台灣中醫實習醫學生表現之研究

Research of the Clinical Performance of Chinese Medical Interns in Taiwan

中醫師徒傅承制度逐漸被學校教育取代，為了橋串書本理論與臨床實務間的差距，學校的中醫教育除了原有內容外，增加了臨床技能訓練課程與以問題為導向的學習課程。本研究希望評估三種不同養成背景的中醫實習醫學生於實習機構之臨床表現差異。以自擬問卷訪問95學年度同時指導中醫學系、學士後中醫學系的中醫實習醫學生以及中醫師特種考試及格學員之中醫院部的專任醫師。以相依樣本的單因子變異數分析來檢驗三個群體表現的平均數是否具有差異。若ANOVA分析之F值達顯著，進一步進行多重事後比較。整體而言，指導醫師給實習醫學生的評分多半集中在「尚可」與「滿意」，而三種不同背景的中醫實習醫學生在臨床實務各有優勢。其中學士後中醫學系實習醫學生的整體表現略勝一籌；中醫學系實習醫學生的表現雖然居次，但在撰寫病例、閱讀典籍期刊、住院會診方面則表現相對突出。 The personnel training of Chinese medicine dependent on master and apprentice teaching system in the past has been substituted by school education now. In order to minimize the difference between the theories in the books and clinical practice, the school Chinese medicine education nowadays focuses on increasing training programs of clinical skills and problem-based learning (PBL) courses besides the existing courses. This research hopes to evaluate the differences of clinical performance among three groups of Chinese medicine interns with different backgrounds. This research is investigated by the guide doctors among the interns of Chinese medicine, Post-bachelors of Chinese medicine, and the interns with Chinese medical special exam qualified backgrounds during the practice training stage through questionnaire. The repeated measure analysis of variance (ANOVA) was used to compare the mean difference among these three kinds of Chinese medicine interns. If F-value is significant, it will be tested by multiple comparisons further. Generally speaking, the scores that guide doctors grade gathered between 3 and 4, and the three groups of interns with different backgrounds have the superiority respectively in the clinical performance. Post-bachelors of Chinese medicine interns show slightly better performance in whole displays. The interns of Chinese medicine have outstanding performance in writing charts, reading ancient books and journals and inpatient consultation.