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  • 學位論文

畢業後一般醫學訓練之學習壓力與學習滿意度之初探-以某醫學中心為例

A study on leaning stress and satisfaction of the post graduate first year residency training in a medical center

指導教授 : 楊志良
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摘要


醫師養成是艱辛且漫長的路程,適度的壓力是進步的原動力,太 多或太少的壓力都對學習者有不良的影響。因SARS事件發現我國醫 學訓練有所偏誤,而建立「畢業後一般醫學訓練制度」,促使全人醫 療模式得以落實。本研究之目的為瞭解畢業後第一年住院醫師在醫學 中心接受訓練的學習壓力源、學習壓力反應、學習成效與學習滿意 度,及其相關因素,同時更進一步探討醫師個人屬性對學習壓力源、 學習壓力反應、學習成效與學習滿意度之影響。研究對象為民國95年 9月至96年4月接受中部某醫學中心主辦「六個月」一般醫學訓練的所 有第一年住院醫師,採普查方式取得58位醫師。將經過專家效度評 定、預試及修正後之結構式問卷,由研究者親自至各訓練場所給每一 位符合條件之醫師填寫,有效回收率為100%。整份問卷之內部一致 性Cronbach’s L值介於0.76至0.92之間。研究結果發現:醫師在參與 一般醫學訓練的過程中,所承受的壓力絕大部份來自於「病患的照 顧」;學習壓力反應以「心理層面」的感受為主;學習成效方面有七 成以上醫師同意『我在一般醫學訓練後,能提升處理病人問題的能 力』,有65.5%醫師認同『一般醫學訓練,對於我未來行醫生涯有幫 助』;學習滿意度方面有81%的醫師對「教師教學」感到滿意,有74.1 %的醫師滿意醫學訓練的人際關係。有近八成的醫師認為內科訓練的 II 壓力最大,以「病人病況差且複雜」與「工作負荷大」為首要原因; 有近五成的醫師認為內科訓練的滿意度最高,以「學習較多」為首要 原因;有六成醫師認為合適一般醫學訓練的時間應為「三個月」。對 於學習壓力、學習壓力的反應方式、學習成效與學習滿意度方面,在 性別、年齡、婚姻狀況、醫院屬性與原屬科別上並無統計上的顯著差 異。但畢業於私立學校的醫師對學習成效的感受程度顯著大於公立學 校的醫師(P<0.05)。而不曾在目前受訓醫院實習的醫師對學習成效 的感受程度顯著大於曾在此醫院實習的醫師(P<0.05)。學習壓力與 學習壓力反應達0.751的正相關,學習壓力與學習成效及學習滿意度 呈現負相關。因此,醫療管理決策者除設計合理學習的內容及方式 外,也應堅持在醫療品質上予以適當的要求,除了改善醫師培訓的流 程,使得醫師學習的質與量能達到平衡外,也促使醫師不斷的成長。

並列摘要


The aim of the study is to investigate the stressors of learning, the reactions of the stressors, the satisfactions and outcomes of learning and other factors in the First- Year residents. Moreover, the study is going to ascertain what the influences of the stressors of learning, the reactions of the stressors, the satisfactions and outcomes of learning among different personalities of these First-Year residents. The participants of this study were drawn from a census of 58 First- Year residents at a medical center in middle Taiwan, who had received the six- months postgraduate year residency program (PGY) between September 2006 and April 2007. The responses rate of questionnaire was 100%, and the internal consistency of the Cronbach's zwas between 0.76 and 0.92. The results revealed that patients care was the major stressors among First- Year residents. Mental stress was the major reactions toward learning stress. Over 70% of these residents aggressed or strongly agreed that the effects of learning would promote their capacities in patients care. About 65% of these residents indicated that the PGY could benefit to their career. Furthermore, 81% of the First-Year residents satisfied their educators, and 74.1% of these residents were satisfied in interpersonal relationships. Approximately 80% shown that complicated conditions among patients and overload were the main stressors in the clinical training, about 50% of residents expressed that the effects of clinical training was highest than other training in different department, and nearly 60% of the residents suggested that three months would much more suitable for the postgraduate year residency program. The outcomes of the study also IV present that the stressors of learning and the reactions of the stressors were positively correlated, but the stressors of learning and satisfaction and performance of learning were negatively correlated.

參考文獻


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被引用紀錄


何秀菊(2014)。學生參與校外實習之學習壓力、學習滿意度與職涯發展之相關研究-以科技大學學生為例〔碩士論文,朝陽科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0078-0905201416542554
陳光輝(2016)。受僱醫師適用勞動基準法對醫院經營之影響〔碩士論文,國立中正大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0033-2110201614042866
許志明(2016)。以360度評核回饋結果分析一般醫學訓練學生對未來選擇科系之關聯〔碩士論文,國立中正大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0033-2110201614053209

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