模擬醫學應用於醫學人文教育之初探

The research starters of medical simulation applies to medical humanities education

謝宛蓉(Shieh Wan-Rong)

指導教授 ： 高美英

臺北醫學大學/人文暨社會科學院/醫學人文研究所/碩士(2016年)

摘要

近年來隨著醫療科技進步與病人自主權的覺醒，醫病關係與臨床決策趨於
複雜化，病患方漸漸不再只是位居被動。因此，在醫事人員實行醫療行為時，察覺並理解病患感受顯得十分重要。近年來醫學模擬課程，已成為各醫學院教學的必備工具，然而以導入模擬醫學使學生接受人文議題薰陶之教學方式仍屬少見。本研究之醫學人文臨床模擬課程目標為協助醫學系四年級學生，藉由體驗模擬困難情境了解病患方處境。
本研究為103 學年度上學期醫學人文整合課程之中，針對困難情境模擬課
程的課程相關研究，將尚未進入臨床環境的四年級醫學生以便利取樣方式，選取學生人數164 人以模擬教學試驗作為研究場域、標準病人為教學工具之臨床情境進行模擬試驗，讓學生扮演醫師與病人兩種角色，讓學生藉由模擬課程體驗臨床醫療困境。本研究量化分析醫學生在模擬課程時的表現，並透過對參與模擬課程的9 位醫學生深度質性訪談，了解學生的課程體驗與真實感受。
研究結果顯示模擬課程中，醫學生的性別、扮演角色的順序和模擬病人讓
學生在模擬課程的表現有差異。從研究中看出模擬病人在模擬課程中是重要的影響因素，讓學生得以看到醫師的執行模式，有加強模擬情境真實感與教學的成效。學生在訪談中表示其認為模擬課程確實體驗到臨床醫療困境，並期望課程可以加以修改後持續實施。模擬病人在模擬課程中不僅是教具，更讓學生有機會得以藉由模擬課程落實體驗困難情境，並獲得課程體驗，建構出對於病患的同理心以及對倫理議題的敏感度，體驗到臨床的不確定性，以利未來遇到相似困難情境，能運用既有模擬經驗加以克服。

關鍵字

臨床模擬情境教學 ； 模擬病人 ； 困難情境 ； 醫病關係

並列摘要

In recent years, medical simulation has become an indispensable tool for teaching programs in medical school. However, medical simulation is still rare in humanistic education of medical students. The purpose of this study is to evaluate the effectiveness of this kind of simulated medical humanistic education for the fourth-grade medical students.

The convenience sampling method was employed in this research. Total 164 fourth-grade medical students who haven’t started their clinical courses yet were included in the study. This course is part of integrated medical humanities curriculum. The design of the course is creating a clinical dilemma and letting the students participate in the setup situation. There are two kinds of characters which are physicians and patients, and students played as these two roles in turns. The instructor of the course discussed with them after medical simulation and students gave some feedback. In order to understand the personal experiences of the students’ simulations, the researcher conducted an in-depth interview to collect the students’ opinions about their thought of the simulations.

The results show that the medical students have different performance depend on gender, the order of role-playing and simulated patients. Obviously, simulated patients are important factors in simulation situations, allow students to see the doctor's execution mode. According to the interview, students expressed their real experiences of the clinical dilemma in this setup simulation courses would be helpful for the similar events in the future.

並列關鍵字

Simulated patient ； Clinical dilemma ； Doctor-patient relationship

參考文獻

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