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Journal of Medical Education

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病人自主與知情同意, 明濱 李

Journal of Medical Education

自主原則係指患者在理性狀態下有權決定自己的行爲，包括決定及選擇醫療專業人員及治療方式；醫療人員認爲對患者有益的醫療行爲亦應先得到患者之充分授權或認可。因此自主原則常被認爲易與傳統的醫主原則相衝突，整合或協調「病人自主」與「醫主」兩大原則，有赖於良好的醫病溝通；其基本前提在於醫師應能充分提供患者可理解的病情知識與治療方法及可能引起的利與弊，以獲取病人的同意。健康照顧的基礎在於建立及尊重患者之「自主性」，本文主要以此爲主軸，並以「知情同意」爲範例，討論其内涵及相關之影響因素與衍生之問題。「知情同意」常用的表達方式爲同意書簽署，其主要功能在於表現其對患者「自我決定權」的尊重，鼓勵患者能更積極主動地參與治療決定。簽署同意書應視爲一動態「過程」，而不是一紙靜態的「證明文件」。簽署的過程包含了資訊的提供、患者之充分瞭解、主動意願、同意簽署、醫事人員之敎育患者而獲患者之主動同意；整個簽署過程對於治療進行通常具有正面價值。自主原則爲人性醫療的根本準則，其徹底落實有赖於倫理敎育品質的提昇；以個案爲中心、以實例爲基礎之啓發性討論式敎學，配合臨床實習與督導，及師長的床邊敎學與臨場示範等身敎方式都是培養醫學生未來能尊重及創造患者「自主」的有效方式。

小班教學“團體學習量表”的探討與評估, 美英 高, 宇宙 李, 碧鴻 呂, 子薇 施, 明濱 李

Journal of Medical Education

台灣目前的小團體敎學雖然仍在起步的階段，但是對此種敎學方式的評估是刻不容緩的。在重新建構了比較適合於團體學習的量表—團體學習因素量表—之後，本研究即在檢测和評估此量表的運用情形。本研究根據204位參與小組敎學的醫學系學生，在經過兩次的測試之後，再以確認性因素分析的方法，重新檢驗團體學習因素的模型與資料配合的程度。結果顯示在控制各因素與指標問項，使其彼此之間互不相關之後，五個次量表中，仿同互動學習、自我揭露、人際關係和參與度比較能正向的代表團體學習因素，而規避／衝突則受團體學習因素的影響爲負向的且程度較低。而對各個次量表而言，前測與後測之間的穏定性都相當的高，綜合這些結果反映出本量表是可以作爲一學習團體評量的工具。但是研究結果同時也建議，團體學習因素量表本身仍有一些可以改進的地方。且因研究本身的限制，乃需要更多的實證資料來檢證，特別是應用在具有不同特質的對象上。

Evaluation Of The Faculty Development Program, Kai-Kuen Leung, Wei-Dean Wang, Ching-Yu Chen, Bor-Shen Hsieh

Journal of Medical Education

In 1992, medical education reforms were implemented at National Taiwan University College of Medicine (NTUCM). Faculty development is considered to be the most critical component for the success of the reforms. The administration of small group teaching and problem-based learning courses, as well as preparation of teaching materials for basic and clinical science integrated courses demand a tremendous amount of manpower. In response to actual needs, a faculty development program was implemented in 1995. During the past two years, twenty teaching staffs were sent to three medical schools in the US for one month of teacher training. This study is …

醫學生的身心調適與生涯規劃, 光煬 謝

Journal of Medical Education

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生涯發展與服務：認知的取向, 美英 高

Journal of Medical Education

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如何增進大講堂授課的學習效果, 芳蓉 胡

Journal of Medical Education

大講堂授課能將大量的知識，以較便捷的方式一次傳遞給多數人，有其存在的價值。不過由於大講堂授課缺乏師生的互動與直接討論的機會，學生的學習效果較難掌握。因此須要應用一些方法與技巧來提高授課效果。在講課內容方面，宜因材施教，深淺合適並且條理分明。在講課方式方面，宜注重“聽覺”與“視覺”的引導教學效果。可藉助各種輔助教具，如：幻燈片、錄影帶、圖片等來提昇“視覺”的教學效果。授課聲音宜音量、速度適中，並有高低起伏以提昇聽覺的教學效果。在授課時間分配方面宜攷慮學生的心理狀態，最好能將一小時的課程，平均區分爲三段落，加強每一段落的高潮性，並舉實例討論，以期達到良好的學習效果。

口腔外科學與牙醫學系教學, 寬敏 張

Journal of Medical Education

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美國賓州大學醫學院教育考察, 獻堂 周

Journal of Medical Education

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為邁向二十一世紀的住院醫師訓練建言, 維正 姚

Journal of Medical Education

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醫學教育紀事, -

Journal of Medical Education

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外科臨床教育改革方案：外科100, 佐武 林, 金堅 張

