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中醫藥研究論叢
 221.24 以客觀結構臨床測驗評估中醫實習醫學生中醫實習之學習成效
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TJ TCM.22(1) : 255-264, 2019
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以客觀結構臨床測驗評估中醫實習醫學生中醫實習之學習成效
Use of An Objective Structured Clinical Exam (OSCE) for Evaluating the Learning Effectiveness in the Clinical Internship of Chinese Medical Students
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沈炫樞1,5 葉家舟2,5 陳建仲3,5 陳建霖4,5 柯建新1,5*
1 佛教慈濟醫療財團法人花蓮慈濟醫院中醫部，花蓮，台灣
2 佛教慈濟醫療財團法人大林慈濟醫院中醫部，嘉義，台灣
3 佛教慈濟醫療財團法人台中慈濟醫院中醫部，台中，台灣
4 佛教慈濟醫療財團法人台北慈濟醫院中醫部，台北，台灣
5 慈濟大學學士後中醫學系，花蓮，台灣
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【摘要】
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背景：利用客觀結構臨床測驗對中醫實習醫學生進行臨床能力評估，了解實習的學習成效。
對象與方法：收案對象為2017 年6 月至2018 年5 月進行實習之中醫醫學生42 位。利用前後測分數差異來評估實習之學習成效。前後測皆為6 站。
結果：後測之總成績有明顯進步(366.7±39.6 VS 396.7±48.9)，以科別來說，中醫婦科、中醫內科、中醫傷科後測成績較前測成績高(48.1±12.2 VS70.9±11.1, 50.9±18.1 VS 66.6±10.7, 45.6±18.7 VS 57.9±14.1)。然而，中醫兒科後測成績則明顯退步(64.8±10.3 VS 51.8±10.5)。以面向來看，中醫四診與臨床技能操作後測成績顯著進步。
結論：整體而言，經過一年實習後，中醫實習醫學生有不錯的學習效果，但在病史詢問方面仍有進步空間。此結果可供臨床教師作為教學課程改進之參考。
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【關鍵詞】客觀結構臨床測驗、中醫、實習、學習成效
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Hsuan-Shu Shen1,5 Chia-Chou Yeh2,5 Jian-Jung Chen3,5 Chien-Lin Chen4,5 Chien-Hsin Ko1,5*
1Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Hualien, Taiwan
2Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Chiayi, Taiwan
3Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taichung, Taiwan
4Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taipei, Taiwan
5School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
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【Summary】
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Background: Based on the guidance in Chinese Medicine Clinical Skills Assessment Model and Clinical Teaching Practice Training Program, supported by the Ministry of Health and Welfare, we conducted the objective structured clinical examination (OSCE) to evaluate the learning effectiveness in the clinical internship for the fifth-year traditional Chinese medical (TCM) students.
Subjects and methods: A total of 42 Chinese medical students were enrolled in the study during July, 2017 to May, 2018. A pretest-posttest design was employed by this study. Participants were evaluated by the OSCE before and after the 1 year clinical practice with 6 assessments of clinical skills.
Results: The total score of posttest was significantly higher than that of pretest (366.7±39.6 VS 396.7±48.9, P<0.001). In term of subjects, the score at the posttest were higher than at the pretest, as the internal medicine of TCM (50.9±18.1 VS 66.6±10.7, P<0.0001), the gynecology of TCM (48.1±12.2 VS 70.9±11.1, P<0.0001) and the traumatology of TCM (45.6±18.7 VS 57.9±14.1, P=0.001). Notably, the score of the pediatrics of TCM at the posttest declined significantly than at the pretest (64.8±10.3 VS 51.8±10.5, P<0.0001). In terms of dimensions, the ability of the four diagnostic methods and the clinical skills of TCM improved among the TCM students after the clinical practice training.
Conclusions: To conclude, the TCM students made the progress in clinical competency after 1-year clinical internship, but there is a suggestion on improving the ability for the patient’s history taking. The result could provide the information for the clinical preceptors on the modification of teaching program.
Keywords：Objective Structured Clinical Examination, Traditional Chinese Medicine, Internship Program, Learning Effectiveness
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