. Keyword : personal construct, death education, role-playing, medical school undergraduates