尊嚴教學？抑是羞辱式教學？實習醫學生的觀察與質性述說

Dignified or Humiliating Teaching? Observations and Qualitative Narratives of Medical Students during Clinical Rotations

目的：本研究旨在了解醫學生在臨床實習期間所觀察或經歷的尊嚴學習或貶抑羞辱學習經驗。方法：研究期間為2023年9月至12月，邀請32名在教學醫院進行臨床實習的六年級醫學生參與研究。資料蒐集方法為質性訪談。資料分析採取內容分析法。結果：研究結果顯示，從批評中學習以及尊重的教學氛圍是尊嚴教學的樣態。然而，臨床學習過程中的「羞辱式教學」確實存在，尤其是醫學生對於自身所面對的疾病或者病例欠缺臨床所期待的專業知識能力時。羞辱式學習經驗可能發生在他人身上，亦可能是自身經驗。儘管羞辱性的教學行為需要被制止，但考量成績的因素，許多醫學生皆選擇隱忍自己所遭遇的羞辱與恐嚇，並鮮少透過正式申訴管道進行意見反映。結論：臨床實習是醫學教育的一環，必須覺察醫學生在臨床實習期間可能經歷的恐嚇與羞辱行為。面對這些有辱人格尊嚴的教學行為，應採取更有效且更尊重的教學方法。

Objectives. This study aimed to better understand dignified and degrading learning experiences encountered by medical students during their clinical rotations.
Methods. This study was conducted between September and December 2023. The study included 32 sixth-year medical students currently undergoing clinical rotations in clinical settings. Data were collected through qualitative interviews and analyzed using a content analysis method.
Results. The study's findings suggest that learning from criticism and teaching in an atmosphere of respect are examples of dignified teaching. However, ''humiliating teaching'' occurred in the clinical learning process, particularly when medical students lack the pro-fessional knowledge and competencies required by the clinic for the diseases or cases they encounter. Humiliating learning experiences can occur in the presence of others or privately. Although demeaning teaching behaviors must be eradicated, many medical students prefer to suffer the humiliation and intimidation they face because they are afraid of receiving low grades. Furthermore, students rarely consider addressing their concerns through formal complaint procedures.
Conclusion. Dignified learning during clinical rotations is part of medical education. It is critical to be aware of the disturbing and humiliating behaviors that medical students may encounter during clinical rotations. In response to these degrading teaching behaviors, more effective and respectful teaching approaches should be implemented.
(J Med Health. 2025;14(3):47-54)