Student-Centered Learning in Medical Education in Relationship to Patient-Centered Care in Clinical Settings

以學生為中心的醫學教育和以病人為中心的臨床照顧之間的關聯

關超然(Chiu-Yin Kwan)；李孟智(Meng-Chih Lee)；周致丞(Fremen Chih-Chen Chou)

Student-centered learning ； Self-directed learning ； Problem-based learning ； Competence-based medical education ； Patient-centered healthcare ； 以學生為中心的學習 ； 自主學習 ； 以問題為導向的學習 ； 基於崗位勝任力的醫學教育 ； 以病人為中心的醫療照顧

醫學與健康期刊

9卷3期（2020 / 11 / 01）

1 - 11

英文

While our society has now inevitably marched into the 4^(th) industrial revolution which are symbolized with internet of things and artificial intelligence, the concept of education 4.0 which reflect a personalized education, or student-centered learning (SCL) per se, has been modified for the generation of internet natives. However, the everyday practice of medical education still relies much on lectures which still typically echo the mode of teacher-centered learning. This commentary is geared to reinforce the concept of SCL in medical education in relation to patient-centered healthcare. Firstly, SCL is appropriately defined as the six-principle learning (e.g., personalized, self-directed, outcome-based, active, reflective, and flipped classroom learning) and twelve characteristics for students practicing SCL are introduced to conceptualized SCL. Secondly, problem-based learning with a three-dimension concept (i.e., the Population, Behavior and Life Science perspectives) is illustrated to demonstrate how the six principles and twelve characteristics of SCL are incorporated within the integrative and holistic perspectives of medical education. Finally, via elaboration of the connection between problem-based learning in undergraduate education and competency-based medical education in postgraduate training in light of preparing students for future professionals in holistic healthcare, this commentary concludes that the inspiration of SCL remain vibrant through the whole continuum of medical education, in which a similar set of transferrable values of learning outcomes move from student-centered basic medical science education towards patient-centered clinical healthcare.

當我們的社會已無法避免地邁進以物聯網和人工智能為象徵的第四次工業革命的同時，體現個體化教育的精神或以學生為中心學習（Student-centered learning, SCL）本身的4.0版本的教育理念，已經為了新一代的互聯網人在悄然改變。然而，現在醫學教育的日常實踐仍然依賴於講學授課，典型地迴響著以教師爲中心的被動學習。本文的評論旨在強化以學生為中心（SCL）的醫學教育理念並將之聯貫到以病人為中心的醫療照顧。首先，SCL可以恰當地定義為六項原則（個性化、自主性、以結果為導向的學習等），並陳述學生在實踐過程中所需要具備的十二個要素來把SCL的理念具體化。其次，以具三個維度特徵（群體、行爲和生命科學）的Problem-based learning（PBL）為例，說明如何將SCL的六項原則和十二項特徵融入整合性和全人性的醫學教育。最後，通過詳細闡述以問題為導向的學習（PBL）的醫學本科教育和基於崗位勝任力（Competency-based medical education, CBME）的專科教育培養過程的醫學教育之間的內在互容性，對未來醫療衛生行業從業者的整合全人化的素質做準備。此文的評論認為SCL的概念在整個醫學教育的銜接過程中的作用充滿前景活力，從以學生為中心的醫學基礎教育邁向以病人為中心的醫療臨床照顧都具有相似的，並可相容轉移的價值觀。

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