新整合課程：分年、分段、分組教改之經驗及學生評論回饋分析

New Integrated Curriculum: Experience of Curriculum Reform and Analysis of Student's Feedback

10.6145/jme.200512_9(4).0003

陳偉德(Walter Chen)；沈戊忠(Wu-Chung Shen)；洪瑞松(Jui-Sung Hung)；楊美都(Mei-Due Yang)；陳安琪(An-Chyi Chen)；彭成元(Cheng-Yuan Peng)；林國瑞(Kuo-Juei Lin)；林綽娟(Chouh-Jiaun Lin)；蘇百弘(Bai-Horng Su)；吳錫金(His-Chin Wu)；許朝添(Chao-Tien

課程改革 ； 問題導向學習 ； 臨床技能與溝通 ； 學生回饋 ； curriculum reform ； problem-based learning ； clinical skills and communication ； student's feedback

Journal of Medical Education

9卷4期（2005 / 12 / 01）

24 - 36

繁體中文

中國醫藥大學醫學系自2001年起進行大規模的課程改革，設置教改執行委員會統籌，將傳統依學科作大堂授課的課程，改為依器官模組作混合式教學的「新整合課程」，並增加問題導向學習(problem-based learning, PBL)及臨床技能與溝通(clinical skills and communication, CSC)的課程。從2001至2005年間共有三屆377名醫學生完成臨床十二個模組，學生們對模組課程評論之問卷回收率為71.5%(54.1%~97.0%)，三屆學生總平均滿意度有逐年提昇之趨向，分別為3.76、3.81及3.98（5分很滿意；1分很不滿意）。總共2146人次之敘述性評論回饋中，正面贊同性回饋佔26.3%，批評建議性回饋佔73.7%；依課程安排、教師教學、教學資源、學業評量、其他等五項分類之敘述性建議，對新整合課程之推動有極大的助益。如文獻所述，領導團隊、合作風氣、團體成員參與、評論檢討、人力資源發展、行政配合等是成功推展教改必備的要素，本校教改的經驗，可供其他醫學院參考。

The School of Medicine, China Medical University has carried out an extensive curriculum reform since 2001. A curriculum reform executive committee, in charge of the planning and implementation of the curricular change, was made up of faculty members and students. Traditional discipline-based lectures were changed into an organ-based New Integrated Curriculum in a form of blocks that combined problem-based learning (PBL) and clinical skills and communication (CSC). Between 2001 and 2005, three cohorts of 377 medical students completed 12 clinical blocks and returned course evaluation questionnaire with a 71.5% (54.l to 97.0%) recovery rate. The average satisfaction of the students increased year by year and was 3.76, 3.81 and 3.98 for the last three years respectively (5 for very satisfied; 1 for very unsatisfied). Of the 2146 descriptive feedbacks, positive feedback accounted for 26.3%, while critical feedback accounted for 73.7%. The critical feedbacks could be classified into five groups: course arrangement, teaching content and methods, teaching resources, students assessments, and other factors; these have been of great benefit as we have tried to improve our New Integrated Curriculum. As stated, leadership, a cooperative climate, participation by school members, evaluation, human resource development, and politics are the key elements needed for successful curriculum reform. The experience of our school should be helpful to other medical schools.

1. 賴明亮、潘偉豐、薛尊仁(2002)。以問題導向學習方式實施病態生理學之教學評估。醫學教育，6，147-158。
   連結：
2. 醫學院評鑑委員會－評鑑準則：財團法人國家衛生研究院醫學院評鑑委員會
3. Liaison Committee on Medical Education. Washington DC & Chicago, 1997
4. Bernier GM Jr,Adler S,Kanter S(2000).On changing curricula: lessons learned at two dissimilar medical schools.Acad Med,75,595-601.
5. Bland CJ,Starnaman S,Wersal L(2000).Curricular change in medical schools: how to succeed.Acad Med,75,575-594.
6. Chen W,Shen WC,Kao ST(2005).Presented at the Annual Scientific Meeting of the Association for the Study of Medical Education.UK:Newcastle upon Tyne.
7. Chen YC,Fang JT,Lin JD(2005).Evaluation of problem-based learning education after clerkship at the Chang Gung University School of Medicine.Chang Gung Med J,25,758-763.
8. Cherng WJ(2002).Educational reform: problem-based learning at Chang Gung University, an overview.Chang Gung Med J,25,716-722.
9. Davis MH,Harden RM(2003).Planning and implementing an undergraduate medical curriculum: the lessons learned.Med Teach,25,596-608.
10. The Education Committee of the General Medical Council
11. Hudson JN,Tonkin AL(2004).Evaluating the impact of moving from discipline-based to integrated assessment.Med Educ,38,832-843.
12. Leung KK,Lue BH,Lee MB(2003).Development of a teaching style inventory for tutor evaluation in problembased learning.Med Educ,37,410-416.
13. Leung KK,Wang WD,Chen CY(1997).Evaluation of medical education reform at National Taiwan University College of Medicine.J Med Education,1,21-30.
14. Lin CS(2005).Medical students' perception of good PBL tutors in Taiwan.Teach Learn Med,17(2),179-183.
15. Miller GE(1990).The assessment of clinical skills/competence/ performance.Acad Med,65
16. Papa FJ,Harasym PH(1999).Medical curriculum reform in North America, 1765 to the present: a cognitive science perspective.Acad Med,74,154-164.
17. Peters AS,Greenberger-Rosovsky R,Crowder C(2000).Long-term outcomes of the New Pathway Program at Harvard Medical School: a randomized controlled trial.Acad Med,75,470-479.
18. The Executive Council, The World Federation for Medical Education(1998).International standards in medical education: assessment and accreditation of medical schools` educational program.A WFME position paper. Med Educ,32,549-558.
19. Wang WD,Lue BH(2003).National Taiwan University College of Medicine, the design of medical humanities courses for clerkships.Acad Med,78,1073-1074.
20. Wang WD,Yang PC,Chen CY(2004).Using senior residents as standardized patients for evaluating basic clinical skills of medical students.J Formos Med Assoc,103,519-525.
21. Consortium of Academic Health Centers for Integrative Medicine, May 2004
22. WFME Global Standads for Quality Improvement
23. Yu HY,Wu ZA,Su MS(2000).Zhonghua Yi Xue Za Zhi.Taipei:
24. 王惠珀、洪永泰、何弘能(1997)。醫學課程教學效果調查之分析。醫學教育，1，411-420。
25. 呂碧鴻、梁繼權、李明濱(1998)。小班教學課程之評估分析。醫學教育，2，386-397。
26. 高美英、李明濱、呂碧鴻(1999)。醫學系教學評量結果之三年追縱分析。醫學教育，3，70-78。
27. 陳震寰、郭英調、蕭光明(1998)。問題基礎學習小班教學可行性之先驅研究。醫學教育，2，398-408。

1. 雷漢聲、黃錦華、涂卉(2016)。問題導向學習教學模式下學習動機對學習滿意度影響之研究─以弘光科技大學為例。商管科技季刊，17(4)，467-491。