活化醫學倫理教育課程策略之探討--以臺北醫學大學醫學系為例

A Strategy Study on Curriculum Reform for Medical Ethics─An Example in Taipei Medical University

曾瑋莉(Wei-Li Tseng)

指導教授 ： 胡俊弘教授 ； 邱弘毅教授

臺北醫學大學/醫學院/醫學科學研究所/碩士(2003年)

摘要

醫學倫理在近年儼然已成一門顯學，隨著醫學科技的日益進步，醫療層面不再侷限於單一的醫病關係，其涵括道德、宗教、法治、生命倫理、基因倫理與研究倫理等觀念，而因倫理所衍生的問題日益受到重視。現今，各醫學校院急起改革，期望自現有的醫學教育中，融入人文教育，培養出術德兼修的醫師。如何活化教學策略，發揮教學成效來真正落實醫學人文教育，是現今各醫學校院努力之課題。 本研究主要目的為瞭解醫學院學生在接受醫學倫理教育上，對於學校所採行之教學策略反應如何？由學生的反應及醫師學習典範的深度訪談中，歸納出試行之教學策略改進方向建議。本研究以臺北醫學大學九十一學年度醫學系二年級學生為對象，利用自填式問卷進行資料蒐集，共得有效樣本50人，所得資料以描述性統計、T test與逐步多元迴歸方式進行分析，重要結果如下： 一、研究對象在未修課前對自我醫學倫理知識之評估為偏低的；而於修完醫學倫理課程後之認知程度顯著高於未修習醫學倫理課程前之認知程度。 二、活化醫學倫理教育課程之有效策略為小組討論教學方式（PBL）、志工服務實習課程及良好之醫師典範學習。 三、研究對象評估以小組討論教學方式（PBL）運用於醫學倫理概論課程所得之學習成效顯著優於大講堂教學方式。 四、研究對象評估參與醫院志工服務實習課程可以幫助自己：1.了解將心比心的真義；2.在服務病患的過程中體會病人的苦痛；3.培養與病人的溝通能力。而受試男女學生在該項得分並無顯著差異，顯示均能於該項實習課程中獲得相同之成效。 五、研究對象認為良好之典範學習醫師應具備以下之特質與態度： 人格特質：1.親和力強、情緒穩定、幽默開朗、樂觀豁達、無強烈之優越感 2.關懷他人、尊重生命、視病如親、願意付出自我、具備服務的熱誠 3.精益求精的研究態度，良好之溝通能力 專業態度：醫術高明、行事果斷、虛心學習、願意傳承經驗、能以身作則 本研究結果摘要如上，期望能透過臺北醫大學醫學系學生，對活化醫學倫理教育課程策略做一完整的呈現，透過醫學倫理教育與醫院志工服務實習之實踐，將醫學倫理概念灌輸予未來的醫療人員與教育者，從而對建立良好醫病關係與形塑醫師典範學習做更進一步的落實與推廣，也建議未來研究者可採質性晤談，以縱貫性研究呈現典範學習對醫學生的實質影響意義。 關鍵字：醫學倫理、問題導向的學習模式（PBL）、大講堂教學方式、角色扮演、志工服務、典範學習

關鍵字

醫學倫理 ； 問題導向的學習模式 ； PBL ； 大講堂教學方式 ； 角色扮演 ； 志工服務 ； 典範學習

並列摘要

Medical ethics has become an explicit study in recent years. With the advancement of medical technology, medical treatment is no longer confined to mere relationships between doctors and patients, but contains ethics, religion, laws, life ethics, gene ethics and research ethics. Ethics-related issues therefore received growing attention. Nowadays, medical schools are in a reform spree, looking forward to integrating humanism into medical education for bringing up good physicians. How to activate teaching strategies to reinforce humanism in medical education has become a goal that every medical school is striving for. The main purpose of this study is to understand how medical students react to the school’s teaching strategies on medical ethics. After collecting responses from students and conducting in-depth interviews with selected role models, the study presents suggestions and directions for enhancing teaching strategies. The research questionnaire surveyed 50 sophomore students at the Faculty of Medical of Taipei Medical School. For data analysis, descriptive statistics, t-test, and multiple regression analysis were used. The key findings of the research are as follows: 1.Students’ self-evaluation of medical ethics knowledge was lower before taking medical ethics courses. After completing the courses, their understanding of medical ethics has become obviously higher. 2.The effective strategies to activate medical ethics courses are Problem- based Learning (PBL), joining volunteer service for practical training, and taking good physicians as role models. 3.According to students’ assessment, using PBL on medical ethics courses is obviously more effective than classroom teaching. 4.Students think that taking volunteer service as a practical training in hospitals could help on: 1. Understanding other people’s thoughts; 2. Realizing patients’ pain; 3. Enhancing communication abilities with patients. There is no significant difference between male and female students on the views of such practical training. 5.Students think good role models should equip the following characteristics and attitudes: Personality traits: 1.Friendly; emotion stable; humorous; open; optimistic; not showing strong sense of superior 2.Caring others; respecting lives; treating patients as families; willing to contribute oneself; possessing enthusiasm to serve people 3.With a perfection-driven research attitude; excellent communication skills Professional attitudes: brilliant medical skills; assertive and decisive; modest and open-minded on learning; willing to share experiences; setting a good example with one’s own conduct It is expected that the study conducted in Taipei Medical School will be able to present strategies for activating medical ethics courses. Through medical ethics courses and hospital volunteer service, medical ethics can be instilled to prospective medical workers and educators, so to establish good relationships with patients and promote role modeling. It is suggested that future researchers to use in-depth interviews and a longitudinal research to show the real influence of role modeling on medical students. Key Words: medical ethics, Problem-based Learning(PBL), classroom teaching,role play, volunteer service, role modeling

並列關鍵字

medical ethics ； Problem-based Learning(PBL) ； classroom teaching ； role play ； volunteer service ； role modeling

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