醫學生倫理素養之提昇: 以三國演義課程為例

Medical context becomes more and more complicated in recent years, and the relationships between physicians and patients are with a lot of tensions. Ethic literacy is emphasized in medical universities, and it is worth exploring how to improve basic ethics through general education course. Depicted stories of loyalty, filial piety, chastity, and righteousness, Romance of the Three Kingdoms could be major material to elevate ethic literacy. However, it lacks exploration to evaluate the effectiveness on how to improve undergraduates' ethical literacy. The lecturer, as a facilitator in the class, initiated students to discuss ethic issues through stories to realize the essential attitude of interpersonal relationship, and modern life and medical ethic situations were also discussed in advance to get more self-awareness, learn how to solve problems, and familiarize with critical thinking through writing reflection journal. The present study was based on the classic reading course at TaipeiMedicalUniversity during 2013 autumn semester, and the reflection journals of 17 weeks from 37 students, the self-rating learning questionnaire, and teaching performance rating executed by Office of Academic Affairs were analyzed to evaluate the effectiveness on elevating ethical literacy. Results showed 5 aspects of ethic literacy elevating: 1. To learn good virtue; 2. To criticize mistakes; 3. To differentiate and contemplate dilemma situations; 4. To elevate personal moral level; 5. To put morality into action. Quantitative data showed that two self-rating items related to ethics literacy were low instead. In general, the averages of the 20 items of self-rating learning questionnaire were above 4.32, and the teaching performance rating on learning effectiveness rated by students themselves were above 4.58, so that the overall improvement was approved. In the future, the element of peer interactions could be added, and the ethical literacy should become the main goal of the course. By adapting assessment tools with better reliability and validity tested before and after the course, the elevating of ethical literacy would be further affirmed.