本文由問題導向學習 (Problem-Based Learning, PBL) 認識論觀點來看PBL 以 問題情境誘發學習、發展臨床推理與自我導向學習等能力的理論基礎與方法，並 說明客觀結構式臨床測驗 (Objective Structured Clinical Examination, OSCE) 用於 訓練與評量臨床技術的執行方式。繼而表明在職能治療教育宗旨下，PBL 與OSCE 用於培育具備終身學習與臨床實務能力的職能治療專業人才的合適度。文中並分 享以PBL 結合OSCE 作為訓練臨床技術實施於課程中的實務方法。結果顯示，學 生確實能於循序漸進的訓練中獲得臨床技術的發展，由效果量的檢視也顯示，學 習成效是來自於PBL 結合OSCE 的實施成效。因此，建議於職能治療教學中透過 OSCE 操作，幫助學生習得的知識能用於臨床技術的發展以銜接臨床實務工作， 此外，教學中由小規模單一課程融入PBL 作為嘗試，是協助教師與學生熟悉與開 展PBL 課程的最佳策略。

From the perspective of epistemology, the theoretical basis and approach of problem-based learning (PBL) via use of clinical scenarios to facilitate learning, enhance clinical reasoning, and assess self-directed learning abilities of students is discussed. The application of an objective structured clinical examination (OSCE) in clinical skills training and evaluation is also presented. The strengths of PBL and the OSCE in preparing occupational students for lifelong learning abilities and clinical competences are also elaborated. Integration of PBL and OSCE in developing a clinical training curriculum showed that the clinical skills of students benefit from step-by-step training. Statistical analysis revealed that the training effect was due to the application of PBL and the OSCE. Therefore, we suggest that teaching occupational therapy via an OSCE helps students apply knowledge in clinical cases and develop clinical skills. In addition, integrating several PBL cases within a single curriculum is an optimal strategy to help teachers and students familiar with PBL.