跳到主要內容

臺灣博碩士論文加值系統

(18.97.14.86) 您好!臺灣時間:2025/02/20 05:56
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

: 
twitterline
研究生:張家納
研究生(外文):Chia-na Chang
論文名稱:醫學生習醫動機與影響動機強弱因素之探討
論文名稱(外文):The Study of Motivation of Medical Students to Be Doctors and Its Influential Factors
指導教授:尤素娟尤素娟引用關係
指導教授(外文):Su-chuan Yu
學位類別:碩士
校院名稱:慈濟大學
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2006
畢業學年度:94
語文別:中文
論文頁數:88
中文關鍵詞:醫學教育執業選擇習醫動機醫學生
外文關鍵詞:medical studentsmotivationcareer choicemedical education
相關次數:
  • 被引用被引用:13
  • 點閱點閱:2476
  • 評分評分:
  • 下載下載:145
  • 收藏至我的研究室書目清單書目收藏:2
研究背景:世界各國的醫師,代表高教育程度與高收入的專業人士,在台灣尤是。根據瞿海源(1992)台灣職業聲望排行研究顯示,原有變項若再加上教育程度與所得收入,醫師是職業排行的首位。也因此,醫學系在台灣的大學入學科系排行上,始終獨占鼇頭,不曾受近年來醫療糾紛等負面報導所影響。然而,台灣近年來,社會經濟及醫療環境改變,加上大學入學制度的變革,對高中學子一直所嚮往成為醫學生會有什麼影響?他們選擇醫學系的動機為何?有哪些因素影響他們想要成為醫生?不同原因進入醫學系的學生,是否在看待他們未來的職業與執業科別的選擇與型態上也有所不同?影響其習醫動機強弱因素又為何?我們的醫學教育又該如何針對上述現象的瞭解與研究而有所改變與加強?
研究目的:希望了解1.醫學生的背景。2.醫學生的習醫動機。3.影響動機強弱的因素為何。4.不同原因進入醫學系的學生對醫學生活及未來職業的看法是否不同。5.對醫療行業的了解。6.對未來執業的期待及考量。期待能對醫學教育的改革有所助益,俾以培育專業的醫師來服務社會。
研究方法:本研究之資料來源是由慈濟大學尤素娟助理教授提供的問卷調查資料與開放式問卷結果。問卷調查以2002年東部某醫學系學生為對象,針對醫學生之個人基本資料、習醫動機、對醫學系的感受、對醫師職業的認知與期待、將來執業選擇等部分為研究基礎,並以尤素娟助理教授兩個年度醫學生習醫動機開放式問卷為輔,俾以對研究問題更深入的瞭解。本研究調查結果分析採用SPSS 10.0統計軟體,並參考林生傳教授修訂Hollingshead 所提出之「兩因素社會地位指數」,作為社經地位的分級標準,同時運用描述性統計、T test、單因子變異數分析、相關及線性迴歸等方法來了解影響醫學生習動機強弱的因素,以及因不同原因入學的醫學生間的差異。
研究結果:1.醫學生來自高社經地位家庭的比例將近六成。2.醫學生選擇醫學系的前三個原因是父母的期望、興趣以及考試分數落點。3.超過六成的醫學生入學前不了解醫學系,半數以上的醫學生入學後不識任何醫學典範。4.將近九成的醫學生認為醫師理應高收入,而七成以上認為自己被醫師的高收入所吸引,但是也有九成的醫學生認為醫師具有特殊的社會責任。 5.影響醫學生習醫動機強弱的正向因素依次為:醫師的高收入吸引力、因興趣選醫學系、認知醫師有特殊之社會責任、入學之前就了解醫學系;負向因素則是醫學生就讀之年級。6.因興趣入學的醫學生,入學前就明顯較了解醫學系,也比較有景仰的醫師前輩,對醫師特殊社會責任的認知較高。
結論:1.目前台灣醫學生來自高社經地位家庭的比例較20年前更高。2.醫學生選擇醫學系的原因,大多不是因為自己的興趣,而是為了符合社會對醫師是高收入、穩定職業的期待。3.醫學教育需注意醫學生的身教,並了解醫學生對醫學教育的感受,以減少醫學生在醫學教育中的不適應。4.醫學生雖然對醫師的高收入感興趣,但也深知醫師對社會的特殊責任。5.有興趣習醫的醫學生,通常入學前對醫學系的了解較多,也對社會責任及典範的認知較高,有助於加強其習醫動機。
Background & Objective : In Taiwan, doctor is deemed as a highly respected profession with renowned academic association and financial security as well recognized all over the world. Unlike the US system, high school graduates here need to pass the university entrance test for college eligibility. While medical school has traditionally ranked the number one or the only choice among the list of college majors, medical students are acknowledged top performers at high schools or colleges, and most of them coming from a high socioeconomic family. However, do we select the right person to become doctors is the question long been raised by educational reformers?

