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內科學誌 Scopus

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篇名 醫師制度改革方式(含PGY訓練至內科專科醫師訓練)
卷期 34:1
並列篇名 Reforming Trends of Physician Training System (Including Pgy To Internal Medicine Residents Training)
作者 楊盈盈
頁次 007-011
關鍵字 全人照護內科專科醫師訓練醫療照護訓練醫學教育Holistic careInternist trainingHealthcare trainingMedical educationScopusTSCI
出刊日期 202302
DOI 10.6314/JIMT.202302_34(1).03

中文摘要

蘇格拉底在公元前400年就曾說過「除非整體好,否則部分永遠不會好(The part can never be well unless the whole is well)」。現今的全人醫療(或全人照護)的執行者堅信,最有效的治療是以全人進行整體考量,而不是針對部份或單一疾病的治療。醫療照護的主體是人而不是病,因此全人醫療近年來在各國逐漸受到重視。美國醫學研究院(Institute of Medicine, IOM)於2001年發表之對21世紀醫療品質的期許(Crossing the Quality Chasm- A New Health System for the 21st Century)中,提及21世紀的新醫療體系應強調以病人為中心之醫療照護,並探討醫療專業人員須如何培養核心能力,才能提供民眾具有品質與價值之醫療服務,這與全人照護之精神緊密相連。建議醫療機構內對內科年輕醫師的「全人醫療」素養的評估方法包括:(1)定期統計內科年輕醫師接受「全人醫療」的時數。(2)臨床單位定期以專業素養迷你全人演練評量(Professionalism, Mini-Evaluation Exercise, P-MEX),迷你臨床演練評量(Mini-Clinical Evaluation Exercise, mini-CEX),操作型技能直接觀察評量(Direct Observation of Procedural Skills, DOPS)或案例導向討論(Case-based Discussion, CBD)等多元方法評估內科年輕醫師「全人醫療」的訓練成果。(3)定期舉辦客觀結構式臨床技能測驗(Objective Structured Clinical Examination, OSCE)及模擬醫學訓練,評估內科年輕醫師「全人醫療」素養的訓練成果。(4)應定期評核教學病歷是否呈現「全人醫療」精神,並回饋給臨床單位之培育計劃主導者(program director),再回饋到相關單位。期待所有在接受內科專科醫師訓練的醫師,皆能具備全人醫療素養的能力。

英文摘要

Socrates said in 400 B.C. that “The part can never be well unless the whole is well”. Today's practitioners of holistic medicine (or holistic care) firmly believe that the most effective treatment is one that considers the whole person, not a part or a single disease. The subject of patient care is the person, not the disease, and so holistic care has gained increasing attention in recent years. The Institute of Medicine (IOM) in 2001 published Crossing the Quality Chasm - A New Health System for the 21st Century, in which it is stated that the new health care system of the 21st century should emphasize patient-centered care and explore how health care professionals should develop core competencies to provide quality and value health care to the public, which is closely related to the spirit of whole-person care. This is closely linked to the spirit of whole-person care. Suggested methods for assessing the “holistic care” competencies of young physicians in health care settings include regular statistics on the number of hours of “holistic health care” received by young physicians in internal medicine. The clinical unit should regularly assess the “holistic care” competency of young physicians in internal medicine by various methods such as Professionalism, Mini-Evaluation Exercise (P-MEX), Mini-Clinical Evaluation Exercise (mini-CEX), Direct Observation of Procedural Skills (DOPS) or Case-based Discussion (CBD). We also conduct objective structured clinical skills tests on a regular basis. Regularly conduct Objective Structured Clinical Examination (OSCE) and simulated medical training to assess the training outcomes of young physicians in “holistic medicine”. Regularly evaluate whether teaching medical records present the spirit of “holistic medicine” and provide feedback to the program director of the clinical unit and then to the relevant units.

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