畢業後一般醫學訓練住院醫師對訓練課程之觀點調查分析

Analysis of the Viewpoint of First Postgraduate Year Residents towards General Medicine Training

10.6145/jme.200912_13(4).0007

呂碧鴻(Bee-Horng Lue)；鄭逸如(Yih-Ru Cheng)；王長偉(Chang-Wei Wang)；高美英(Meei-Ying Kao)；陳秀蓉(Hsiu-Jung Chen)

一般醫學訓練 ； 畢業後第一年住院醫師 ； 學習觀點 ； first postgraduate year residents ； general medical training ； learning viewpoint

Journal of Medical Education

13卷4期（2009 / 12 / 01）

268 - 274

繁體中文

目的：本研究調查畢業後第一年(First postgraduate year, PGY1)住院醫師對一年期一般醫學訓練的看法及自覺學習成效。研究方法：以2006年度PGY1醫師為研究對象，問卷調查期間為2007年1月至6月。評估PGY1住院醫師自覺一年期一般醫學訓練的幫助程度與壓力感受，以及以開放式題項探索其對此訓練之看法。資料檢測以質性分析法進行。結果：共有407位PGY1住院醫師完成對一般醫學訓練幫助程度與壓力感受之評估。PGY1住院醫師自覺幫助程度依大小排序為專科全人醫療訓練、專科相關選修、一般醫學實務訓練、社區醫學基本課程、社區醫學相關選修。壓力感受程度大小依序為專科相關選修、專科全人醫療訓練、一般醫學實務訓練、社區醫學相關選修、社區醫學基本課程。有467位PGY1住院醫師填寫對此訓練的看法之開放式題項。PGY1住院醫師認為一般醫學訓練能增進全人醫療能力、瞭解醫療模式與行為及有助於生涯規劃，但課程內容不嚴謹、教學品質不穩定、重複實習醫師訓練課程及行政文書作業太重。訓練時間不宜一年。結論：PGY1住院醫師著重專科相關訓練。一年期之一般醫學訓練課程需更嚴謹規劃方能提升學習成效。

Purpose: The aim of this study is to investigate the perceived learning effectiveness of first postgraduate year (PGY1) residents and their viewpoints on general medicine training. Methods: PGY1 residents in the academic year 2006 were the study subjects. The study was conducted from January to June 2007. The degree of helpfulness and the perceived stress levels of the students were assessed. The approach to this assessment of the training program involved open questioning. The dataset was analyzed by qualitative methods. Results: A total of 407 PGY1 residents were assessed to explore the helpfulness of five training modules. The results gave the following decending order of helpfulness: the holistic care training in a specialty field, the specialty related elective course, general practice training, the basic community medicine course and the community medicine related elective course. The perceived stress levels for these courses, also in decending order, were: the specialty related elective course, the holistic care training in a specialty field, general practice training, the community medicine related elective course and the basic community medicine course. A total of 467 residents filled out the open questionnaire. Residents believed that the general medicine training was able to promote their holistic care competency and helped them understand the medical care model and medical care behavior as well as helping their career planning. However, the less concrete the teaching material, any fluctuation in teaching quality, overlapping of a course with internship and overloading with administrative clerical work were identified as weaknesses by the residents. Some even complained that the one-year training period was over-long and should be shortened. Conclusion: PGY1 residents were found to center their interest on training in their specialty. The planning of the one-year course should be more precise and concrete in order to promote learning effectiveness.

1. Lue BH,Kao MY,Chen HJ(2009).Analysis of job stress and satisfaction among first postgraduate year residents: a nationwide survey in Taiwan.J Med Eduaction,13,113-121.
   連結：
2. (2003).Graduate Medical Education Directory 2002-2003.Chicago:American Medical Association.
3. Chu TS (Eds)(2009).Six Core Competencies in Residency Training.Taipei:Taiwan Association of Medical Education.
4. Hsieh BS(2004).Current status and perspectives of postgraduate general medicine training.Taiwan Joint Commission on Hospital Accreditation and Quality Improvement General Medicine Training Newsletter,1,3.
5. Hsieh BS(2003).General Medicine Education.Taipei:National Taiwan University College of Medicine.
6. Institute of Medicine.(2003).Health Professions Education: A Bridge to Quality.Washington DC:The National Academies Press.
7. Jeng TT(2005).Report on survey of general medicine training among first postgraduate residents in 2004.
8. Kassebaum DG,Szenas PL(1994).Factors influencing the specialty choices of 1993 medical school graduates.Acad Med,69,163-170.
9. Levey RE(2001).Sources of stress for residents and recommendations for programs to assist them.Acad Med,76,142-150.
10. Patton MQ(2002).Qualitative research and evaluation methods.Thousand Oaks, CA:Sage.
11. Petersdorf RG(1993).Primary care-medical students' unpopular choice.Am J Public Health,83,328-330.
12. Pitt E,Rosenthal MM,Gay TL(2004).Mental health services for residents: more important than ever.Acad Med,79,840-844.

1. 馮紀新,陳建仲,邱詩方,伍崇弘(2019)。中醫專科醫師制度的建立與推動之研究。中醫藥研究論叢，22(1)，243-253。