臨床教師與學員對教學計劃執行的認知分析初探－－以一區域教學醫院為例

Preliminary Analysis of Perceptions about Teaching Program Implementation by Clinical Teachers and Students at a Regional Teaching Hospital

目的：本研究欲了解在教學計畫執行後，學員與臨床教師間計畫評量之認知結果是否有所差異，並試圖探討其原因，以促進臨床教師與學員間之溝通、落實計劃改善並提升教學品質。方法：依據美國國家醫學研究院(IOM)所提出醫療人員應具備之核心能力、教學醫院教學費用補助計畫稽核要點與教學醫院評鑑缺失為參考，設計一結構式問卷，分別對教學計畫內的受訓學員與臨床教師進行橫斷面問卷調查，以SPSS 12.0統計軟體進行描述性與推論性統計分析。結果：整體學員對教學計畫執行以學術研究與文章發表能力、能將一般醫學學習課程融於學習過程中及明確的課程設計與確實執行教學內容為最不滿意的前三名，且在明確的課程設計與確實執行教學內容一題，整體學員普遍認為不足，而臨床教師卻認為其已確實執行(p<0.05)。進一步分析，對教學計畫執行之認知差異主要來自醫師族群，且在有清楚的教學目標及整體滿意度方面，醫師學員明顯比臨床教師更不滿意(p<0.05)。學員族群中的醫師學員，對於學術研究與文章發表能力較醫事人員學員還不滿意(p<0.05)。結論：整體而言，本院臨床教師在教學熱誠、能以身作則執行全人醫療照護等方面，在學員的認知調查中，滿意度皆很高，但教學模式較無結構性，不熟悉相關教學技巧且因忙碌而未確實執行教學課程，則可能是造成雙向差異的主要原因。另外，醫師的教學訓練可能因為忙碌、教學計畫缺乏持續性規劃之負責人，造成整體學員與臨床教師對教學計畫的認知有較大且具意義的落差。建議未來應定期對學員與臨床教師作教學計畫的評估與調查，才能真正了解教學計畫執行之缺失，以作為課程設計改善之依據，方能提升教學計畫執行之品質與成效。

Purposes: This study was conducted to gain a better understanding of perceptions by students and clinical teachers about newly implemented teaching programs in order to promote communication between teachers and students and improve the quality of education. Methods: A questionnaire was designed to include the necessary competencies expected of a medical staff as proposed by the Institute of Medicine. The subjects were students and clinical teachers in the training programs. SPSS 12.0 statistical software was utilized for descriptive and inferential statistical analysis. Results: Students were most dissatisfied with academic research capabilities, integration of general medical courses into the learning process, and implementation of academic content in clinical practice. In particular, students felt the last topic was inadequately covered; however the clinical teachers considered it to be fully implemented. Further analysis found that these different opinions came primarily from student-doctors. In the area of clear teaching objectives and overall satisfaction, student-doctors were more dissatisfied than their clinical teachers. Student-doctors were also the most dissatisfied with academic research capabilities when compared with students in other medical staff. Conclusions: Overall, clinical teachers in our hospital were rated highly by their students with respect to enthusiasm for teaching and conscientious medical care; however, the students felt that the teaching model was poorly structured, teachers were not familiar with relevant educational skills, and teachers did not fully implement courses due to lack of time. As the training were interrupted because of more serious clinical issues and no one was in place to ensure continuity of teaching program, which may have resulted in significant differences of opinion about the teaching program by students and clinical teachers. In the future, we suggest regular surveys of both teachers and students to find ways to implement more effective programs.