智慧型電腦輔助學習系統實驗性教學之研究─基礎臨床整合課程學習環境系統(III)

以電腦為基礎擬仿臨床情境的教學系統過去二十五年來吸引了關心醫學 教育者的注意。多媒體技術的演進，提供了精巧的平台介面和數位系統，能夠在 個人電腦畫面呈現醫學案例，作為自主學習的資源;尤其是網際網路的發展更可 能帶來對醫學教育革命性的影響。這些發展不僅對臨床教育和繼續教育有影響； 在基礎醫學教育的改革中也扮演了重要的角色。但是這些輔助系統在教學運用上 如何改變學習型態，實際成效為何，以及會遭遇什麼困難，都值得儘早探討，以 提供教學設計上的參酌，避免無謂的投注。 台大醫學院自民國八十一年起，開始在基礎醫學課程施用臨床醫學案例， 試行整合臨床與基礎教育，從事以問題為導向的小團體教學與主動學習模式。醫 學資訊學也被列為必修課目，並嘗試與這種教學及學習模式結合，學習網路被開 發應用在教育訓練上。網路教學的去中心化和合作學習特性使得小班教學增加一 個可能的媒介，本計畫即是針對建立一個學習輔助系統環境的應用研究，目的在 設計小組教學的介面指引，提供給學生作為校園輔助學習網絡的一環，預期能夠 增進學生主動學習的動機，以及小團體學習的動態發展。 本計畫在第一年與第二年的成果中已經確立輔助系統的架構，並且開發針 對團體學習因素的評量工具。第三年計畫將使用對象分為實驗組與對照組，進行 比較研究。參與的小組成員在課室聚會前的準備與課後待解決問題的後續追蹤 裡，將使用輔助系統作為常規的學習活動。藉著系統平台收集資料、運用網路資 源、與相互討論，以解決問題；對照組則自由沿用過去課前準備形式。在學期結 束後收集使用網路系統中小組的學習流程，並針對所有對象分期中與期末兩次， 進行團體學習因素的評估，從事比較分析。結果顯示，使用該系統的實驗組同學 和對照組同學在參與度、成員人際關係、互助學習、自我表露等因素均沒有差別； 對小班學習規避和衝突的態度也沒有影響。但在期中與期末的比較上，未使用網 路的同學則顯示在小班教學參與度和人際關係上有顯著的退步，部份反應了小班 教學團體學習正向因素隨著課程進行逐漸下滑的趨勢。在校園學習網路的應用設 計上應謹慎為之，創造有利條件。Computer-based clinical simulation has exerted a revolutionary impact on medical education during the past decade. There are rich potentials need to be explored in this area. The evolution of the technology through multimedia to the invention of INTERNET provides an environment for the development of sophisticated interfaces and digit systems that may serve as a learning resource and environment. The computer-assisted instruction/learning(CAI or CAL) program is not only tailormade to meet the needs of clinical and continuing medical education, but can be applied to undergraduate pre-clinical curriculum. However, the effect of the application, how to integrate the network activity into the curriculum and provide a reward for participation remain the crucial problems. In 1992, the College of Medicine at National Taiwan University started problem-based small group tutorials in integrated clinical-basic courses for basic medical sciences. An essential requirement of computer-literacy training has also been established and incorporated in to these courses. This project aims at designing a learning-supported network for the medical students to promote their self-learning motivation, and facilitate collaborative and cooperative learning. The idea of Computer-Supported Cooperative Work( CSCW) is to be tested in this study. In the third year of this project eleven tutorial groups ( N = 88) participated in the experiment, in which supporting system was used as an adjunct mode to pre-class and post-class group discussion. Five tutorial groups ( N = 39) never accessed the system. The comparisons of the group learning factor showed that there was no significant difference between the system-user and non-user. However, the non-user tend to rate the lower scores on group engagement and interpersonal relationship in the final measurement comparing to the mid-term measurement