臺灣博碩士論文加值系統

二十世紀以後社會變遷與醫療科技的迅速發展，醫學生不可能從學校中學習到所有的知識與資訊，新的學習方法稱做問題為導向的學習（Problem-Based Learning；PBL）主要是強調自我學習的技巧。從1969年加拿大MacMaster大學發展PBL學習方式後，很多學校也陸續的採用這種以個案為主用問題解決方式的小組學習。雖然針對醫學生與教師對於PBL認知與態度的研究有很多，但在國內卻沒有任何相關的研究，從學習過程、學習行為、英文能力與教育的型態等皆可顯示國內外學生的差異，所以也可能會影響學生對於PBL的接受程度。本研究主要是瞭解臨床教師與醫學生對於PBL的認知與態度，以提供醫院管理者在規畫與設計醫學教育制度的參考。
臨床教師與醫學生的問卷除了基本資料外，其餘部份的設計是相似的。這兩份問卷都包含了一些項目如：對傳統與PBL教學的看法、對PBL教學的態度、對PBL的認知。教師問卷的寄發是選擇庚醫院內科、外科、婦產科、小兒科、神經內科、精神科等六科，醫學生則選擇長庚大學醫四、醫五、醫六的學生發給問卷，在八十九年四月底完成問卷的回收，問卷分析則包含89位臨床教師與78位醫學生。
主要的研究結果發現：
1. 有實際參與的臨床教師在PBL學習評鑑結果、PBL績效評核與PBL認知測驗的回答，比無實際參與的臨床教師正向。
2. 有實際參與PBL教學的學生在傳統學習評鑑結果的看法比無實際參與者負向。
3. 臨床教師在PBL學習評鑑結果與PBL績效評核的看法比學生正向。
4. 影響臨床教師與醫學生對PBL認知與態度的因素有參與PBL的經驗、年齡與年資、科別、有無實際參與PBL、性別、喜歡臨床醫學的程度等。

Abstract
Social changes and medial technology develops dramatically in twenty century. Medical student cannot learn all information and knowledge from medical school. The new concept of learning is called “ Problem-Based Learning; PBL” that it appears to enhance and maintain self-direct leaning skills. Since 1969, MacMaster University developed PBL curriculum, the new program being adopted by an increasing number of medical schools emphasizes case-oriented problem solving in small tutorial groups. Although there have been numerous studies of medical students’ and tutors’ perceptions and attitudes about PBL, there are not any in Taiwan. The difference of learning processes, learning behaviors, English abilities and education methods between countries can affect student to accept PBL. The importance of this study is figured out the perceptions and attitudes of clinical tutors and medical students in Taiwan, therefore, to provide healthcare managers a guideline to build appropriate medical education system.
The tutor and student questionnaires, developed by author, are similar except basic information. Both questionnaires contained some items such as the opinion about conventional and PBL curriculum, the attitude towards PBL and the perception of PBL. A tutor questionnaire was mailed to the clinical tutors who are medical, surgical, gynecologic, pediatric, neurological, psychiatric specialists in Chang-Gung Hospital. A student questionnaire was given to medical students who are fourth, fifth and sixth year students in Chang-Gung University. The questionnaires were collected by the end of April 2000. The study included 89 clinical tutors and 78 medical students.
The major findings of this study were shown as follows.
1. Clinical tutors ever participate in PBL curriculum more positive than non-participate in learning evaluation result of PBL, performance assessment of PBL and perception test of PBL.
2. Medical students ever participate in PBL curriculum more negative than non-participate in learning evaluation result of conventional.
3. Clinical tutors more positives than medical student in learning evaluation result of PBL and performance assessment of PBL.
4. The factors of influence clinical tutors’ and medical students’ perception and attitude are participate experience, age and attending years, department, participate or non-participate, sex, and the degree of clinical medicine favorite.

第壹章 緒論1
第一節 研究背景與動機1
第二節 研究目的4
第三節 預期貢獻5
第貳章 文獻探討6
第一節 以問題為導向學習之起源與定義6
第二節 實施以問題為導向學習的理由9
第三節 傳統與問題為導向課程之差異12
一 、教導方式的種類12
二 、傳統與PBL記憶方式15
三 、傳統與PBL課程之優劣19
第四節 PBL教學在國外的實證研究20
一 、PBL教學的認知調查21
二 、PBL教學的態度調查23
第五節 影響PBL認知與態度之因素25
第參章 研究方法27
第一節 長庚大學醫學系推動PBL之背景介紹27
第二節 研究設計與研究架構31
一 、研究設計31
二 、研究架構31
第三節 研究假說33
第四節 研究變項與操作型定義34
一 、變項之操作型定義34
二 、名詞解釋37
第五節 研究材料與方法38
一 、研究流程38
二 、研究對象39
三 、研究工具39
四 、資料蒐集41
第六節資料處理與分析方法42
一、資料處理42
二、統計分析51
第肆章 研究結果52
第一節 六科臨床教師總體與回覆問卷教師之比較52
第二節 師生基本變項的描述性分析54
一 、臨床教師基本資料54
二 、學生的基本資料：55
三 、參與PBL的經驗57
四 、師生對傳統教學與PBL教學的看法60
五 、師生回答對PBL教學的態度63
六 、師生對PBL教學的認知64
第三節 師生有無參與PBL教學與基本背景之關係65
第四節 師生有無參與PBL教學與態度和認知的關係68
第五節 檢驗自變項與依變項的相關程度72
第六節 分析影響師生態度與認知的主要因素76
第伍章 討論82
第一節 研究方法的探討82
第二節 主要研究結果的討論84
一、傳統課程與PBL課程的比較84
二、影響師生對PBL教學認知與態度的因素85
第二節 研究限制90
第陸章 結論與建議91
第一節 結論91
第二節 建議92
一 、對於學校與醫院的建議92
二 、對於後續研究者的建議93
參考資料95
三 、中文部份95
四 、英文部份95
附錄一：教師問卷98
附錄二：學生問卷102

參考資料
三、中文部份
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2. 長庚大學暨醫院。長庚大學暨長庚醫院New Pathway 醫學教育改革系列報告：香港大學考察報告。長庚大學教務處、醫學院醫學系，長庚醫院醫學教育委員彙集各科醫學教育小組。1999。
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