- 期刊
- OpenAccess
「敘事醫學倫理」之課程建構及教學經驗
Narrative Medical Ethics Curriculum, the Experience from Kaohsiung Medical University
摘要
目的：近年來，敘事醫學在培養醫療人員的同理心及提升臨床情境的理解能力上，已經逐漸在世界各國得到肯定。然而在台灣目前的醫學教育中，卻仍未有相關正式課程的經驗及成果報導。我們認為在醫學教育的早期階段引進敘事醫學，或許對於往後醫學生的醫學倫理教育會有助益。本文報導高雄醫學大學在98學年度所進行之「敘事醫學倫理」課程的經驗與結果。方法：本研究乃於2010年2月至6月間，在高雄醫學大學，由醫學人文教師與臨床醫師共同合作開設敘事醫學倫理課程。授課對象為醫學院醫學系與呼吸治療學系二年級學生。課程內容包括敘事知識及技巧的教學與實作，以及訪談真實病人故事的團體敘事活動。我們以學生對課程的問卷評值調查、學生的敘事寫作成果（包括學生個別敘事寫作及團體敘事報告）的分析，以及對教師之教學經驗的彙整，評估整體課程的效益及可行性。結果：學生能各自以不同的觀點及敘事手法，完成病人故事的團體敘事報導。學生回饋中也顯示，對於提升對自我主觀性的覺察，以及對他人所敘故事的開放性，此敘事課程確實有其效果。結論：我們對低年級醫學院學生所進行的敘事醫學課程，對於培養敘事技巧、觀點取替，以及主觀性覺察等能力等確實有效且可行。
並列摘要
Objectives: In recent years, narrative medicine has gradually gained worldwide recognition as an effective strategy to enhance and facilitate empathy and perspective-taking in healthcare professionals. Narrative approaches to patients by healthcare professionals require competencies in narrative skills, perspective-taking and awareness of subjectivity. With the introduction of narrative medicine in the early years of medical school, students themselves may benefit more from medical ethics training in later years. However, we have only limited experience with narrative curricula in Taiwan. Therefore, we implemented an experimental narrative curriculum at Kaohsiung Medical University for year-two students in order to determine the effectiveness and feasibility of early education in narrative medicine. Methods: A 16-week educational experiment was conducted by philosophy teachers and clinical doctors at Kaohsiung Medical University from February to June, 2010. Year-two students from the College of Medicine who had attended prior courses in bioethics were recruited. The curriculum was composed of lectures and practice exercises on narrative knowledge and skills, and group narrative activities including patient interviews and narrating stories. The effectiveness and feasibility of the curriculum were evaluated by students' responses to questionnaires, evaluation of students' story writing, and reflections from teachers. Results: The evaluation of curriculum was done by student rating and the learning outcome was assessed by both verbal and written group reports. Students were able to accomplish group reports that narrated the patient stories from different perspectives and using different narrating skills. In the feedback session, students also remarked on the effectiveness of narratives to increase their awareness of their own subjectivity, as well as their openness to stories narrated by others. Conclusion: Our narrative curriculum in the early years for students attending the College of Medicine is effective and feasible in the cultivation of competencies in narrative skills, perspective-taking and awareness of subjectivity.
參考文獻
延伸閱讀
- 林慧如（2016）。從敘事學談醫學倫理教育之人性化改革。應用倫理評論，(61)，77-92。https://www.airitilibrary.com/Article/Detail?DocID=10282483-201610-202004080025-202004080025-77-92
- 邱淑媞（2005）。實務導向之醫學人文課程設計與初步成效評估。Journal of Medical Education，9(4)，55-67。https://doi.org/10.6145/jme.200512_9(4).0006
- 陳偉元（2021）。敘事治療脈絡性理解在督導歷程中的應用與體會。諮商與輔導，(431)，35-37。https://www.airitilibrary.com/Article/Detail?DocID=16846478-202111-202111180012-202111180012-35-37
- 黃德揚（1972）。Clinical Observations of Infants and Children with Malnutrition in Kaohsiung Medical College。Acta Paediatrica Sinica，13(2)，68-77。https://www.airitilibrary.com/Article/Detail?DocID=00016578-197206-13-2-68-77-a
- 梁繼權、王維典、陳慶馀、謝博生（1997）。Evaluation of Medical Education Reform at National Taiwan University College of Medicine。Journal of Medical Education，1(1)，21-30。https://doi.org/10.6145/jme.199703_1(1).0005