藥學客觀結構式臨床測驗（OSCE）教案設計實務

Pharmacy Objective Structured Clinical Examination (OSCE) Scenario Design Practice

10.6168/FJCP.201810_26(4).0001

鄭景耀(Ching-Yao Cheng)；吳明芬(Ming-Fen Wu)；劉文雄(Wen-Shyong Liou)

客觀結構式臨床測驗 ； 教案設計 ； 測驗藍圖 ； 評量表 ； Objective Structured Clinical Examination ； OSCE Scenario Design ； Blueprint ； OSCE Checklist

臺灣臨床藥學雜誌

26卷4期（2018 / 10 / 31）

251 - 257

繁體中文

隨著臺灣醫學教育發展，客觀結構式臨床測驗(objective structured clinical examination, OSCE)已納入國家考試項目。而「提升用藥安全」連續11年被衛生福利部醫策會所推動的「年度醫院病人安全工作目標」列為首要項目，以及病人用藥意識增加，藥師的角色已逐漸轉型為必須參與跨領域醫療團隊並提供臨床病人所需的藥事照護服務。然而，藥師執行臨床藥事照護需具備「專業知識」(knowledge)、「態度」(attitude)與「技能」(skill)等基本核心能力，為了確保藥師的臨床照護能力與確保服務品質，「Miller學習與評量金字塔理論」建議以標準化病人為基礎的OSCE，是最適合用來評估「能做正確（表現能力）」(shows how)學習成果的工具。教案設計為進行OSCE評估的首要工作，進行設計前需考量的重點，包含教案藍圖、主題設定、評估對象、情境、考生指引、考官指引、標準化病人指引與評量表等具體項目，相信是許多撰寫OSCE教案的藥師仍在探索的問題。本文擬依據國家考試之教案模式與筆者舉辦OSCE教案設計工作坊之心得，期望提供有效又可行的教案設計與撰寫方法，讓在藥學領域裡有心投入教案設計者，有個參考的步驟與方向。

Objective structured clinical examination (OSCE) is currently used in the Senior Professional and Technical Examinations for qualifying medical doctors in Taiwan. The promotion of drug safety has been ranked at the top priority for 11 consecutive years in the ＂Hospital Patient Safety Annual Goals＂ issued by the Ministry of Health and Welfare. At present, the role of pharmacist, apart from providing clinical pharmaceutical services, also incorporates the participation across different professional medical teams. To realize this role, some core basic competency of a pharmacist is required. They include ＂knowledge＂, ＂attitude＂ and ＂skill＂. To ensure such high levels of clinical care, the evaluation of learning outcomes of pharmacists is necessary. One standard evaluation method regarding ＂shows how＂ is OSCE, as recommended in the ＂Miller's learning and assessment pyramid theory＂. One primary task of OSCE is the design of the teaching plan. In the design, the key points considered are the following: teaching blueprint, case theme, assessment objectives, the medical situation, participant guidelines, examiner guidelines, standardized patients guidelines and the OSCE checklist. The above issues are likely in the minds of most pharmacists planning an OSCE. Findings of the present study were generated based on: (1) the lesson planning model of the Taiwan national examinations, together with (2) our own experiences in organizing a workshop on the design of OSCE teaching plan. Results could provide an effective and practical reference for the scenario design for pharmacists involved in writing OSCE lesson plans.