基于台湾地区两部新法的《同性婚姻法与病患自主权利法（SMPRA）模块新课程》：一项混合方法研究。

A novel curriculum for the Same-Sex Marriage Act and Patient Right to Autonomy Act (SMPRA) module based on two new laws in Taiwan: a mixed-methods study.

机构信息

School of Medicine, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist, Taipei City, 11490, Taiwan.

Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Chenggong Rd., Neihu Dist, Taipei City, 11490, Taiwan.

出版信息

BMC Med Educ. 2023 Feb 4;23(1):91. doi: 10.1186/s12909-023-04076-9.

DOI:10.1186/s12909-023-04076-9

PMID:36739384

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9899378/

Abstract

BACKGROUND

The establishment of laws has had a tremendous impact on holistic medical care. The Patient Right to Autonomy (PRA) Act and the Same-Sex Marriage Act have been passed in Taiwan, and both have sparked intense societal debate. The Same-Sex Marriage Act and PRA Act (SMPRA) teaching module was created for the Gender, Medicine, and Law (GML) course of the medical curriculum. This video trigger-assisted problem-based learning (VTA-PBL) software has integrated content on the aforementioned legislative proclamations. It upends conventional beliefs and fosters reflective practices on sexual rights and the right to representation among medical students. This study examined how the SMPRA module affected the knowledge and attitudes of medical students taking up the GML course.

METHODS

A simple pre-/post-test design evaluated the outcomes of the PBL module to examine the changes in knowledge and attitudes of medical students toward same-sex marriage rights. In 2019 and 2020, 126 and 49 5th-year medical students took up the GML course, respectively. The GML components included a video scenario representing advanced decision-making and a healthcare agency with a same-sex couple, a PBL discussion, and student feedback presentations. The mechanisms of feedback collection and measuring student knowledge and attitudes toward sexual rights differed between one cohort in 2019 and the other in 2020. Pre- and post-lecture tests were used in the first school year, whereas a post-lecture open-ended questionnaire survey was used in the second school year.

RESULTS

In total, 90 and 39 eligible questionnaires were received in the first and second school years, respectively, which corresponded to response rates of 71% and 80%. Students showed a better understanding of and positive enhancement of proficiency in legal and ethical content and relevant clinical practice. Qualitative analysis revealed that students viewed healthcare providers as checkpoints for conflicts of interest; medical ethics as the cornerstone of clinical practice; cultural background as a significant influence on decision-making; and empathetic communication as the cornerstone of relationships between patients, family members, and doctors.

CONCLUSION

The GML course of the SMPRA module fosters reflective practices on ethical and legal sexual rights issues.

摘要

背景

法律的制定对整体医疗产生了巨大影响。《病人自主权利法》（PRA）和《同性婚姻法》在台湾获得通过，这两项法案都引发了激烈的社会辩论。《同性婚姻法》和《病人自主权利法》（SMPRA）教学模块是为医学课程中的性别、医学和法律（GML）课程创建的。这个视频触发式基于问题的学习（VTA-PBL）软件整合了上述立法声明的内容。它颠覆了传统观念，培养医学生在性权利和代表性方面的反思实践。本研究考察了 SMPRA 模块如何影响学习 GML 课程的医学生的知识和态度。

方法

采用简单的前/后测试设计评估 PBL 模块的结果，以检验医学生对同性婚姻权利的知识和态度的变化。2019 年和 2020 年，分别有 126 名和 49 名五年级医学生学习了 GML 课程。GML 课程包括一个代表高级决策的视频情景和一个有同性伴侣的医疗保健机构、PBL 讨论和学生反馈展示。2019 年的一个队列和 2020 年的另一个队列在收集反馈和衡量学生对性权利的知识和态度方面的机制有所不同。第一个学年使用课前和课后测试，第二个学年使用课后开放式问卷调查。

结果

在第一学年和第二学年，分别收到了 90 份和 39 份符合条件的问卷，相应的回复率为 71%和 80%。学生对法律和道德内容以及相关临床实践的理解和熟练程度有了更好的提高。定性分析显示，学生认为医疗保健提供者是利益冲突的检查点；医学伦理是临床实践的基石；文化背景对决策有重大影响；同理心沟通是患者、家属和医生之间关系的基石。