Journal of Medical Education

台大外科100是台大醫院外科部，針對86學年度五年級醫學系學生所做之臨床敎育改革方案的總稱。本計畫是由召集人醫務秘書林佐武副敎授，在總主持人外科部主任張金堅敎授的大力支持下，與外科部各功能分科主任所共同研擬的臨床敎學方案。内容是外科的核心課程，總共有100個題目，每一個題目都是先陳述一個病人的病情，附帶幾個問題，讓學生在學期開始之前，就可以先行預習。上課時，老師僅就問題的内容作討論，讓學生可以從回答問題中去發揮，在30分鐘内，就能夠對該項疾病有了基本的常識認知。題目的安排以本土化爲原則，把台灣常見的外科相關疾病納入，每天討論十題，在十天内完成。外科從敎授到總住院醫師都要參與敎學，也算是總住院醫師的訓練課程。實習的最後一個星期，還安排每位學生跟定一位老師，以增進學生對外科醫師工作及生活型態的認識。如果試辦成功，將可作爲將來發展核心學分的濫觴。

通識教育課程的檢討, 天鈞 張

Journal of Medical Education

為進一步瞭解醫學院實施通識敎育後，醫學院和非醫學院學生對課程之反應，特別對前者以「人與醫學」，後者以「醫學與生活」為例，做一評估和探討。「人與醫學」主要敎授醫學院及公衛學院各學系學生醫學的發展歷史。「醫學與生活」主要教授非醫學院學生醫學知識。每週一次，每次2小時，以大講堂授課方式敎學。此次調查，「人與醫學」修課學生250位，「醫學與生活」修課學生212位。期末測驗時，在答案紙附上問卷調查，包括：課程有否幫助，內容是否適當，授課講員是否適當，以及詢問印象最深刻的講题為何，和建議改進事項。結果顯示在「人與醫學」課程內容和講義方面有69-79%的學生認為很有幫助、有幫助或是很恰當和恰當，而在「醫學與生活」則有89-95%在這個範圍。至於認為課程內容和講義尚有幫助、沒有幫助或是尚恰當和不恰當者，在「人與醫學」為21-31%，在「醫學與生活」只有5-11%。舉例、實用和幽默的敎學方式與學生對授課主題是否印象深刻有關。在建議改進事項方面，印製講授内容大綱或中文講義是學生最需要的，限制上課人數則為學生第二大要求。內容儘量生活化、常識化，多舉案例、多談臨床經驗，和幻燈片儘量中文化也是共同希望的。在「人與醫學」比較特殊的建議改進事項是希望有小組討論機會和能實地參觀。由上面的研究，我們可以瞭解對醫學院學生而言，「人與醫學」的敎學技巧尚待加強，而對非醫學院學生而言，醫學知識的灌輸，顯然受到相當大的歡迎，但仍有可以改進的地方，而印製中文講義，和限制上課人數，是應立即著手進行的。

牙科放射線學非同步遠距教學之短期成效, 思光 陳, 瑞松 陳, 萬烘 藍, 季全 謝

Journal of Medical Education

本研究探討利用全球資訊網建置之非同步電腦輔助敎學環境下，使用管理軟體與否，對牙醫系學生牙科放射線學臨床實習學習成效之影響。全班二十四位本年度五年級牙醫系學生參與此學習成效研究，以該班級於四年級修習牙科放射線學課程之部分期末測驗作為評估工具，實習時學生分為兩組，第一組於實習中接受無管理式全球資訊網電腦輔助敎學，第二組於實習中接受使用管理軟體之全球資訊網電腦輔助敎學，兩組同學於實習後立刻接受測驗，以比較實習時使用管理軟體與否的全球資訊網電腦輔助教學對學得知識記憶保存之影響。結果顯示，兩組學生於期末考之表現無大差異(t=0.24, P=0.41)，無管理式全球資訊網電腦輔助敎學組實習結束後同學測驗成績為期末考時之75.1%，而使用管理軟體全球資訊網電腦輔助敎學組實習結束後同學測驗成績為期末考時之83.0%。此研究結果顯示依目前之實習方式，實習時之輔助學習系統有其需要，而使用管理軟體的全球資訊網電腦輔助敎學有較好的輔助學習效果(t=2.35, P=0.05)。為更深入了解全球資訊網敎學管理軟體建置之非同步敎學環境對牙科放射線學學習成效之影響，需要長期研究之資料，並應使用更廣泛客觀之評量工具。

醫學生涯規劃研究：專科與執業地點的選擇, 宇宙 李

Journal of Medical Education

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美國羅徹斯特大學醫學院教育考察, 繼權 梁

Journal of Medical Education

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瑞典倫得大學口腔衛生醫學院教育考察, 思光 陳, 萬烘 藍

Journal of Medical Education

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New Perspectives For Maximum Likelihood Time-Delay Estimation, John A. Stuller

Electrical and Computer Engineering Faculty Research & Creative Works

This Paper Introduces a New Realization for Maximum Likelihood Time-Delay Estimation (TDE) that Illuminates the Relationships between Maximum Likelihood TDE and Other Methods. We Obtain the Result by Deriving the Likelihood Function using a Fundamental Method that Appears to Be New to the Field of Array Processing. This Method is a Natural Complement to the Generalized Karhunen-Loève Expansion. © 1997 IEEE.

