線上學習應用於醫師在職教育之實證研究：以國內醫學中心為例

User Acceptance of On-line Learning: An Example of Doctor Extension Education in Medical Centers

隨著總額預算的來臨，醫療產業未來要面對的是品質競爭的時代。醫師是醫療團隊中的主角，對醫療生產力和醫院競爭力都具有絕對的影響。此外，醫療工作是種情境導向且非例行化的工作，每個病患都有其獨特情境，醫師必須不斷提高醫療專業知識與技術水準，提升自身專業上的能力，才能更掌握臨床疾病的診斷與治療的解決方法與答案。然而，醫師工作忙碌，加上人力的短缺，要醫師在固定時間上課實有困難，而在職教育又有其需要。因此，如何善用具有彈性學習模式的線上學習，對推展醫師的繼續教育是很重要的。本研究探討國內線上學習應用於醫師在職教育之執行現況、成效、及影響因素，以提供醫院導入與應用線上學習之參考。本研究之主要目的有二：（1）瞭解線上學習在醫師在職教育應用之現況，以提供學術界與實務界之參考；（2）瞭解影響線上學習應用在醫師在職教育的滿意度之因素，提供醫療同業推行之參考，以及學術界後續相關研究之基礎。本研究以問卷為測量工具，問卷內容根據文獻探討與專家訪談後設計。接著，以隨機抽樣方式，針對國內17家醫學中心來進行資料蒐集，共寄出問卷1月20份，回收342份，有效回收問卷了為331份，有效樣本回收率為32.45%。最後，利用逐步迴歸分析，來探討各相關因素對於醫師滿意度之影響。研究結果顯示：（I）對醫院組織文化的看法，會因年齡、教育程度、醫院區域別等不同會有所不同；（2）醫師的電腦態度及電腦素養，會因醫院屬性不同而有所不同；（3）醫院的資訊能力，因醫院所層的區域性不同而有所差異；（4）使用者特性、組織特性、與課程特性等對線上學習使用態度皆呈現顯著的正向影響。

With the advent of the Global Budget, the quality-demanding era is a key dimension in which hospitals should consider. To have customer-centered pol icy, reform medical education, and publicize evidence-based medicine, establishing a learning hospital and enhancing the hospital force for competition are critical. Doctors are the key members in the medical team. Their productivity absolutely has a great influence on medical productivity and competitive advantage. Doctors ought to continuously improve their professional knowledge and technological skill to have the solutions and answers to the diagnoses and therapies of clinical diseases. In view of the heavy workload and the lacking manpower, it is difficult for doctors to attend classes at a certain time. On-line learning with a flexible learning mode can be employed for doctor extension education. The study is to explore factors influencing user acceptance of on-line learning. A questionnaire was developed by reviewing related literature and interviewing with some domain experts. Subsequently, 1,020 questionnaires were distributed and collected by a random sampling from 17 medical centers. The usable responses were 331. The response rate was 32.50%. Results from a stepwise regression analysis indicated that: (1) attitude toward computers and computer literal are significantly correlated with the hospital size; (2) user characteristics, organizational characteristics, and course contents are significantly positive correlated with the attitude toward on-line learning. Implications from the findings are also provided.