問題導向學習對醫學系學生學習表現之影響——以某醫學院跨學系小組討論課程為例

Exploring the Effect of Interdisciplinary Problem-Based Learning on Medical Students’ Performance: A Case Study from a Medical School in Taiwan

本研究旨在針對個案醫學院，探討導入1年的問題導向病理與藥理小組討論課程後，學生的學習表現。本研究採單組前後測設計，透過104及105兩學年進行資料蒐集，每學年第一學期初、第一學期末及第二學期末發放學習成效問卷調查，以及一次教師引導技巧量表。104學年資料旨在建立問卷信效度；105學年，發出129份正式問卷，三次回收有效問卷分別為120、119及108份其中有108名醫學生完成之三次問卷皆判定為有效，故以此進行分析。結果發現，醫學生在參與一學期的問題導向小組討論課程後，整體的學習即有進步，特別在自我導向學習、批判性思考、主動參與、推理技巧、獨立研究等層面，唯有團體互動並沒有明顯成長，然而在第二學期後，學習曲線則進入高原期，未發現顯著的成長。而醫學生參與的組別是否為跨學系小組，在整體的學習表現與各構面，並無顯著不同。此外，教師引導技巧中的結構式學習引導，能夠預測醫學生的學習表現。本研究並提出實務與未來研究上之相關建議。

The aim of this study was to explore the impact of one-year interdisciplinary problem-based learning (PBL) class on fourth-year medical students. A pre-post test research design was applied to collect data on medical student performance from 2015 to 2016 academic years. Each year, the learning effectiveness was measured three times: once at the beginning and once at the end of the first semester, and one more time at the end of the second semester. In addition, the tutorial skills of the teacher were measured at the end of the second semester. The data collected in the 2015 academic year was used to establish the validity and reliability of the questionnaires. In the following academic year, there were 129 medical students in total, among which 108 of them completed all three surveys. The results showed that (a) among the six dimensions of learning effectiveness of PBL, the scores in self-directed learning, critical thinking, active participation, reasoning skill and independent study were improved after the first semester, but no further improvement was found at the end of the second semester; (b) the participation of students from other discipline (pharmacology students) did not result in a significant interaction effect; and (c) the tutoring skills, especially the constructive learning skills, seems to be positively associated with student learning performance. Practical recommendations are provided accordingly, and further researches are warranted.