Yale Nurse, Yale School Of Nursing

Yale School of Nursing Alumni Newsletters and Magazines

No abstract provided.

Public Participation Program Development: An Analysis Of Public Participation In The Water Industry, Marcia Lynne Holmberg

UNLV Theses, Dissertations, Professional Papers, and Capstones

The field of public participation is a distinct, but yet unpolished facet within the public relations industry. While the purpose of and need for public participation are becoming increasingly clear, many remain unaware or unconvinced of its advantages. Likewise, even among those who endorse the necessity of public participation, its methods and strategies continue to be a mystery to most.

One industry, in particular, that has recognized and embraced the benefits of conducting public participation is the water utility industry. The purpose of this thesis is to 1) crystallize the understanding of why public participation is a necessary and advantageous …

Mastodon, 80% Complete: Poems, Jonathan Johnson

Dissertations

Many of the poems in this collection are set in the vast woods and along the Lake Superior coastline of Michigan's Upper Peninsula. Others take place in and around the poet's remote cabin in northern Idaho where the Selkirk, Bitteroot, and Cabinet mountain ranges converge. However, they all take as their definition of wilderness the complete external beyond the individual consciousness, including the body, other people, and the decaying cultural landscape, as well as vistas of yet unmolested nature. The poems chronicle an ongoing attempt to occupy the borderlands of faith between imaginative will and allegiance to the world, that …

Reading, Writing, And Multimedia: A Writing Portfolio, Kathy A. Lynn

Digitized Theses and Dissertations (prior to 2008)

A portfolio submitted in partial fulfillment of the requirements for the degree Arts in Professional Writing in the Department of English in the College Humanities, and Social Sciences of Kennesaw State University. December 1997.

Overview Of (1→3)-Β-D-Glucan Immunobiology, David L. Williams

ETSU Faculty Works

Glucans are (1→3)-β-D-glucose polymers that are found in the cell wall of fungi, bacteria and plants. Glucans are known to stimulate humoral and cell-mediated immunity in humans and animals. In addition to the potent immune stimulatory effects of (1→3)-β-D-glucans, there are a number of toxicological effects associated with exposure to the water-insoluble, microparticulate form of the polymer. Recent investigations have suggested a potential role for (1→3)-β-D-glucans in inhalational toxicity. Specifically, (1→3)-β-D-glucans have been implicated in the symptomatology associated with 'sick building' syndrome. The mechanisms by which (1→3)-β- D-glucans mediate immune stimulation and, perhaps, toxicity are currently under investigation. It is …

University Reporter - Vol. 02, No. 04 - December 1997, University Of Massachusetts Boston

1996-2009, University Reporter

No abstract provided.

Number 1, 1997, Palara Editors

PALARA: Publication of the Afro-Latin/American Research Association

Complete Issue

Tidally Driven Residual Circulation In Shallow Estuaries With Lateral Depth Variation, Chunyan Li, James O'Donnell

CCPO Publications

Tidally driven residual circulation in shallow estuaries with lateral depth variation has been studied analytically using a two-dimensional, depth-averaged model. The solution is presented for a v-shaped channel. Exchange flow is found to be correlated with the topography. The magnitude of this exchange flow depends mainly on four parameters: the ratio between the minimum depth on the shoal and the maximum depth in the channel, the ratio between the tidal amplitude at the mouth and the mean depth, the ratio between the length of the estuary and the tidal wave length, and the ratio between the tidal timescale and the …

Should The Criteria Used To Determine The Recognition Of An Impairment Loss Depend On The Asset In Question?, Rachel Moore

Honors Theses

No abstract provided.

Gender, Ethnicity And Space: The Case Of Racial Ethnic Minority Women Telecommuters In Omaha, Ne, Hope Kawabata

Student Work

Telecommuting is a labor process in which employees work from home on a regular basis, but maintain contact with the office through telecommunications technology such as computer networks, facsimile machines, voice messaging systems, and so on. Telecommuting has become very popular in recent years; however, little is known about its social and spatial impacts. Preliminary research on gender and telecommuting has shown that telecommuting tends to reinforce a traditional division of domestic labor and identification of women with the home; however, whether this is the case for ethnic minority women is unknown. This thesis research used in-depth, semistructured interviews to …

Review Of "The Pacifist Impulse In Historical Perspective" Edited By H. L. Dyck, J. William Frost

Religion Faculty Works

No abstract provided.

The Place Of The Psyche In A Constructed World, Kenneth J. Gergen

Psychology Faculty Works

The vast majority of social constructionist writings have been critical of psychological science-on both ideological and conceptual grounds. The constructionist emphasis on microsocial processes also functions oppositionally to psychological accounting. The existing animus grows, however, from a realist metaphysics and a correspondence view of language, neither of which constructionism endorses. Viewing the relationship between constructionism and psychological science in more pragmatic terms, we find three significant ways in which constructionism contributes to a more fully enriched and broadly effective psychology. First, critical constructionism functions to denaturalize psychological accounts, opening them to reflexive deliberation, and democratizing the field more generally. Second, …