Methods : A questionnaire is designed for quantitative analysis in this study. And the database is provided by Dr. Suchuan Yu , an assistant professor in the Department of Public Health at Tzu chi University , which a questionnaire is designed for quantitative analysis . She interviewed 209 medical students in 2002 which indicates 77.4 % of response rate. The purposes are (1) to understand the backgrounds of Taiwan medical students under the recent development of medical educational reform and economy recession, (2) to find out what motivate them to finish the training and become a doctor , (3) to explore the future career choice of medical students, and (4) to know the diversity of the students with different choosing reason. There also are two surveys for 90 students conducted by Dr. Yu in 2002, 2004. Which are designed for understanding the choosing reasons of medical students.

Results: Results from a total of 209 medical students composing of freshmen and inters are :
1. The proportion of medical students coming from a high socioeconomic background is even higher than before: 58 % versus 47%.
2. 70% medical students choose doctors as their professional career not to fulfill wishes of their own but to satisfy expectations from parents and teachers. High socioeconomic status of a medical career is indicated as the reason of expectations.
3. High income of doctors is the most important factor that motivates medical students to become doctors. Self-interest ranks second, followed by willingness to resume special social responsibilities as doctors, and knowing more about medical training before entrance. However, motivation becomes less as medical students approaching their year of higher grade.
4. Those students entering medical school because of self-interest know more about medical school before entrance and are more willing to hold the special social responsibilities of doctors. They also can identify more role models around them.

Conclusions :The percentage of medical students from a high socioeconomic family is higher than twenty years ago . And in Taiwan, most medical students choosing medical profession are not for self-interest as before. High income of doctors , Self-interest , willingness to resume special social responsibilities as doctors, and knowing more about medical training before entrance can motivate medical students to become a doctor. But as more the years they live through medical school life, less motivation they have. So It is much more important to choose medical students with self-interest to medical profession instead of high achievement in high school.
第一章、緒論-------------------------------------------- 1
第一節、研究背景與動機--------------------------------- 1
第二節、研究目的--------------------------------------- 3
第二章、文獻探討---------------------------------------- 4
第一節、醫學生的人口統計學特徵------------------------- 4
第二節、習醫動機--------------------------------------- 11
第三節、生涯規劃--------------------------------------- 15
第三章、研究方法---------------------------------------- 23
第一節、研究架構--------------------------------------- 23
第二節、樣本及資料來源--------------------------------- 24
第三節、問卷設計--------------------------------------- 24
第四章、研究結果---------------------------------------- 26
第一節、描述性分析------------------------------------- 26
第二節、雙變項分析------------------------------------- 38
第三節、相關性分析------------------------------------- 61
第四節、迴歸分析--------------------------------------- 62
第五節、開放式問卷結果--------------------------------- 66
第五章、討論------------------------------------------- 67
第一節、描述性統計------------------------------------- 67
第二節、變項間的關係----------------------------------- 71
第六章、結論與建議------------------------------------- 76
第一節、結論------------------------------------------- 76
第二節、建議與研究限制--------------------------------- 80
中文部分
李淑娟(2001)。《e世代醫學生》後續報導問卷研討會。2001/06/26 民生報主辦。
宋豪麟、施靜茹(2005.2.7)。準醫師選志願 精神科 比整形外科還紅。聯合新聞網,連結http://morpheus.typepad.com/iait/2005/02/post_5.html
林生傳(1996)。教育社會學,第三章 社會階級化與社會。高雄市:復文書局出版,P 48。
林金源(2003)。書中自有黃金屋:台灣家庭教育支出與所得不均等的長期變化。思與言雜誌 第41 卷第3期。
林大森(2005)。大學多元入學方案制度平等性檢視—教育社會學的觀點。檢索於94.11.20,取自ttp://www.fgu.edu.tw/~common/myweb4/94info/serv01-4.htm
季緯珠、楊志良(1985)。醫學生社會化因素之探討。中華民國公共衛生學會雜誌,5,3-23。
紀駿輝(1984)。醫學生對未來執業的態度-中國醫藥學院醫學生之調查研究。公共衛生,13,273-285。
洪百薰(1997)。臺灣省地方醫護人員養成計畫養成人員服務狀況調查。臺灣省公共衛生研究所。
高美英、呂碧鴻、李明濱、王維典(2000)。醫學生的專科偏好與相關因素探討。醫學教育,4(1),23-37。
陳慶餘、李龍騰(1993)。「台灣地區醫學生從事基層醫療之意願及其影響因素之調查」,中華民國家庭醫學雜誌,6,51-61。
郭泰裕(1995)。醫學生選擇醫療科別相關因素分析。中國醫藥學院醫務管理研究所碩士論文(全國博碩士論文摘要檢索系統編號:84CMCH0528001)。
黃孝鏘、謝小岑、秦燕、黃蒂、洪德茂(1993)。醫學中心住院醫師、實習醫師生活、學習、工作現況及其從醫動機之探討。公共衛生,20,277-283。
黃旐濤、張慈桂、蕭正光、姚霞玲、李明亮(1998)。全民健保對未來醫師來源在質與量上的影響。醫學教育,2,168-179。
許芳菊、黃勝雄(2001)。e 世代醫學生價值觀大調查。康健雜誌,6,74-81。
莊惠雯(2002)。影響不同職級醫師專科選擇因素之探討。高雄醫學大學公共衛生學研究所碩士論文(全國博碩士論文摘要檢索系統編號:91KMC00058007)。
陳清芳(2005.1.17)。台灣醫師先進感嘆草莓族醫師吃不了值班苦。中央社報導。
曾志朗、黃素菲(1999)。醫學院學生生涯發展需求與輔導方案設計之研究。學生輔導,61,126-136。
曾志超、尤元奎(2003)。台灣社會貧富差距日益擴大之省思。國家政策論壇季刊,4。
楊明仁、蔡瑞熊(1999)。某醫學院學生之專科選擇及相關因素。醫學教育,3(2),15-21。
黎士鳴(2000)。影響醫學生選科因素之探討。醫學教育,4(2),55-67。
劉士永(2004)。社會替喊窮的醫師付過驚人的學費。新新聞週刊,921,醫學人間專欄。
蔡淑鈴、瞿海源(1992)。主客觀職業階層結構研究:初步探討,台灣社會現象學術研討會宣讀論文,中央研究院三民主義研究所主編。
謝博生(2000)。醫療與社會,第十一章 醫病關係的變貌 。台北市: 台大醫學院出版, p.133。
顏裕庭(1998)。台灣醫學教育的軌跡與走向。藝軒圖書出版公司, p231。
羅碧(2004.12.7)。生育率下滑 婦產科過寒冬。自由時報,生活新聞。

