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畢業後一般醫學訓練社區醫學學習成效之評估

An Interventional Study Assessing Community Medicine Learning among Residents Undertaking the Course "Post-Graduate Year One (PGY-I) General Medicine"

摘要


The project ”post-graduate (PGY-I) general medicine training” has been conducted in Taiwan with the aim of promoting the competence of medical graduates with respect to patient-centered care. Furthermore, a further aim is to enable them to provide a higher quality of medical care and eventually to meet better the needs of health care system. The duration of this training project is three month, including one month of community medicine training, which it as hoped would improve the medical graduates' knowledge of and attitude toward community health. This study was performed to investigate the knowledge and attitude relative to community medicine amongst PGY-I residents undertaking the course described above and to identify any changes that had occurred after the one month of training in community medicine. In addition, the graduates' willingness to learn community medicine and their learning needs ere also investigated. A total of 83 PGY-I residents who undertook this course completed the interview questionnaire both pre and post course. The results showed that the PGY-I residents' accurate response rate in terms of their know ledge had been improved significantly the course (0.45 vs. 0.52, range 0-1, t=0.497, p<0.00l). However, post-course, eight out of fifteen know ledge items still had a less than 50% accurate response rate. In addition, the PGY-I residents had a positive belief in community medicine that as unchanged by the course and three from six items of negative beliof that had become less negative after the course. Post-course, we found that about seventy percent (72.3%) of residents showed a willingness to learn community medicine and this was an increase compared to before the training course [R1] and we also found that the residents' satisfaction with the community medicine training as almost eighty percent. In conclusion, the residents who took community medicine course PGY-I showed a significant improvement in their knowledge of community medicine despite a relatively low accurate response rate for several items, possibly due to inadequate time. A more positive belief in community medicine after the training course was a second important outcome. In addition, the incorporation of the training needs expressed by the residents into future courses on community medicine will be a worthwhile effort.

並列摘要


The project ”post-graduate (PGY-I) general medicine training” has been conducted in Taiwan with the aim of promoting the competence of medical graduates with respect to patient-centered care. Furthermore, a further aim is to enable them to provide a higher quality of medical care and eventually to meet better the needs of health care system. The duration of this training project is three month, including one month of community medicine training, which it as hoped would improve the medical graduates' knowledge of and attitude toward community health. This study was performed to investigate the knowledge and attitude relative to community medicine amongst PGY-I residents undertaking the course described above and to identify any changes that had occurred after the one month of training in community medicine. In addition, the graduates' willingness to learn community medicine and their learning needs ere also investigated. A total of 83 PGY-I residents who undertook this course completed the interview questionnaire both pre and post course. The results showed that the PGY-I residents' accurate response rate in terms of their know ledge had been improved significantly the course (0.45 vs. 0.52, range 0-1, t=0.497, p<0.00l). However, post-course, eight out of fifteen know ledge items still had a less than 50% accurate response rate. In addition, the PGY-I residents had a positive belief in community medicine that as unchanged by the course and three from six items of negative beliof that had become less negative after the course. Post-course, we found that about seventy percent (72.3%) of residents showed a willingness to learn community medicine and this was an increase compared to before the training course [R1] and we also found that the residents' satisfaction with the community medicine training as almost eighty percent. In conclusion, the residents who took community medicine course PGY-I showed a significant improvement in their knowledge of community medicine despite a relatively low accurate response rate for several items, possibly due to inadequate time. A more positive belief in community medicine after the training course was a second important outcome. In addition, the incorporation of the training needs expressed by the residents into future courses on community medicine will be a worthwhile effort.

參考文獻


衛生署醫字第0920208513號公告。台北:衛生署。
Imanak S,Ys Shuhorak,Emuva S(1999).An analysis about geriatric medicine/ medical education sent to members of the Japanese Society of General Medicine.Nippon Ronen Igakkai Zasshi.36,553-560.
Kassebaum D,Szenas PL(1994).Factors influencing the specialty choice of 1993 medical school graduates.Acad Med.69,164-170.
Lefford F,McCrorief(1994).A survey of medical undergraduate community-based teaching: taking undergraduate teaching into the community.Med Education.28,312-315.
Petersdorf RG(1993).Primary care-medical student's unpopular choice.Am J Public Health.83,328-330.

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