社區與人文為導向的末期醫療照護之醫學教育

Community and Humanity Directed End-of-Life Care in Medical Education

在醫學教育中，可使用不同授課方式達成課程的目標，使用多種教學策略是適當的。對於三種學習要素（認知，心理動力和情感）是同等重要，末期照護的教學能夠符合上述的目標。以病人為中心的緩和醫療模式取代醫師為導向的執業是末期照護的特性。安寧療護近二十年來在台灣發展得很上軌道，但醫學院教育仍缺乏正式的末期照護的課程是嚴重的教學議題。早點了解病人和家屬的需求有助於醫學生日後的醫療工作，所以選擇適當的教學方法支持此課程目標是合適的。社區的學習是很重要的學習場所，我們可以讓學生藉由e 化學習的方式來充實末期照護的知識，然後安排醫學生到社區實際接觸末期照護的活動，可更早接觸病人與家屬。

In medical education, the delivery of course objectives can potentially utilize a wide variety of modes of delivery, including the traditional lecture, case-based learning, small group tutorials, computer assisted learning, bedside clinical teaching and home visits, etc. The use of multiple educational strategies is optimal. It is equally important for three domains of learning (cognitive, psychomotor and affective). End-of-life care education can fit the above goals. Patient-centered palliative care model instead of physician-directed practice is the main characteristic of end-of-life care. Hospice and palliative care had been developed well in Taiwan since 20 years ago. But lack of formal end-of-life care curriculum in medical school in Taiwan is still a serious teaching issue. Since medical professionalism consists of those behaviors by which we demonstrate that we are worthy of the trust bestowed upon us by our patients and the public, because we are working for the patients’ and the public’s good. Besides, medical humanities is an interdisciplinary field of medicine which includes the humanities (literature, philosophy, ethics, and religion), social science (anthropology, psychology, sociology), and the arts (literature, film, and visual arts) and their application to medical education and practice. The humanities and arts provide insight into the human condition, suffering, personhood, our responsibility to each other, and offer a historical perspective on medical practice. Early exposure to patients’ and their families’ needs, and to have opportunities to appreciate the joy of being able to help. It is important that the educational method chosen supports the curriculum objectives and is feasible. Therefore, community is the important site for this objective. Students can view the pre-recorded teaching video film by e-learning. Community with patients and their family at anywhere is the major skills for students in medical school.