近年台灣開始學習外國作法,使用客觀結構式臨床技能測驗(Objective Structured Clinical Examination, OSCE)作為測驗醫學教育臨床技能的評量方式,同時運用標準化病人(Standardized Patient, SP)為重要評估工具;此法之運用已是國內公認趨勢,但很少有研究是對實施現況與標準化病人行為做相關了解。本研究以標準化病人為對象進行質性研究,訪問7間醫學中心共32位標準化病人,藉以了解各醫學中心在此部分之運作現況,也對標準化病人角色規範認知來源做探討,另找出創造標準化病人利他行為與工作投入現象之相關因素為何,從而對其有更多認識。 研究發現如下: 一、各家醫學中心做法各有不同,而訓練方式包含素質也呈現層次不齊之情況,至於標準化病人演出之「穩定性」與「一致性」在控制上也有進步空間。 二、目前各醫學中心在標準化病人的正式相關規範與要求上不夠明確與成熟,造成在人際互動中才有的非正式規範相較於前者,對標準化病人反而有更深影響。 三、與標準化病人利他行為與工作投入出現之相關影響因素包含:性別、正向人際關係、過去擁有志願服務經驗、親友家人不反對態度、服務年資在一年以內、擁有婚姻、非學生的其他職業以及參與動機;這些因素間的不同組合關係對標準化病人行為有一定程度之影響。
Taiwan has started using Objective Structured Clinical Examination (OSCE) from overseas in recent years as an evaluation method to test clinical skills of medical education, and standardized patient (SP) has also been applied as an important assessment tool. This kind of examination has been generally accepted and become a trend in Taiwan. However, only few studies have focused on the current development and the behavior of standardized patient. This study takes standardized patients as subjects and was conducted by interviewing 32 standardized patients through a qualitative survey in seven medical centers. This study enables us to realize the current development of SP related work in medical centers, to confer the norm sources of standardized patient , and to explore the factors that cause standardized patients’ altruistic behavior and job involvement. The results show that: (1) Methods of SP related work and trainings including qualities applied vary among medical centers, and the ability to control the stability and consistency in the role-playing needs to be improved. (2) So far the related formal norms and requests authorized by medical centers for standardized patients to follow are not clear and complete enough. It makes the informal norms which embedded in the people interaction has much deep influence on standardized patients than the former. (3) The factors related to the altruistic behavior and job involvement of standardized patients include:gender, positive relationship, previous volunteering experiences, objective attitude from family, under one year’s SP experience, marriage, occupation other than students and motivation. The different combination of these factors has some levels of influence on the behavior of standardized patients.