英文部分
Adkins RJ, Anderson GR, Cullen TJ, Myers WW, Newman FS, Schwarz MR.(1987).Geographic and specialty distributions of WAMI Program participants and nonparticipants. J Med Educ,62,810-817.
Association of American Medical Colledges National Resident Matching Program Database. National Resident Matching Program Results and Data 2001:Selected Data Tables.Available at:http://www.nrmp.org/res_match/data_tables.html
Barzansky B, Etzel S.(2002). Educational Programs in US Medical Schools, 2001–2002 .JAMA , 288(9),1067–1072.
Cantor JC, Miles EL, Baker DC, Baker LC.(1996). Physician service to the underserved.Inquiry ,33,167-180.
Collins J P, White G R.(1993). Selection of Auckland medical students over 25 years:a time for change.Medical Education ,27,321-327.
Davidson RC, Lewis EL.(1997) Affirmative action and other special consideration admissions at the University of California, Davis, School of Medicine.JAMA ,278,1153-1158.
Dhalla IA, Kwong JC, Streiner D L, Baddour RE, Waddell, A E, Johnson IL.(2002). Characteristics of first-year students in Canadian medical schools.CMAJ ,166(8),1029-1035.
Dorsey E,Ray JD, Rutecki GW.(2003).Influence of Controllable Lifestyle on Recent Trends in Specialty Choice by US Medical Students. JAMA,290(9),1173-1178.
Easterbrook M, Godwin M, Wilson R, Hodgetts G, Brown G, Pong R, et al.(1999) Rural background and clinical rural rotations during medical training: effect on practice location. CMAJ,160(8),1159-1163.
Esmail A, Nelson P, Primarolo D, Toma T.Acceptance into medical school and racial discrimination,BMJ 1995;310:501-502
Everett C. Hughes(1956).The Making of a Physicians-General Statement of Ideas and Problems.Human Organization ,14(4),21-25.
Gelfand DV, Podnos YD, Wilson SE, Cooke J, Williams RA.(2002) .Choosing general surgery: insights into career choices of current medical students. Archives of Surgery,137(8),941-5.
Howe A, Ives G.(2001). Does community-based experience alter career preference? New evidence from a prospective longitudinal cohort study of undergraduate medical students. Medical Education,35(4),391-7.
Kassebaum DG, Szenas PL.(1993). Rural sources of medical students, and graduates' choice of rural practice.Acad Med,68,232-236.
Kassebaum DG, Szenas PL. (1994).Factors influencing the specialty choices of 1993 medical school graduates. Academic Medicine,69,163–170.
Kenneth Ludmerer(1999).TIME TO HEAL: American Medical Education From the Turn of the Century to the Era of Managed Care. Oxford, 514 .
Komaromy M, Grumbach K, Drake M, Vranizan K, Lurie N, Keane D, et al.(1996). The role of black and Hispanic physicians in providing health care for underserved populations.N Engl J Med,334,1305-1310.
Krol D, Morris V, Betz J, Cadman E.(1998).Factors influencing the career choices of physicians trained at Yale-New Haven Hospital from 1929 through 1994.Academic Medicine,73,313-317.
