台灣各界對醫學系學制變革可行性的看法

The Feasibility of Implementing Medical Curricular Change: Taiwanese Perceptions

10.6145/jme.201003_14(1).0001

蔡淳娟(Tsuen-Chiuan Tsai)；林其和(Chi-Her Lin)；劉克明(Keh-Min Liu)

醫學教育 ； 招生 ； 醫學系學制 ； 面談 ； 學士後學制 ； medical education ； student selection ； medical curriculum ； interview ； graduate entry program

Journal of Medical Education

14卷1期（2010 / 03 / 01）

1 - 14

繁體中文

醫學系學制決定選到的醫學系學生，影響醫療品質甚鉅；如今，台灣醫師的服務能力與熱忱等問題可能普遍存在，然而台灣醫學系選取高中畢業生，於醫學院求學期間幾乎沒有退場機制，顯示醫學系招生與學制需要再經反省。方法：本研究以網路和書面問卷的方式收集資料，問卷依照受訪者背景分為行政主管、教師、學生與家長版，詢問受訪者對進行醫學系學制及招生方式改變之看法，面對改革可能遭遇的阻礙，以及此變革可能對自身或學校的衝擊等。結果：總計收到有效問卷1658份，以醫學系學生填答人數(73.7%)最多，一般認為改為六年制變化不大，但是問全面改後醫制時發現，各界人士之反應非常分歧，贊成二類學制的醫學院主管與醫學系教師幾乎是各半，非醫學系教師較多贊成後醫制，而醫科學生及高中學生／家長則較多贊成傳統學制，大多數受訪者都贊成畢業後的臨床訓練，一般認為阻礙改後醫制的首要原因為面談甄選之疑議與醫學教育界缺乏共識，家長們可能是最不能接受變革的群組。作者群建議「醫預科加上部分後醫制」模式，並提醒對此議題深入研究，建立專家間共識，在理論基礎上確立改制方向，本研究提供台灣各界的意見，以為將來進行變革時溝通協調與建立配套措施之依據。

The selection of medical students is closely related to the medical curricular model (high-school or graduate-entry), and this process is a major determining factor in the ultimate healthcare quality. Currently in Taiwan, the medical curriculum with high-school entry and a few drop-outs during the years studying medicine may cause problems, and thus a reevaluation of the curricular model is required. Methodology: This study used both internet and paper surveys to ask participants about their preference for a curricular model and their perceptions about the resistance/impacts derived from curricular changes. The participants were divided into 4 groups: administrative leaders, faculty, students, and parents. Results: There were 1658 responses in total, mainly from Taiwanese medical students (73.7%). Six-year curriculum was considered a model unchanged. When asked about the choice between high-school and graduate-entry programs, respondents were equally split in supporting each model. More non-medical faculty supported graduate-entry programs, while more students and parents supported high-school entry. The majority approved of postgraduate training. The major barriers to implementing a graduate-entry program included the equality of oral interviews and a lack of consensus. Parents were most often opposed to changing the graduate medical program. The authors suggest a new curricular model that offers a pre-medical program and accepts a significant proportion of graduate-entry students. This study also highlighted the importance of gathering a consensus for future directions based on evidence and sound philosophy. The data in this research provide a basis for future communication and implementation of changes.

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2. 蔡博方,黃寬重,曾美芳(2022)。醫學人文的關鍵時刻─有心插柳的規劃與開放式的論述發展。長庚人文社會學報，15(2)，83-118。