張美惠2006-07-262018-07-112006-07-262018-07-112003http://ntur.lib.ntu.edu.tw//handle/246246/22888臨床醫學教育的目標，在培養醫師能有效發揮醫療技能，滿足病人及社會的 需求，創造高品質的醫療環境。醫學生的基本臨床技巧，包括醫病關係、病史詢 問、理學檢查、以及臨床推理（臨床問題解決）等，則為臨床醫學教育的基本教 學項目。進年來由於高科技檢查的進步和整體醫療環境的影響，醫療照顧逐漸轉 向以檢查為主，臨床技巧教學常常被忽略。加上傳統的臨床醫學教育的評量方式 以紙筆測驗為主，偏重記憶、缺乏思考、與臨床脫節，輔以指導教師短暫片面的 臨床觀察，缺乏完整客觀的標準。造成醫學教育的扭曲，醫學生錯誤的學習動機、 態度和方向。臨床能力的評量即是針對各項臨床技能的評量，是一種以實際表現 為基礎的評量方式，評量結果除了要能反映出受試者的不同程度外，還要能夠反 映出學習缺失，而能提供導正機會，幫助指引受試者往後的學習，並達到實際操 作練習的效果。主題結構化臨床測驗使用標準病人，是一種「以實際表現為基礎 的測驗」，研究證實能夠了解醫學生的學習能力、客觀地進行評量、並給予醫學 生適當的回饋，是目前公認最能達到有效評量的方式。本研究的研究對象是醫學 系五年級學生與臨床小兒科教師，以多重測驗站的「以實際表現為基礎」整合型 測驗模式為方法：包括有臨床實例命題(個案敘述型式、多媒體型式)，主題結構 化(群組)臨床測驗。 第一年研究的目的在探討適合醫學生和老師的測驗模式、醫學生的基本臨床 技巧學習狀況及缺失，進而了解個案設計、評量項目設計的適當內容，迄今已進 行五組同學的整合型測驗模式，回收176 份問卷，建立題庫：個案敘述型式、多 媒體型式，主題結構化群組臨床測驗11 題。待學期結束，將進行問卷統計，題 庫內容檢討，並就題目難易度與學生成績做交叉分析，作為題目評鑑度分析。The goals of medical education are to cultivate physicians capable of applying their medical skills to meet the needs of the patients and society, and to create a high quality medical care environment. Basic clinical skills, including history taking, physical examination, patient interaction, logic thinking and clinical management are considered as key elements in medical practice. But traditional clinical medicine teaching methods are lectures and bedside teaching. Traditional clinical performance assessments are given by paper examination and a little information over a short period of observation time. The traditional assessment methods have limited competency in assessing students’ clinical ability and capacity and distort the students’ motivation and attitudes for learning. So teaching medical student of basic clinical skill has long time been ignored. Very few courses on clinical skills are offered. Both teachers and students do not pay much attention in learning and implementing basic clinical skills. The situation has changed. Clinical performance examination using Objective Structured Clinical Examination (OSCE) has become the most popular method in teaching and evaluating clinical performance of medical students. This study includes 5th year medical students and clinical pediatric teachers in a multiple station performance assessment including Group Objective Structured Clinical Examination (GOSCE), OSCE, multimedia test, case study test (patient management problems) and traditional paper test.. The study can 1. emphasize the importance of basic clinical skills in patient care. 2. help to evaluate individual student’s clinical performance in patient contact. 3. provide timely personalized feedback and detailed performance report to improve student learning. 4. provide information to clinical teachers how teaching strategy should be revised for better results. 5. develop the GOSCE and OSCE model in the pediatric background. 6. facilitate a patient centered care model for better care quality.application/pdf229477 bytesapplication/pdfzh-TW國立臺灣大學醫學院小兒科醫學教育主題結構化群組臨床測驗medical educationgroup objective structured clinical examinationreporthttp://ntur.lib.ntu.edu.tw/bitstream/246246/22888/1/912516S002007.pdf