臺灣博碩士論文加值系統

本研究之目的在於探討中部某醫學大學醫學研究所之碩、博士班學生，面對實證醫學教育課程所需之文獻搜尋技能、統計學運用與評估文獻技能及寫作技能時，是否會產生焦慮，進而探討其焦慮程度是否與其學習成效有關。

本研究之研究對象為48名醫學研究所碩、博士班新生，以「文獻搜尋焦慮量表」、「圖書館焦慮量表」、「統計焦慮量表」及「寫作焦慮量表」為研究工具，藉由描述性統計、獨立樣本t檢定、相關及迴歸分析來考驗各項假設；並抽選焦慮程度較高之學生進行質性訪談，以了解學生焦慮之成因。

本研究結果發現如下：
一、 學生在接受實證醫學教育時，確實會遭遇困難，並有壓力、焦慮及對自己不具信心之情況發生。
二、 文獻搜尋焦慮在性別、班等別、年齡組別及有無論文發表經驗等不同人口學變項上皆無顯著性之差異。
三、 圖書館焦慮在性別、班等別、年齡組別及有無論文發表經驗等不同人口學變項上皆無顯著性之差異。
四、 統計焦慮在不同人口學變項之班等別呈現顯著差異；本研究之碩士班學生在統計焦慮之程度上明顯高於博士班學生。
五、 寫作焦慮在學生就讀之班等別，以及是否擁有論文發表經驗上呈現顯著差異；碩士班學生之寫作焦慮程度高於博士班學生；不具論文發表經驗者的焦慮程度高於具有論文發表經驗之學生。
六、 總結評論文獻作業成績在學生就讀之班等別、年齡組別，及是否擁有論文發表經驗上呈現顯著差異；碩士班學生之總結評論文獻作業總成績明顯低於博士班學生；年齡≦40歲之學生的總結評論文獻作業總成績也明顯低於＞40歲之學生；不具論文發表經驗者之總結評論文獻作業總成績亦低於具有論文發表經驗之學生。
七、 文獻搜尋焦慮、圖書館焦慮、統計焦慮及寫作焦慮間之關係呈現正相關。
八、 文獻搜尋焦慮、圖書館焦慮、統計焦慮及寫作焦慮與總結評論文獻作業成績間之關係呈現負相關。
九、 文獻搜尋焦慮、圖書館焦慮、統計焦慮及寫作焦慮並無法明確預測總結評論文獻之作業總成績。
十、 學生對實證醫學教育多持肯定之態度，也表示實證醫學在現今的醫療環境中是相當重要的實踐理念。
十一、 學生在遇到困難時多會自行尋求協助。
十二、 學生針對自我評估而認為需再自我加強之部分為：書目管理技能、與論文寫作相關之能力、新資訊之掌握、文獻搜尋技能、統計學應用及文獻評估技能、英文能力及臨床應用能力。
十三、 學生希望學校能多加強開設文獻篩選之評估、書目管理軟體之應用、統計軟體應用之實際操作，及文獻寫作之教學等相關課程；另希望圖書館能增加教學課程場次及配合學生之時間與需求給予個別指導。
十四、 圖書館及統計、寫作焦慮程度較高之學生在上過相關課程及有過論文發表經驗後，仍覺有尚需加強之處。
十五、 學生對學校之實證醫學教育所作之建議：(1)結合臨床醫療之應用、(2)讓學生了解實證醫學對臨床醫療之意義及精神、(3)採取小班教學及實機上課模式、(4)課程的加強與調整、(5)將圖書館利用教育課程列為必修課程、(6)請圖書館館員加入課程之教學團隊中。

最後，依據研究發現提出結論與建議，亦即學生在接受實證醫學教育時，確實有焦慮之狀況產生，但應可藉由課程之設計及圖書館之協助來降低學生之焦慮程度。教學者應正視學生之學習狀態，幫助學生克服障礙、降低焦慮，以期提升學生之學習成效。

摘要……………………………………………………………i
目次……………………………………………………………iii
表次……………………………………………………………vi
圖次……………………………………………………………viii

第一章 緒論…………………………………………………1
第一節 研究背景與動機……………………………………1
第二節 研究目的……………………………………………6
第三節 研究問題……………………………………………6
第四節 名詞釋義……………………………………………7
第五節 研究範圍與限制……………………………………10

第二章 文獻分析……………………………………………11
第一節 實證醫學之簡介……………………………………11
第二節 實證醫學之運用技能………………………………15
第三節 國內外醫學院校之實證醫學教育現況……………19
第四節 實證醫學應用於臨床醫療之障礙…………………24
第五節 焦慮問題探討………………………………………27

第三章 研究設計與方法……………………………………34
第一節 研究方法 ………………………………………36
第二節 研究對象及場域……………………………………38
第三節 研究工具……………………………………………42
第四節 資料處理及統計分析………………………………50

第四章 調查研究結果………………………………………54
第一節 四種焦慮表得分之描述性統計……………………54
第二節 四種焦慮程度及總結評論文獻作業總成績在不同人口學
變項上的差異性分析………………………………59
第三節 四種焦慮程度之間的相關性探討…………………64
第四節 四種焦慮程度與總結評論文獻作業成績之間的相關性探討 ……………………………………………………65
第五節 焦慮程度對總結評論文獻作業總成績之影響的迴歸分析.. ……………………………………………………67

第五章 質性訪談結果與綜合討論…………………………72
第一節 質性訪談結果………………………………………72
第二節 綜合討論……………………………………………113

第六章 結論與建議…………………………………………133
第一節 主要研究發現………………………………………133
第二節 結論…………………………………………………140
第三節 建議…………………………………………………143
第四節 未來研究建議………………………………………148

參考文獻 ……………………………………………………150

附錄
附錄A 文獻搜尋焦慮量表（預試） ………………………164
附錄B 本研究之問卷 ………………………………………168
附錄C Bostick’s 「Library Anxiety Rating Scale」
………………………………………………………………178
附錄D 訪談大綱一（文獻搜尋焦慮） ……………………181
附錄E 訪談大綱二（圖書館焦慮） ………………………182
附錄F 訪談大綱三（統計焦慮） …………………………183
附錄G 訪談大綱四（寫作焦慮） …………………………184
附錄H 譯碼表大綱 …………………………………………185

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