背景與目的：根據物理治療師法，物理治療師有開立物理治療項目的處方權。但現行的醫療體系，醫師在照會物理治療的同時，也會開立物理治療項目，尤其是復健專科醫師。回顧文獻，未見有人對照會醫師在照會單上有、無詳列物理治療項目是否會對學生的學習態度有所影響的報告。所以本研究欲藉由問卷調查，探討照會醫師在照會單上有、無詳列物理治療項目究竟對學生的學習態度與專業反應是否會有所差異；又兩種不同的處方內容對臨床教師需求的程度是否亦會有所不同。此研究可以作為未來改善實習制度之參考。方法：本實驗以兩個照會制度不同的大型醫院之物裡治療實習生為研究對象。甲醫院照會病患接受物理治療之醫師為復健科醫師，會在照會單上詳列治療項目；乙醫院之照會醫師為非復健之專科醫師，在照會單上只寫診斷，並不開立物理治療項目。本實驗以86-87學年度曾在這兩大型醫院實習過的23位物理治療畢業生為調查對象，學生選擇甲乙兩家醫院的先後次序是隨機分配，最後資料完整的有20份。結果：大多數學生認為在乙醫院沒有詳列物理治療項目的照會制度下實習的效果較好(P<0.05)；且在此制度下，若有臨床教師在旁邊指導，比單獨評估或治療病人的學習效果好(P<0.05)。學生為解決問題所選擇之輔助教學者，多數以臨床教師為優先(P<005)；若採將處方權保留給治療師的照會制度，似乎可以提高學生到該單位實習的意願。結論：本研究之受訪學生較希望在醫師不列治療項目的制度下實習；臨床教師在此照會制度下被需求的程度較高。

Background and Purposes: The Physical Therapy Practice Act of Taiwan empowers physical therapists the right to prescribe physical therapy programs. However, physical therapists in Taiwan usually follow the programs prescribed by the referring physician completely when treating their patients. In certain hospitals, physicians prescribe physical therapy in the form of consultation. It remains unclear whether the content of physician referrals and the presence of clinical instructor have any influence on the learning preference of senior physical therapy students. The purpose of this study was to investigate the effects of different physical therapy referral systems and the presence of clinical instructors on the learning attitude of senior physical therapy students during their clinical affiliation. Methods: Twenty students who selected their clinical affiliation in two hospitals with different physical therapy referral systems participated in this study and were surveyed by a questionnaire, regarding their learning attitude and their dependence on clinical instructors when practicing under different referral systems. Results: The majority of the senior physical therapy students preferred practicing in hospitals where physical therapy referrals were delivered in the form of consultation (p<0.05). Most of the students indicated that they had higher motivation as well as better learning effect on clinical practice if they did not have to follow the prescribed program strictly. In the cases when physical therapy referral were received withoutdetailed programs, students felt that the presence of clinicalinstructors were needed to assist them in problem solving. Conclusions: The physical therapy students show higher motivation in clinical practice in hospitals where the physicians do not prescribe physical therapy programs in their referral. In such case, the presence of clinical instructors is essential for consultation.