門診醫病關係初探－醫學生在“醫師與人文”課程之問題導向學習

A Preliminary Study Assessing the Relationship between Physician and Patients in Outpatients Department-Problem-Based Learning amongst Junior Medical Students

周迺寬(Nai-Kaun Chou) ； 王水深(Shoei-Shen Wang) ； 周玲玲(Lin-Lin Chou) ； 陳宜君(Yee-Chun Chen) ； 林明燦(Ming-Tsan Lin) ； 李伯皇(Po-Huang Lee) ； 侯勝茂(Sheng-Mou Hou)

《Journal of Medical Education》 8卷2期 (2004/06) Pp. 159-167

https://doi.org/10.6145/jme.200406_8(2).0004

摘要

由於社會結構急速變化，必須加強醫學生的社會醫學教育，为了提升學生的學习動機，台大自1992年採用問題導向學习的小組教學方式来進行醫學生的社會醫學人文課程，期待醫學生能本著人文的關懷，開始學醫生涯。本人在二十堂課中，分别與學生探討人際關係－醫病關係、認識全民健保、社會時事、傅統及民俗醫療……等等各個主題，本組醫學生對其中的課堂主題之一「醫病關係」非常有興趣，为了深化學生的興趣，也讓醫學生進一步瞭解现代醫生與病人的溝通情形，在本人的指導下，本組醫學生設計了一份問卷，以台大醫院门診病人为訪查對象，做立意取樣調查。全部問卷346份，但所得有效問卷为339份(97.9%)。調查結果，受訪者男女比例约4.5約5.5；年齡分佈以31～40歲为多，其次21～30歲；受訪者對醫師解釋病情有67%表示大致聽得懂，27%完全聽得懂，5%不太懂：而为尋求其他參考意见，以逛醫院換醫師占40%为最多。67%受訪者認为會進一步與醫師溝通。此次的研究報告是老師應用問題導向的學习模式，指導醫學生發现問題，深入分析問題並尋求解決問題的一個教學過程的呈现。

關鍵字

問題導向學習 ； 醫病關係 ； 門診

並列摘要

To fulfill future requirements for the training of physicians, the National Taiwan University College of Medicine introduced problem-based learning (PBL) in 1992. As we know, the relationship of physicians and patients depended on good communication and comprehension. In order to realize this doctor-patient relationship, a questionnaire was designed and used with an interview in a convenient manner for purposive sampling of patients visiting the outpatient department of National Taiwan University Hospital. Descriptive statistics were used to analyze the results. There were 364 interviews and 339 completed questionnaires (a response rate of 97.9%). In this study, the ratio of male and female was 9:11. The results showed that 67% of the respondents indicated that they had good medical communication with their physician. This was useful because, in association with PBL, it allowed medical teaching staff and students to understand the preliminary relationship between physicians and patients in outpatient department. This, in turn, has made possible later more detailed and gentle medical communication with their patients, which will prevent future unnecessary medical disputes.

並列關鍵字

problem-base learning ； relationship of physicians and patients ； outpatient department

參考文獻

謝博生(1999)。醫學人文教育。台北:國立台灣大學醫學院。

謝博生(2003)。一般醫學教育－後SARS時代的醫師培育。台北:國立台灣大學醫學院。

李明濱、李宇宙、林信男(1997)。利用小組教學方式實施醫學倫理教學。醫學教育。1，201-215。

Tysinger JW,Klonis LK,Salder JZ(1997).Teaching ethics using small-group, problem-based Learning.J Med Ethics.23,315-318.

Schmidt HG,Moust HC,Evensen, DH(Eds.),Hmelo, CE (Eds.)(2000).Problem-based learning: a research perspective on learning interactions.Mafnwah, N.J.:Lawrence Erlbaum.