醫學倫理法律之醫病溝通教育是否影響醫學生未來的專科選擇

The Influence of a Medical Ethics- and Law-Based Doctor-Patient Communication Course on Future Specialty Choice of Medical Students

鄭希彥(Shi-Yann Cheng)；林莉華(Lih-Hwa Lin)；高忠漢(Chung-Han Kao)

醫學倫理 ； 醫事法律 ； 問題導向式學習 ； 醫病溝通 ； Medical ethics ； Medical law ； Problem-based learning ； Doctorpatient communication

醫學與健康期刊

5卷2期（2016 / 09 / 01）

45 - 55

繁體中文

目的：台灣近年來醫療糾紛與訴訟快速成長，嚴重影響醫學生選擇專科執業行為。本校為了解醫學生在中國醫藥大學北港附設醫院接受醫學倫理法律為基礎之醫病溝通整合性特設課程後，是否會影響其未來的專科選擇，故設計觀察性的世代研究。方法：本研究乃針對於2011年9月至2013年4月至北港附設醫院見習的學生為觀察組，而至非北港附設醫院見習的學生為對照組。在歷經實習醫師、通過國家執照考試與畢業後一般醫學訓練，約2年半至3年半的時間後，在衛生福利部醫事查詢系統，查得其執業科別，以卡方檢定比較兩組學生的專科選擇差異。結果：本研究的學生共有258名，於2016年1月31日截止查詢，通過國家醫師執照考試與一般醫學訓練後共有173名選擇專科執業，其中在北港附設醫院見習者有91名，在非北港附設醫院見習者有82名，對專科的選擇並無差異。結論，由本研究得知，不論當初有無接受醫病溝通整合性特設課程，對爾後專科執業的選擇並無差異。

Objectives. The significant increase in medical disputes and lawsuits in recent years in Taiwan has severely affected specialty selection of medical students in practice. For this reason, we designed an integrated doctor-patient communication course based on ethics and law and conducted a cohort study to understand whether this course influenced the students' future specialty selection. Methods. This study was conducted among clerkship students who practiced from September 2011 to April 2013. The students practicing in China Medical University Beigang hospital were assigned to a study group, while those students practicing in Kuang Tien General Hospital and Saint. Mary's Hospital Luodong were assigned to a control group. After students completed their internships and passed the national licensing examination and post-graduate medical training, we obtained data on specialties within which those students were practicing from the medical inquiry system of Ministry of Health and Welfare about 2.5 to 3.5 years post clerkship. The difference between two groups was calculated using chi-square test. Results. This study included 258 medical students, 173 of whom completed the internship and passed the national licensing examination and post-graduate medical training before the deadline query on January 31, 2016. Analyzing data from ninety-one of 173 students in the study group and 82 of the students in the control group, we found no significant difference between two groups (p=0.3955). Conclusion. The integrated course on doctor-patient communication in clerkship did not influence specialty selection in the students.

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