「與病人為友」課程對醫學生之學習成效研究

Effect of a Course ''Standing by the Patients'' on Medical Students' learning

如何培養今日的醫學生成為明日的良醫？實非易事。國外的文獻發現以病人為師的醫學教育，對醫學生而言，不但能加強醫術學習，也有助於培養視病猶親的態度。本研究以兩年來選修「與病人為友」課程之138位醫學生為對象，從社會建構觀點，根據醫學生在開放性問卷的內容進行資料的質性分析。研究結果彙整成四部分，共32項學習成效，第一部分：從陪伴病人中主要學習到與陌生病人建立友誼的過程與體會，學習要對病人投入傾聽、愛、幽默與同理心，學習到如何去陪伴及關心病人。第二部分：領悟到健康就是福，要珍惜生命是最高的一項，其次是領悟到投身醫業的使命感，要體恤病人減少其痛苦及醫師不僅要有精湛的醫術，更要有心靈的安慰。第三部分：有關對醫學生角色的影響，學習到以一種謙卑的態度向病人學習，期許能醫術醫德兼備最多，其次是培養醫學人文素養，激發愛與關懷，亦可從病人的角度，檢視病人對醫師的期待。第四部分：有關課程的意義及重要性，主要認為以病人為師，可以培養醫學生視病猶親的態度，其次是賦予醫學生更重的使命感。本研究結果，可以作為醫學教育改革的參考，向病人學習、以病人為師的課程是可行有益的學習方式。

How to nourish today's medical students to become tomorrow's good doctors is a diffcult task. It was found in literature that educating students treat patients as teachers not only strengthened medical skill learning but also develops students' attitude to serve patients as relatives. This study intended to investigate the effect of a course ''Standing by the Patients'' on medical students. Learning over a two-year period, 138 medical students taking the course were invited to respond open-ended questionnaires. The data collected were analyzed on the basis of social constructivism. The results are classified into four main parts, consisting of 32 subcategories. Which can be boiled down to a new understanding of doctor-patient relationship. After the hands-on experience of caring the invalid, could respect patients as their knowledgeable others and are more ready and willing to listen to them and to learn from them. In summary, the course ''Standing by the Patients'' is beneficial for medical student's learning. The findings of this study hopefully may provide useful information for the advancement of medical education.