臺灣的醫學生多參與跨國醫療志工隊，或在醫療場所工作實習時，常遇到醫療英文跨文化溝通問題，但醫學英文跨文化研究多以醫院為場域，較少融入大學階段教學。而近年Design for Change（DFC）教學法興起，其教學四步驟（發現問題、想像解決方法、行動實踐，分享），能符合醫學領域學生對跨文化問題解決與英文溝通的需求。故本研究旨以DFC方法融入醫學大學之英文跨文化溝通課程，探討學生跨文化能力學習成效。本研究於「英文跨文化溝通」課程（四班所有學生的其中90位學生）中，每堂課介紹一個跨文化概念與醫療文化衝突案例，學生再以DFC步驟分析案例、討論解決之行動實踐。本研究採行動研究法，在授課過程持續反思，改進DFC教學方法，並蒐集教學日誌、學生評量與報告、教學回饋等資料，探討教學成效。結果顯示，課程中期學生已能尊重不同文化，但對實際醫療文化衝突解決與實踐仍感困難。經調整教學，引導學生參與醫療文化衝突解決DFC行動實踐報告後，能提升學生跨文化衝突解決行動學習成效。本研究可增進大學生國際交流能力，且DFC方法融入跨文化英文課程，亦是醫學大學英語教學新嘗試，或能為臺灣英語教育開拓不同視野。

Many Taiwanese medical students participate in international medical volunteer teams and often encounter cross-cultural communication problems. However, the cross-cultural research in the medical field mostly takes places in hospitals and is rarely integrated into medical university teaching. In recent years, the Design For Change (DFC) education method has become popular, and its four steps (discovering problems, imagining solutions, taking action, and sharing results) meet the needs of medical students for cross-cultural problem-solving and communication. Therefore, the purpose of this study is to integrate the DFC method into 4 Cross-cultural Communication in English courses (90 students from all students in the courses) at a medical university for exploring the students’ intercultural competence learning outcomes. The 4 “Cross-cultural Communication in English” courses introduced a cross-cultural concept and a medical culture conflict case each week; students then analyzed the case through the DFC steps and discussed conflict resolution action methods. Informed by the action research method, the researcher conducted continuous reflection in the teaching process to improve DFC teaching methods. Also, the researcher collected teaching journals, exams, teaching feedback and other materials to analyze the effectiveness of the DFC teaching method. Results found that during the course midterms, students are able to respect different cultures, but still have difficulty in practicing cultural conflict resolution and medical cross-cultural actions. After adjusting the teaching method and integrating the DFC action praxis report for students to participate in culture conflict resolution actions, the effectiveness of students' cross-cultural learning outcomes improved. This research enhances the international communication competence of college students, and integrating the DFC method into the cross-cultural English curriculum is also a new attempt in medical English teaching in Taiwan.