台灣牙醫學生之同理心變化調查

Measurement of Changes in Empathy during Dental School in Taiwan

10.6145/jme.200512_9(4).0005

陳思光(Curtis Suu-Kuang Chen)；雪曼•傑夫(Jeff Sherman)；李達維(Ta-Wei Lee)；林明勳(Ming-Hsuen Lin)；藍萬烘(Wan-Hong Lan)

同理心 ； 溝通 ； 牙醫學教育 ； empathy ； communication ； dental education

Journal of Medical Education

9卷4期（2005 / 12 / 01）

48 - 54

繁體中文

醫療環境中，同理心包括理解病患的經驗與感受，和對病患回應此理解之能力，以為建立互信之基礎。同理心在醫療環境中很重要，在牙醫的醫療行為也應扮演重要角色，但國內尚缺對牙醫師同理心的研究，特別是牙醫學生在養成過程中同理心的變化。本研究使用在美國之牙醫學院研究中證實其信效度的同理心心理量表問卷，以台大牙醫學系各年級共201位學生為對象，回收143份問卷分析後發現，在牙醫系六年修業過程中，一至三年級有較高之同理心，四至五年級同理心降低，六年級又降至更低。一至三年級組與六年級組有顯著差異。此隨年級增加而同理心降低趨勢與以相同問卷調查的美國牙醫系學生相似。整體而言，國內受試之牙醫系學生同理心較美國牙醫學生為低。國內之牙醫教育應重視為何牙醫學生養成中同理心會降低，也應研究為何牙醫學生學前之教育造成國內學生同理心較低。

Empathy has been shown to play an important role in the dentist-patient relationship and is a core competence for dentists. However; little is known about changes in student empathy during dental school in Taiwan. We used a validated questionnaire to compare levels of empathy in dental students across their six years of training. One hundred and forty three students completed a survey including the Jefferson Scale of Physician Empathy (JSPE). First, second, and third year dental students had significantly higher empathy scores than 6th year dental students. Consistent with other literature in medical settings, the timing of the decline in empathy levels corresponded to increases in patient exposure. The average empathy is lower in Taiwan dental students than in the States. We suggest that training students in the interpersonal skills designed to enhance the dentist patient relationship should continue throughout dental school training.

1. Sherman JJ,Cramer A(2005).Measurement of changes in empathy during dental school.J Dent Educ,69(3),338-345.
   連結：
2. Association of American Medical Colleges(1999).Report I Learning objectives for medical student educationguidelines for medical school.Acad Med,74,13-18.
3. Avery JK.(1985).Lawyers tell what turns some patients litigious.Med Malpractice Rev,2,35-37.
4. Beckman GB,Markakis KM,Suchman AL(1994).The doctor-patient relationship and malpractice: Lessons from plaintiff depositions.Arch Intern Med,154,1365-1370.
5. Colliver JA,Willis MS,Robbs RS(1998).Assessment of empathy in a standardized-patient examination.Teach Learn Med,10,8-11.
6. Grace EG,Sarlani E,Balciunas BA(2002).Referring patients for stress-related disorders.Gen Dent,50(6),538-539.
7. Hojat M,Gonnella JS,Mangione S(2003).Physician empathy in medical education and practice: experience with the Jefferson Scale of Physician Empathy.Sem Intergrative Med,1,25-41.
8. Hojat M,Gonnella JS,Nasca TJ(2002).Physician empathy: definition, components, measurement, and relationship to gender and specialty.Am J Psych,159,1563-1569.
9. Hojat M,Mangione S,Nasca TJ(2001).The Jefferson scale of empathy: development and preliminary psychometric data.Educ Psychol Meas,61,349-365.
10. Kleinknecht RA,Klepac RK,Alexander LD(1973).Origins and characteristics of fear of dentistry.J Am Dent Assoc,86(4),842-848.
11. Laskin DM,Greene CS(1972).Influence of the doctor-patient relationship on placebo therapy for patients with myofascial pain-dysfunction (MPD) syndrome.J Am Dent Assoc,85(4),892-894.
12. Levinson W(1994).Physician-patient communication: a key to malpractice prevention.J Am Med Assoc,273,1619-1620.
13. Marzola R,Derbabian K,Donovan TE(2000).The science of communicating the art of esthetic dentistry.Part I: Patient-dentist-patient communication. J Esthet Dent,12(3),131-138.
14. Rogers CR(1951).Client centered therapy, its current practice, implications, and theory.Boston:Houghton Mifflin.
15. Schouten BC,Eijkman MA,Hoogstraten J(2003).Dentists and patients communicative behavior.Commun Dent Health,20(1),11-15.
16. Sinha PK,Nanda RS,McNeil DW(1996).Perceived orthodontist behaviors that predict patient satisfaction, orthondist- patient relationship, and patient adherence in orthodontic treatment.Am J Orthodontics and Dentofacial Orthopedics,110(4),370-376.
17. Sondell K,Soderfeldt B,Pamqvist S(2002).Dentist-patient communication and patient satisfaction in prosthetic dentistry.Int J Prosthodont,15(1),28-37.
18. Squier RW(1990).A mode of empathic understanding and adherence to treatment regimens in practitioner-patient relationships.Soc Sci Med,30,325-339.
19. Stephan WG,Finlay KA(1999).The role of empathy in improving inter-groups relations.Journal of Social Issues,55,729-743.
20. Suchman LA,Roter D,Green M(1993).Physician satisfaction with primary care office visits: Collaborative Study Group of the American Academy of Physician and Patient.Med Care,31,1083-1092.
21. Weinstein P,Getz T,Ratener P(1982).Dentists' responses to fear and non-fear related behaviors in children.J Am Dent Assoc,104,38-40.

1. Lee, Robert M.K.W.(2011).Problem-based Learning Curriculum: Problems and Possible Solutions.醫學教育,15(4),10-20.
2. Shu-Chung Lii,Ji-Tseng Fang(2023)。Evaluation of Trainee Empathy Enhancement and Learning Outcomes Through Online Education - A Study on Instructional Videos on Shared Medical Decision-Making, Truth-Telling, Patient Emotional Disturbance。醫學教育，27(3)，177-189。
3. Wang, Yi-Hsuan,Hsieh, Molly(2011).The Relationship among Personality Traits, Perceived Emotional Intelligence, and Physician Empathy in Medical Students.醫學教育,15(4),29-38.
4. Wang, Yi-Hsuan,Hsieh, Molly(2013).The Effect of an Empathy Training Program in a Medical School in Taiwan.醫學教育,17(4),156-164.
5. 戴政宏、鄭浩民、楊盈盈、陳震寰、莊喬琳、張景智、高延壽、徐會祺、李發耀、李文興(2010)。以迷你臨床演練評量評估牙醫系實習醫師之一般醫學臨床能力。醫學教育，14(4)，282-292。
6. 謝明儒,胡正申(2022)。醫學漫畫媒材融入人際互動學習同理心之研究。長庚人文社會學報，15(2)，119-157。