Tsai Tsuen-Chiuan, Lin Chyi-Her, Harasym Peter H, Violato Claudio
Department of Pediatrics, Taipei Medical University College of Medicine, Taiwan.
Med Teach. 2007 Mar;29(2-3):128-34. doi: 10.1080/01421590701310889.
The main purpose of this study was to identify and understand the structure of latent traits underlying the concept of medical professionalism of Taiwanese students.
A 32 item questionnaire assessing medical professionalism derived from the definition by the American Board Internal Medicine (ABIM) was distributed to 133 year seven medical students. A five-point rating scale of importance was used to identify the extent of their values or beliefs in each item.
The three items perceived most important were: accountability to patients, respect for patients and their families; and integrity and prudence. The least important component underlying professionalism was 'enduring unavoidable risks to oneself when a patient's welfare is at stake'. Factor analysis resulted in eight factors: 'commitment to care' (factor 1); 'righteous and rule-abiding' (factor 2); 'pursuing quality patient care' (factor 3), 'habit of professional practice' (factor 4); 'interpersonal relationship' (factor 5); 'patient-oriented' issues (factor 6); physician's 'self-development' (factor 7); and finally, 'respect for others' (factor 8). Most of the variance was contributed by factor 1 (34.9%). The mean score of factors ranged from 3.84 (factor 1: commitment to care) to 4.7 (factor 8: respect of others), and the reliability alphas ranged from 0.86 to 0.66.
These results of young physicians' professional values have implications for medical school curriculum for improvement.
本研究的主要目的是识别并理解台湾学生医学职业精神概念背后潜在特质的结构。
一份源自美国内科医学委员会(ABIM)定义的评估医学职业精神的32项问卷被分发给133名七年级医学生。采用五分制重要性量表来确定他们对每个项目的价值观或信念程度。
被认为最重要的三个项目是:对患者负责、尊重患者及其家属;正直与审慎。职业精神背后最不重要的组成部分是“当患者的福祉受到威胁时,自己承受不可避免的风险”。因子分析产生了八个因子:“护理承诺”(因子1);“正直守法”(因子2);“追求高质量患者护理”(因子3);“专业实践习惯”(因子4);“人际关系”(因子5);“以患者为导向”问题(因子6);医生的“自我发展”(因子7);最后是“尊重他人”(因子8)。大部分方差由因子1贡献(34.9%)。因子的平均得分从3.84(因子1:护理承诺)到4.7(因子8:尊重他人)不等,信度系数从0.86到0.66不等。
这些年轻医生职业价值观的结果对医学院课程改进具有启示意义。