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摘要


臨床技能不足向為醫學敎育主事者對當前實習醫師之主要批評之一,為了評估實習對於臨床知識及技能之改進及獲得之成效,本院於去年在實習結束前,舉行第一次實習醫師臨床智能考試,內容為內、外、婦、兒臨床科目臨床知識與技能。命題方式包括筆試與術科考試兩大部分。本研究的主要目的是分析1998學年實習醫師臨床智能考試的結果並進行檢討,希望藉此能對國內醫學院的臨床教育有所助益。研究方法主要針對考題作分析,並且對考题進行評估之問卷調查。此次筆試試題多以臨床實例,除了病史敘述口語化,另有實驗室檢查結果、實物相片、圖表、心電圖、影像、病理切片,供實習醫師判讀、整合、推理操練以得診斷並據以治療。針對考题的分析方法為問項分析,包括困難度和區別度。結果發現86題選擇題中,困難度呈現良好平均分布,但是還有些題目區別性有待提高。問卷調查則由學生分別就題意清晰度、題目困難度、記憶性、思考性和實用性等五個項目,給予低、中、高等不同程度的評估。結果發現認為題意清晰(中~高)的有95.6%,題目困難度分佈適當(低12.6%,中57.7%,高29.7%),認為記憶性高的只有31.8%,認為思考性佳(中~高)達76.4%,認為實用性佳(中~高)的佔有89.0%。內科術科測驗心肺急救術實地操作,外科術科則以豬皮為樣本測驗其縫合術,考生們反應良好。整體而言,本院首次的實習醫師臨床智能考試,過程順利且内容多樣化,測驗具有整合性評估臨床知識與技能的效果,是一項有待推廣的醫學生考試改革突破。

並列摘要


The integrated course lecture is one of the main revolutions in medical education of the Medical College of National Taiwan University in the past 7 years. However, this integrated course lecture was mainly focused on the medical students before their internship. The ability to integrate medical knowledge and clinical performance is also stressed in intern training. However, testing this ability in interns is important. This type of test was done for the first time in 1998. The purpose of this study is to analyze the results of this integrated test of clinical education and collect items, and opinions about the test. Results of this study showed that there was good distribution in the difficulty level, but the discrimination of test items is somewhat poor. It is suggested that more questions with a better discrimination level be included in future tests. Opinions about each test item showed that the most students were satisfied with the degree of question clarification, degree of difficulty, degree of pondering, and practicing in medicine. In summary, the initial experience with an integrated test for interns can provide important information to improve the quality clinical practice and thus in medical education.

被引用紀錄


王玫玉(2002)。醫師的誕生---實習醫師社會化過程之質性研究〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200714495295

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