| Summary: | 碩士 === 國立中山大學 === 醫務管理研究所 === 98 === Objectives：The purposes of this study were to understand the circumstance of the learner about ambulatory care education and to realize the demand and attitudes of learning from the medical students, meanwhile to explore the effectiveness after receiving this education. Besides, this study is also combined with the six core competencies as principles to find out the attitudes of the education from the medical students and the factors of upgrading their clinical skills.
Methods：This cross-sectional study employed quantitative method to conduct the research, and this population included medical students from a medical canter of the southern of Taiwan. Structured questionnaires were conducted to medical students, a total of 78 uestionnaires were distributed with 67 questionnaires being returned.The data is analyzed by SPSS 12.0 and used descriptive statistics, factor analysis, t-test, and ANOVA, correlation analysis, and multiple regression analysis.
Results：The major findings were as following：
The results of this study show that most of the time, the medical students participated 1 to 2 times per month, and they also considered the implementation of 2 times one month is appropriate.The medical students also thought that the most ideal number of patient are three, and the result also showed that there were 36（53％） persons encountered three patients. Besides, the method which the students met was the medical student conducted diagnosis the patients first, and the teacher taught the students then. And there were 52（77.6％） persons encountered this situation.
The study found that the six core competences applied to the ambulatory care education will be classified into three abilities were” basic medical
expertise”、”advanced medical diagnostic skills”and”medical knowledge of professional application”. And the result also showed that after ambulatory care training, the basic medical expertise benefited best to the students, and then was the advanced medical diagnosis and medical knowledge of professional application.The study found that the best benefits of clinical competence of medical students was "history taking" followed by "physical and special inspection" and "clinical diagnostic ability", the lowest score was "the administrative processes". And these three abilities were in compliance with the results of clinical ability from this study which pointed to the “basic medical expertise”. It can be found that the goal of the ambulatory care education for the medical student was aimed to the basic medical ability, this result of the research was matched with the direct and discontinuous properties of the outpatient clinic.
Conclusion：The study found that the most beneficial factors which could enhance the students the overall clinical skills are the frequency of participating ambulatory care education and the attitudes and enthusiasm of the teaching physicians. If we could measure the demand of involving in the ambulatory care education from the trainee, we could effectively distinguish from the clinical operations and clinical teaching schedule, in this way, it will make the system of ambulatory care education perfect.
In addition, the guidance of teachers such as the enthusiasm、communication skills、friendly attitude、teaching ability and the other personal characteristics will affect the effectiveness of the implementation of ambulatory care education. It was recommended to strengthen the capacity of training instructors about teaching, the manager could regularly organize various workshops, seminars, case report, continuous education to train the enthusiastic teaching physician and made them have the teaching skills of instructors in order to enhance the effectiveness of the ambulatory care education.
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