中西結合醫師的養成歷程，包括從事中西醫結合醫療工作之動機、臨床角色之定位、對醫療服務品質之影響、學習之經驗及中、西醫的合作方式如何，至今尚不清楚，以致教、考、用制度如何配合，目前仍無實証研究。本研究目的是在醫療社會變遷中，瞭解一位中西結合醫師，其對「中西醫結合認知及其角色期望看法」之探討。本研究之「中西結合醫師」，是以中國醫藥學院的中西醫結合研究所、醫師中醫學分班及中西醫臨床經驗醫師共150人為對象，以結構性問卷進行橫斷性調查研究。問卷內容之設計是以Likert五分量表，從「非常同意」到「極不同意」分為五個等級，分別給（+2）～（-2）分，來探討其認同度。結果發現： 一、中西結合醫師在角色期望的看法上：在醫療服務、教學指導、學術研究等三方面，都期望未來做一位中西醫結合的工作者。 二、人口因子對中西醫結合認知之分析結果，執業院所在「工作動機」方面（F值=2.45，p值<0.05）及「角色定位」方面（F值=2.64，p<0.05）達統計顯著水準，在角色期望的「學術研究」方面，僅臨床年資達統計顯著水準（F值=2.45，p<0.05），其他無顯著差異。 由上述發現我們知道，這一群中西結合醫師有共識到“中西醫結合是21世紀的潮流”。並期望未來做一位教學、醫療與研究能力之中西醫結合先趨者。希望衛生署當局在中西醫結合發展上，有如下的配合： 一、在政策上，呼籲衛生署應儘速開放具有醫師、中醫師雙重資格者同時登錄執業，消除中西醫結合發展上的最大阻礙，符合教、考、用政策。 二、在教育方面，中西結合醫師的人才養成，首要加強實習及臨床病例討論會。並儘速在醫學院列入中西醫結合通識課程，及對臨床醫師加強中西醫結合之繼續教育，以符合世界衛生組織所呼籲的現代醫學與傳統醫學結合（中西醫結合）將為世界潮流。 三、在臨床上，要儘速建立診療模式的共識，以做為統一病名及病歷格式的參考，便於追蹤、統計臨床療效評估工作，使實証醫學有所憑據。 四、在醫療機構發展上，各醫院應儘速增設中西醫結合部門，以提高醫療服務品質。 五、在推廣方面，應促進兩岸中西醫結合學術交流工作，並蒐集大陸中西醫結合之相關資料，以作為台灣中西醫結合發展之參考。 最後希望本研究結果能提供中西醫結合教育的規劃與即將實施的「醫師繼續教育辦法」，以及正研商「醫事人員具多重資格執業管理辦法（草案）」做參考。; Cultivating integrated traditional Chinese and Western medical doctors is necessary to combine traditional Chinese and Western medicine to the medical treatment, to understand the doctors clinical position, the influence on the quality of medical cares and the relation between the doctors of traditional Chinese medicine and Western medicine. However, there are still some problems to these issues. The purpose of this study is to understanding the expectation of the integrated traditional Chinese and Western medical doctors in the change of medical cares world. The integrated traditional Chinese and Western medical doctors supplied 150 valid questionnaires.( 59 were from students in the master’s programs of the integrated traditional Chinese and Western Medical Science Institute of CMC; 45 were from the traditional Chinese medicine students with a Western medicine doctor background in Chinese Medicine Institute Promotional Center; 46 were from the clinical medical doctors of integrated traditional Chinese and Western medicine.) We used a structural questionnaire to conduct a cross tabulation research survey. This form adopted the Likert Scale of 5 proportional measurements to perform the evaluation. The important results of research are︰1.Role expectation: No matter in the field of medical service, teaching and study. being the workers of integration of traditional Chinese and Western medicine all got the highest scores. 2.In motivation: “hospital organizational style” had significant difference. (F=2.45, p<0.05) In role practice had significant difference. (F=2.64, p<0.05) In role expectation: Only “clinical years” had significant difference. (F=2.45, p<0.05), others: had no significant difference. Our conclusions are︰1.Allowing two-license registers. 2.Strengthening education of internship and clinical cases study seminars. 3. Standardizing uniform model of diagnosis and treatment.4. Establishing clinical department of the integrated traditional Chinese and Western medicine. 5.Promoting academic exchange between Taiwan and China.Through the results of this research, we hope to give the greatest benefit to the plan for two-license registers and continuing professional education. The integrated traditional Chinese and Western medicine can have great function in clinical and provide the best quality of medical cares.
