臺灣家庭醫學科醫學生學習主題與核心課程內容之探討
 
黎士鳴^1,2　孫子傑^2,3,4　林其和^5,6　蔡兆勳^7,8　張家禎^9,10　謝至鎠¹¹
林文元^12,13　顏啟華^14,15　陳育群^16,17　方文輝^18,19　林季緯²⁰　吳晉祥^2,3,4*

 
目的：台灣各醫學院家庭醫學科實習課程時段從一週到六週不等，課程內容差異相當大，本研究透過混合設計方法來發展家庭醫學科醫學生之學習主題與核心課程內容以供各校課程設計的參考。
方法：在第一階段質性研究部分，邀請北部2家、中部、南部以及東部各1家，共5家醫學中心之15名家庭醫學科醫師與5名醫學生接受深度訪談，其中有3名醫師與1名學生另以焦點團體法進行資料收集。在第二階段量化研究部分，邀請7家醫學院家庭醫學科教學相關之27位主治醫師進行專家問卷調查，以階層分析法與模糊德懷術法進行重要性分析。
結果：透過深度訪談與焦點團體法建構出六大學習主題為家庭醫業、疾病不適、行為科學、預防醫學、社區醫學、與長照議題。每項學習主題各有知識、態度、技能三項課程領域，共計建構出18項課程內容。透過階層分析法顯示六大學習主題權重分數至少為0.1，顯示皆有其重要性。模糊德懷術法彙整出核心課程內容分別為學習家醫服務、急症處置轉介、體現病人中心、認識預防醫學、認識社區醫學與評估症狀功能。
結論：本研究擬出六大主題18項課程內容，可供各校依據其時數與資源特性選取適合的課程內容。
（台灣家醫誌2022; 32: 31-44）DOI: 10.53106/168232812022033201004
 
關鍵詞：家庭醫學、核心課程、實習、模糊德懷術法、階層分析法
 

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¹東華大學諮商與臨床心理學系、²成功大學醫學院家庭醫學科、³成功大學醫學院附設醫院家庭醫學部、⁴成功大學醫學院附設醫院斗六分院家庭醫學科、⁵義大醫院兒童醫學部、⁶義守大學醫學院學士後醫學系、⁷臺大醫院家庭醫學部、⁸臺灣大學醫學院家庭醫學科、⁹高雄醫學大學附設醫院家庭醫學科、¹⁰高雄醫大學醫學院家庭醫學科、¹¹花蓮慈濟醫院家庭醫學科、¹²中國醫藥大學附設醫院社區暨家庭醫學部、¹³中國醫藥大學醫學院家庭醫學科、¹⁴中山醫學大學附設醫院家庭醫學科、¹⁵中山醫學大學醫學系家庭暨社區醫學科、¹⁶臺北榮民總醫院家庭醫學部社區醫學科、¹⁷國立陽明交通大學醫學院醫學系家庭醫學科、¹⁸三軍總醫院家庭暨社區醫學部、¹⁹國防醫學院醫學系家庭醫學科、²⁰義大醫院家庭暨社區醫學部
受理日期：110年11月2日　　修改日期：111年1月22日　　同意刊登：111年2月10日
通訊作者：吳晉祥　　　　　通訊地址：64043雲林縣斗六市莊敬路345號　E-mail: jins@mail.ncku.edu.tw

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 The Learning Domains and Core Contents of Family

Medicine Clerkship in Taiwan
 
Shih-Ming Li^1,2, Zih-Jie Sun^2,3,4, Chyi-Her Lin^5,6, Jaw-Shiun Tsai^7,8, Chia-Jan Chang^9,10,
Jyh-Gang Hsieh¹¹, Wen-Yuan Lin^12,13, Chi-Hua Yen^14,15, Yu-Chun Chen^16,17, Wen-Hui Fang^18,19,
Chi-Wei Lin ²⁰, and Jin-Shang Wu^2,3,4*

 
Purpose:The duration of family medicine clerkship (FMC) in Taiwan ranges from one to six weeks, and the contents of the program varies from hospital to hospital. The study accordingly aimed to investigate the learning domains and the core contents of FMC in Taiwan, based on a mixed method design.
Methods: For the qualitative content analysis of Phase One, 15 physicians and five medical students from five medical centers (two in northern Taiwan, one in central, one in southern, and one in eastern Taiwan) were invited to participate in an in-depth interview with three physicians and one medical student among the interviewees requested to join a focus group to collect data concerning their opinions about the goal, learning domains, and curriculum contents of FMC and their expectations and suggestions. For the quantity analysis of Phase Two, 27 professors of family medicine from seven medical schools were invited to complete an expert questionnaire on topics and contents of family medicine clerkship. The analytic hierarchy process (AHP) and the fuzzy Delphi method (FDM) were used to evaluate the importance of the topics and contents.
Results: Based on the results of qualitative content analysis, six learning domains and 18 curriculum contents were constructed. The learning domains included family practice, illness, behavior science, preventive medicine, community medicine, and long-term care. For quantity analysis, AHP found all the six learning domains important as their weighted scores exceeded 0.1. From FDM, the core contents of the six learning domains were respectively family practice, emergency referral, patientcentered care, preventive medicine, community medicine, and functional assessment.
Conclusion:The study used a mixed method design to construct the FMC training framework. 6 learning domains and 18 core contents are proposed and the results can be expected to provide medical schools with a reference for developing suitable syllabi meeting their individual needs and concerns.
(Taiwan J Fam Med 2022; 32: 31-44) DOI: 10.53106/168232812022033201004
 
Key words: analytic hierarchy process, clerkship, core content, family medicine, Fuzzy Delphi method
 

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¹Department of Counseling and Clinical Psychology, National Dong Hwa University; ²Department of Family Medicine, College of Medicine, National Cheng Kung University; ³Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; ⁴Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University; ⁵Department of Pediatrics, E-Da Hospital; ⁶School of Medicine for International Students, College of Medicine, I-Shou University; ⁷Department of Family Medicine, National Taiwan University Hospital; ⁸Department of Family Medicine, College of Medicine, National Taiwan University; ⁹Department of Family Medicine, Chong-Ho Memorial Hospital, Kaohsiung Medical University; ¹⁰Department of Family Medicine, School of Medicine, Kaohsiung Medical University; ¹¹Department of Family Medicine, Buddhist Tzu Chi General Hospital; ¹²Department of Family Medicine, China Medical University Hospital; ¹³Department of Family Medicine, School of Medicine, China Medical University; ¹⁴Department of Family Medicine, Chung Shan Medical University Hospital; ¹⁵Department of family and community medicine, School of Medicine, Chung Shan Medical University; ¹⁶Department of Family Medicine, Taipei Veterans General Hospital; ¹⁷Department of Family Medicine, School of Medicine, National Yang Ming Chiao Tung University; ¹⁸Department of Family and Community Medicine, Tri-Service General Hospital; ¹⁹Department of Family and Community Medicine, National Defense Medical Center; ²⁰Department of Family and Community Medicine, E-Da Hospital
November 2, 2021; Revised: January 22, 2022; Accepted: February 10, 2022.