「標準化病人參與經驗量表」之編製與驗證

Development and Validation of Standardized Patients' Participation Experiences Scale

高聖博(Sheng-Po Kao)；朱紹盈(Shao-Yin Chu)；陳哲翰(Che-Han Chen)；黃韻宇(Yun-Yu Huang)；何縕琪(Yun-Chi Ho)

參與經驗 ； 量表發展 ； 標準化病人 ； participation experiences ； scale development ； standardize patients

測驗學刊

69卷2期（2022 / 06 / 30）

143 - 165

繁體中文

臺灣自2000年初引進客觀結構式臨床技能測驗及標準化病人於醫學教育，同時提供學生接觸真實病人前的過渡學習經驗。臺灣不少醫院招募志工來擔任標準化病人，且必須接受培訓和繼續教育課程，其過程相當耗時費心；再加上華人傳統忌諱觀念的影響，招募及維繫標準化病人實屬不易。為協助醫學校院評估標準化病人之成效，並解決招募不易的難題，本研究旨在編製一份有良好信效度的「標準化病人參與經驗量表」。量表發展歷程包括：（1）訪談15位標準化病人，以「類別－內容」進行訪談逐字稿之分析，形成量表架構與題目內容；（2）由專家進行試題評估與審核，確立量表題目；（3）立意取樣臺灣東部、北部、南部7所醫院的標準化病人，預試有效樣本100份，正式施測有效樣本317份。經項目分析、探索性因素分析、信度分析、驗證性因素分析，編製「標準化病人參與經驗量表」。研究結果包括：（1）經探索性因素分析，原先的39個題目被縮減為22個，進一步透過驗證性因素分析歸納出「參與動機」、「參與感受」、「持續投入」與「健康知能」四個構面；（2）總量表Cronbach's α值為.96，各構面Cronbach's α值介於.90～.96，顯示具良好信度；建構效度SEM模式的整體適配度指標均達標準，顯示適配情形理想。

Taiwan introduced the Objective Structured Clinical Skills (OSCE) test and the use of standardized patients into medical education beginning in the year 2000, with the intention of providing students with transitional learning experience before contacting real patients. Many hospitals in Taiwan recruit volunteers to serve as standardized patients, who must undergo a training program and continuing education courses to become competent. The time-consuming and labor-intensive training, coupled with traditional Chinese taboos to prevent connections with illness, hindered the success of recruiting standardized patients. To aid the hospitals with future recruitment, this study intends to develop a standardized patient participation experience scale with good reliability and validity. The scale was developed through the following processes: (1)15 standardized patients were interviewed, and verbatim transcripts of the interviews were analyzed by ＂category-content＂ to form the scale structure and topic content. (2)Experts were invited to evaluate and review the scale questions. (3)100 volunteers from 7 hospitals in Taiwan, agreed to participate in a pilot study, and another 317 volunteers participated in a formal test. After item analysis, exploratory factor analysis, reliability analysis, and confirmatory factor analysis, the ＂Standardized Patient Participation Experience Scale＂ was developed. The results of the study include: (1)Out of 39 questions, 22 were accepted into the participation experiences scale by the factor analyses, and four factors -- participation motivation, participation feeling, continuous investment, and health awareness -- were identified; (2)The Cronbach's α value of the total scale is .96, and the value of the four factors range from .90 to .96, indicating good reliability; all fitness indices of construct validity in the SEM model matched the standard, showing a good fitness of the scale.

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