106年度「原住民族地區醫事人員繼續教育推廣計畫」

一、計畫緣起

(一)依據:

依據原住民族基本法第24條規定,政府應依原住民族特性,策訂原住民族公共衛生及醫療政策,將原住民族地區納入全國醫療網,辦理原住民族健康照顧,建立完善之長期照護、緊急救護及後送體系,保障原住民健康及生命安全。為積極提升原住民地區醫事人員之專業職能,提供原住民族地區醫事人員繼續教育機會。

(二)沿革:

衛福部 (前為衛生署)自民國74年起辦理醫療網計畫,79年醫療網第二期計畫將山地離島地區列為加強基層醫療網之工作計畫,從此山地離島醫療衛生成為全國重要之衛生建設。其中,亦依照醫事人員執業登記及繼續教育辦法,將山地離島地區之醫事人員之在職專業訓練列入工作重點。過去此類計畫皆由部立醫院執行,提供醫學新知和疾病管理為主之繼續教育活動,成果可觀。然而,進入二十一世紀後,人口老化和氣候變遷對原住民族地區居民健康造成的衝擊愈來愈急遽,繼續教育內容應能納入在地健康需求,考量文化差異和特色,以利原住民族地區醫事人員具備多元健康照護智能。

二、計畫背景

(一)醫學繼續教育與原住民地區醫事人員繼續教育

繼續教育為「使個人工作相關之能力與技術更為專精的過程」,而這個過程是任一專業人員自學校畢業後到執業期間一直持續進行的。醫事人員因其職業特殊性及專業性,故接受持續性的教育訓練除了可以提升本科學能外,亦能藉由不斷地獲取新知以了解醫療領域發展的趨勢。

面對原住民健康議題的特殊性,原住民地區醫事人員更需要在精進專業智能外,能具備跨文化照護能力和培養跨專業合作能力。

適切完善的教育規劃可減少新進人員適應困難,提升留任意願,維持熱情和勝任感,減低醫療機構人力與財力負擔,真正落實「以病人為中心」之理念。

(二) 文化勝任能力:

在文化教育計畫中強調文化勝任能力不只是文化知識的累積,也不只是具備文化覺察和敏感度,更重要的文化技能,也就是能規劃並執行具文化安全性 (cultural safety)疾病照護和健康促進的方案。因此,教育訓練的內容不只注意各種健康議題的社會文化決定因子及機轉,也重視消除存在於照護系統和人員中的偏見和歧視。

(三)跨專業合作:

跨專業教育 (inter-professional education,IPE)的目的即在為各專業進行跨專業間作業 (Inter-professional Practice,IPP)的能力培養。在IPE的教育活動中,團隊成員的本職專業知識,態度和技能是先備智能,以問題導向學習 (problem-based learning) 為主要教學策略,臨床實際案例為主要教材,有時利用標準化病人 (standardised patients)為教具,教導與IPP有關的知識,態度和技能。其評量方式常借用客觀的臨床能力試驗 (Objective Structured Clinical Examination ,OSCE) 來了解成員「智能」的提升與「態度」的改變。

三、 計畫主旨

1.教育活動內容以在地健康議題和社會文化脈絡為主,輔以醫學新知和疾病管理,以利醫事人員拓展視野,培養跨文化健康照護能力。

2.教育目標在培養跨專業合作能力(inter-professional collaboration competency,IPCC),以因應人口老化和氣候變遷對原住民族地區居民健康造成的衝擊,滿足各種健康照護需求。

3.本繼續教育計畫將以跨專業教育 (inter-professional education,IPE)為架構,針對在地重要健康照護議題,例如: 原住民族健康照護、緊急救護課程(包括ACLS及ETTC等)、文化敏感度、通識課程 (包括兩性平等、家暴性侵害、物理治療、職能治療等)納入課程設計主軸,並把長期照護、精神照護、健康生活促進 (例如飲食安全、生態安全等)、溝通協調領導等主題,做融入式課程設計。

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