將個人化學習計畫導入畢業後一般醫學訓練

Incorporating Individualized Learning Plans into Post-Graduate Year Training

在住院醫師的臨床學習上，自主學習（self-directed learning）是重要的一環。然而，目前對自主學習有直接幫助的作法相對有限，其中一項能促進自主學習的作法便是個人化學習計畫（individualized learning plans, ILP）。本研究利用ILP引導PGY學員設定學習目標，發現有助於學員進行自主學習。這些ILP的學習目標不僅與一般醫學訓練內容相符，也能跟ACGME六大核心能力有所呼應，尤其是醫學知識與病人照護。學員執行ILP後，導師根據學員針對各ILP學習目標設定的評估內容與指標，發現在預定期限內，所有學員皆有達成學習目標。在學習動機策略問卷分數的變化上呈現對測驗的焦慮感顯著下降。意見調查結果顯示學員在ILP對自主學習的正面成效給予高度肯定。在這個強調臨床醫師自主學習，乃至終身學習的時代，將ILP融入住院醫師的訓練是不可或缺的。

For resident physicians, self-directed learning (SDL) plays a vital role in their clinical training. However, there are only a few measures that directly facilitate SDL. The individualized learning plans (ILP) program is one of them. This study aims to use ILP to help residents in their first post-graduate year (PGYs) achieve their learning goals, and we found ILP promoted SDL in the contexts of Taiwan. These PGYs’ learning goals were not only consistent with the goals of post-graduate year training but could also be referenced to the six core competencies of Accreditation Council for Graduate Medical Education (ACGME), especially medical knowledge and patient care. After implementing the ILP program, the PGYs all achieved their learning goals within the timeframe as the advisor checked with the criteria for assessment in their ILP forms. The PGYs’ scores of the Motivated Strategies for Learning Questionnaire revealed that their test anxiety significantly decreased. The survey results also showed that the positive effects of ILP on SDL were highly recognized by the PGYs. In the era when greater emphasis is placed on self-directed, lifelong learning of clinical physicians, we need to incorporate ILP into our postgraduate training.