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病例導向式學習應用於放射診斷科臨床教學課程

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病例導向式學習應用於放射診斷科臨床教學課程

Applying Case-based Learning to the

Radiology Clerkship Curriculum

陳榮邦

摘要 目的：為增強放射診斷科臨床教學課程之傳統見習閱片教學與臨床應用之關聯 性，我們希望能以病例為基礎（ Case-based Learning, CBL ）之問題導向式輔助 教學，協助學生增加臨床課程之教學成效。研究方法：於九十學年度本校醫學系 放射線學科嘗試於六年級臨床教學施行 CBL 輔助教學，見習時問為期一週，選 擇其中一間見習醫院之 20 組學生，其中 8 組 39 人採用傳統閱片臨床教學； 12 組 58 人採用傳統閱片臨床教學與 CBL 輔助教學並行，利用本校社群服務 網站於課餘時問進行討論。見習課程結束後，以結構式與閉放式問題進行問卷調 查，結構式問題以李克特氏量表 5 級分計分，評估 CBL 教學成效。結果：問 春結果顯示兩群學生之傳統閱片教學成效並無差異（ P > 0 . 05 ) ，且在 CBL 教 學下，學生認為自己的整體表現平均為 3 . 68 分、小組成員表現平均為 4 . 16 分、小組指導老師之教學幫助則平均為 4 . 4 分。整體顯示 CSL 可以符合學生 對於放射線臨床見習課程的學習需求，且輔以 CBL 見習教學能促使學生主動學 習、提升資料搜尋整合的能力，將閱片教學與臨床病例做一有效結合。結論：在 有限的時問與空間資源下，以網路方式進行以病例為基礎之問題導向式學習是值 得進一步研究與推行。 Abstract

Purpose: The aim of this study was to assess incorporating case-based learning (CBL) with a film- reading course in a radiology clerkship curriculum.

Methods: In the 2001 academic year, 20 groups of fourth-year medical students

participated in a one- week radiology clerkship curriculum in one teaching hospital. Each group consisted of eight to ten students. Eight groups (39 students) participated in the film- reading course only, whereas 12 groups (58 students) participated in a combination of CBL and the film- reading course. As part of CBL, online discussion forums were available for communication between group members, other groups and the tutor. Anonymous surveys were distributed to each student during the last class. The questionnaires were answered using a 5-point Likert scale and open-ended comments. Results: There were no differences in the satisfactory outcomes of the two different teaching groups in the film-reading courses (p > 0.05). In the CBL groups, the average score for student performance was 3.68, group member performance was 4.16 and tutor performance was 4.44. Answers to open

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questions revealed that CBL fulfilled learning objectives for students, and enhanced active learning, thinking and clinical history analyses. CBL was effectively incorporated into the film-reading course. Conclusion: Most students were satisfied with CBL. CBL allied with a film- reading course can be successfully implemented into a radiology clerkship

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