| 摘要: | 背景：
近年「病人安全」議題受世界各國重視，為避免潛在的醫療錯誤發生及提升病人安全，目前國內政府相關單位已推動許多策略及措施，學界亦投入心力研究，然而在病人安全推動的參與上，醫學生常常是被忽視的一員。為有效提升醫療及醫學教育品質，許多國家及知名學者曾提出教育醫學生暸解醫療錯誤及處理錯誤的辦法可提升病人安全，應視為重要角色之ㄧ，此外，醫學生對醫療錯誤之學習及揭露態度可能會因人格特質不同而有差異，有鑑目前國內卻缺乏醫學生對病人安全之相關研究，本研究之目的主要為探討醫學生人格特質對醫療錯誤態度之影響。
研究目的：
一、瞭解國內醫學生人格特質及醫療錯誤態度之現況。
二、探討醫學生人格特質對醫療錯誤議題之態度影響。
研究方法：
以McCrae & Costa所提出之五大人格特質(FFM)架構作為人格分類之依據，並於相關文獻探討後自擬醫療錯誤態度問卷進行調查。以國內北部三家私立大學醫學系大五至大七學生為對象，發放紙本問卷及電子問卷，回收有效問卷483份，回收率56.9%。
研究結果：
一、國內醫學生之人格特質：以「親和性」特質得分最高、其餘依序為「勤勉正直性」、「經驗開放性」、「外向性」，得分最低為「情緒敏感性」。
二、醫學生之醫療錯誤態度：大多數受訪者認為醫療錯誤是可以避免的；超過半數受訪者認為溝通因素是導致醫療錯誤發生的最主要原因；83%受訪者同意參加病人安全相關的教育講座；醫療傷害程度較嚴重時，揭露錯誤之態度會較正向；在錯誤發生後「擔心遭受控告」及「影響到未來就業」是醫學生們最在乎的事情。
三、醫學生人格特質對醫療錯誤之態度影響：醫學生五大人格特質中高親和性、高經驗開放性、高勤勉正直性、高度外向性及高情緒敏感性之特質，對醫療錯誤態度構面均有部分正向之影響。其中以親和性及勤勉正直性兩特質對醫療錯誤態度之影響較大。
結論：
一、高親和性、高經驗開放性、高勤勉正直性、高外向性及高情緒敏感性人格特質之醫學生對醫療錯誤態度均有不同構面之正向影響。
二、針對高度情緒敏感性學生或有需求之醫學生，辦理情緒管理之講座藉此增加學生們對醫療錯誤的暸解及紓解其不安之情緒；在課程設計中增加溝通技巧的訓練及錯誤病例討論；在相關教育講座之中，多宣導病人安全相關政策及病人安全通報系統使用之教育，以建立醫學生對錯誤通報並從中學習的習慣。
三、醫學系學生之親和性及勤勉正直性較高，該類特質學生偏好學習方式為實驗課、小組討論、臨床教學和團體討論，建議未來課程設計可多利用此類教學方式，並適時地分享相關錯誤案例。
四、研究發現人格特質與醫療錯誤態度間具有明顯之影響，研究結果可提供未來甄選學生之參考。
Background: Patient safety has become a very important issue all over the world in recent years. In order to reduce the potential errors and improve healthcare quality, our government has already implemented a lot of strategies and measures, and scholars also made efforts to study on this issue, but study of patient safety focus on medical students are still ignored nowadays.Additionally, many scholars belive that if medical students cognize medical errors, it could help them to avoid medical errors and improve healthcare and medical education quality effectively. It is a potential to find students’ attitudes toward medical errors associated with their personality traits.
Purpose: First, explore the medical students’ personality traits and their attitudes toward medical errors. Second, understand the relationships between their personality traits and attitudes toward medical errors.
Methods: used Five Factor Model developed by McCrae & Costa to classify personality traits of medical students and questionnaires carried on the investigation to realize their attitudes toward medical errors. The objects of the research were medical students studied in medical universities of north in Taiwan.Four hundred eighty-three (56.9%) surveys were included in the analyses.
Results:First, “Agreeableness” is the personality trait scores points high, and other in order is “conscientiousness”, “openness to experience”, ”extraversion” and “neuroticism” scores points lowly.Second, Most interviewees think the medical errors can be avoided; Over half number of interviewees thought the communication factor are the most main reason cause the medical errors occur; 83% participant agreed participates in the education course about patient safety; When the medical injury degree is more serious, the interviewees tend to disclose errors to patients. The things that students care the most are “suffer the accusation” and “influence their employment on the future”. Third, “Agreeableness” “Conscientiousness”, “Openness to Experience”, ”Extraversion” and “Neuroticism” are positively related to medical students’ attitudes toward medical errors, and “Agreeableness” “Conscientiousness” are the traits influence their attitudes significant.
Conclusion:First, “Agreeableness” “Conscientiousness”, “Openness to Experience”, ”Extraversion” and “Neuroticism” are significant positively related to the attitudes toward medical errors.Second, give course about stress and emotional management to sensitive students; Increase trainings for communication skill and case-study about medical errors in the course design.In relevant educational lectures, declare patient safety relevant policies and teach how to use Taiwan patient-safety reporting system(TPR) to form a habit to practice and learn form errors.Third, the medical students in Taiwan are agreeableness and conscientiousness, that traits preference teaching methods are lab classes, small groups, clinical teaching and group discussion. We suggest the teachers might change their teaching method in the future.The study discovered that has obvious relationship among the personality traits and attitudes toward medical errors, the result of study might offer the reference to select students in the future. |
