醫學生早期臨床體驗

The Early Clinical Experience of Medical Students

醫學教育中已知有早期臨床體驗學習，對醫學生在溝通技巧、自我認同以及臨床見實習學習壓力調適，都有助益。本研究以「自我決定論」分析在醫學生臨床體驗的過程中，啟發出不同類型的影響，包括正向的學習意願及動機等。本研究在2016年進行，以一群醫學系四年級未有過臨床經驗的學生為研究對象，臨床體驗活動共計6週，資料收集以質性方式進行課後焦點團體訪談。結果顯示學生對疾病的背景環境因素、病患就醫狀況、以及治療決策推理思考均有提升。此外對於觀察、反思及同理心的提升與人際溝通，均有成長。本研究發現，臨床體驗學習可引發醫學生的內在學習動機，並激發設定更高的學習目標及理想。

Early clinical experience (ECE) benefits medical students by strengthening their communication skills, forming a sense of identity, and alleviating the learning pressure during clerkships has been confirmed in the medical education literature. The purpose of this study was to investigate the self-determination theory, the fundamental needs drive individuals to behave effectively and positively which may in turn influence attitudes and intentions towards students learning. In 2016, a group of fourth-grade students at a medical school in Taiwan were invited to participate in a six-week ECE program. A qualitative method was applied in this research, and data were collected through in-depth interviews, focus groups, and student reports from the course. Students showed awareness of the contextual determinants of care and emphasized patients' motivation for treatment. Moreover, a model of clinical reasoning was used to accommodate the complicated contexts in which clinical problems usually arise. They also reported improvements in their ability to observe, self-reflect, empathize, and communicate interpersonally. When self-determination theory is applied to student learning, the premise begins with students being intrinsically motivated to learn and be inspired students to set and achieve challenging goals.