Lind DS, Cendan JC.(2003) .Two decades of student career choice at the University of Florida: increasingly a lifestyle decision.American Surgeon ,69,53-55.
Lumb AB, Vail A.(2000).Difficulties with anonymous shortlisting of medical school applications and its effects on candidates with non-European names:prospective cohort study.BMJ ,320,82-85.
McManus I C, Richards P, Winder B C, Sproston K A, Styles V.(1995).Medical School Applicants from Ethnic Minority Groups: Identifying if and When They are Disadvantaged.BMJ ,310,496-500.
McManus I C.(1998). Factors affecting likelihood of applicants being offered a place in medical schools in the United Kingdom in 1996 and 1997 :retrospective study.BMJ,317,1111-1116.
Minor S, Poenaru D, Park J.(2003). A study of career choice patterns among Canadian medical students. American Journal of Surgery, 186(2),182-8.
Moy E, Boreman BA.(1995). Physician race and care of minority and medically indigent patients.JAMA,273,1515-1523.
Neumayer L,Kaiser S,Anderson K,Barney L,Curet M,Jacobs D.Lynch T, Gazak C .(2002).Perceptions of women medical students and their influence on career choice.American Journal of Surgery, 183(2),146-150.
Newton DA,Grayson MS,Whitley TW.(1998). What predicts medical student career choice?.Journal of General Internal Medicine,13(3),200-203.
Rabinowitz HK, Diamond JJ, Veloski JJ, Gayle JA.(2000). The impact of multiple predictors on generalist physicians' care of underserved populations. Am J Public Health,90,1225-1228.
Rabinowitz HK, Diamond JJ, Markham FW, Paynter NP.(2001) Critical factors for designing programs to increase the supply and retention of rural primary care physicians. JAMA,286,1041-1048.
Schwartz RW, Jarecky RK, Strodel WE, Haley JV, Young B, Griffen WO.(1989). Controllable lifestyle: a new factor in career choice by medical students. Academic Medicine,64,606–609.
Thornton J, Esposto F.(2003). How important are economic factors in choice of medical specialty?. Health Economics,12(1),67-73.
Woodworth PA, Chang FC, Helmer SD.(2000).Debt and Other Influences on Career Choices among Surgical and Primary Care Residents in a Community-Based Hospital System. The American Journal of Surgery,180(6),570-576.
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
1. 洪百薰(1997)。臺灣省地方醫護人員養成計畫養成人員服務狀況調查。臺灣省公共衛生研究所。
2. 紀駿輝(1984)。醫學生對未來執業的態度-中國醫藥學院醫學生之調查研究。公共衛生,13,273-285。
3. 林金源(2003)。書中自有黃金屋:台灣家庭教育支出與所得不均等的長期變化。思與言雜誌 第41 卷第3期。
4. 高美英、呂碧鴻、李明濱、王維典(2000)。醫學生的專科偏好與相關因素探討。醫學教育,4(1),23-37。
5. 陳慶餘、李龍騰(1993)。「台灣地區醫學生從事基層醫療之意願及其影響因素之調查」,中華民國家庭醫學雜誌,6,51-61。
6. 許芳菊、黃勝雄(2001)。e 世代醫學生價值觀大調查。康健雜誌,6,74-81。
7. 曾志超、尤元奎(2003)。台灣社會貧富差距日益擴大之省思。國家政策論壇季刊,4。
8. 楊明仁、蔡瑞熊(1999)。某醫學院學生之專科選擇及相關因素。醫學教育,3(2),15-21。
9. 黎士鳴(2000)。影響醫學生選科因素之探討。醫學教育,4(2),55-67。
10. 劉士永(2004)。社會替喊窮的醫師付過驚人的學費。新新聞週刊,921,醫學人間專欄。
11. 6. 王其允、項武義 (1970) 是蘋果還是開普勒啟發了牛頓?。科學月刊,第8期。
12. 15. 柯承恩、羅澤裕 (1998) 跨世紀管理控制新方法─平衡計分卡規劃與設計之本土經驗。會計研究月刊,155期,頁28-38。
13. 20. 陳永隆、賴芳忠、李美嫻、韓易光、陳娟娟 (2005) 裕隆日產─從移動價值鏈到知識價值鏈。管理雜誌,368期,頁85-92。