背景：問題導向學習 (PBL)係以學員小組討論實際案例為中心的學習方式，並以分析、解釋與解決問題為目標。這種學習模式已廣泛施行於國內外各大醫學院多年，許多因子會影響學員在PBL 中的表現與學習成效。 目標：試圖找出評估學員在PBL學習表現中的重要面向，進而建立評估學員在PBL 學習表現的工具。以及評量學員在PBL學習表現工具的主客觀性，信效度及可行性。接下來分析學員個體的個性特質如何影響問題導向學習的效果，進而對於日後學員的分組與老師的選擇提供較佳的預測模式。 方法：以中部某一醫學大學93年度 124位醫學系五年級學生為研究樣本，在PBL 課程後進行學員同儕評估，學員個性自評量表 (Big-5 44項短問卷)，以及學業成績(前4年)等資料的收集，以了解學員個性與知識特質對 PBL 學習表現的影響。 結果：針對PBL 表現同儕及導師對學員的評估經主成份分析 (Eigenvalue >1) 分別得到5個(分別命名為控制領導、協助/協同、遵守規定、觀察思索與妥協)，及2個(堅持與權變) 可命名的主成份(根據因素負荷量判斷)。將此評量構面與PBL學員個性及知識特質間進行分析顯示學員的守紀律個性特質與知識水準和其在PBL課程中的控制領導角色扮演呈現正相關 (p<0.05)，而學員的交際性個性特質與其在PBL課程表現中的協助協同與遵守規定呈統計明顯之正相關(p<0.05)。另外，學員想像力的個性特質則與其在PBL 課程中表現遵守規定的角色有統計明顯的正相關(p<0.05)。 結論：本研究結果證明醫學生部份個性特質及知識水準與醫學生在PBL 課程中表現的差異性，此可提供醫學教育者在實施PBL 課程時，從學員本身特質來規劃其在團體中的角色，並提供教師在學員表現上一套完整而客觀的方法。未來需更多資料與更長的時間觀察這些因素間的因果相關性。; Background: Problem based learning (PBL), a student-centered and small group discussion approach to analyze, explain and solve the problem. This learning model has been implemented in all medical universities in Taiwan for years. There are many factors being reported to influence the performance in the PBL course. Purpose: To discover how the personality, knowledge, and tutors’ performance would influence the performance of medical students in the PBL curriculum. Method: A total of 124 undergraduate medical students participated in this survey. The personality was self-assessed by 44-itemed Big Five factors. The knowledge was assessed by their score point average (SPA) in the previous four years at the medical school. The performances of students in PBL curriculum were assessed by peers and tutors, with the use of two newly developed, reliable and validated evaluation sheets. The specialists content validity and the consistency reliability of related measures were tested. Results: The principal components (Eigenvalue >1) of the PBL performance evaluated by peers or tutors were analyzed as five (control/lead, assist/coordinate, obey rules, observe/think and compromise) and two (insist on rules vs flexible) major independent factors respectively. The specialists (n=5) content validity coefficient (Vi) for the PBL evaluation sheet (5-point scale) ranged from 0.8 to 0.95 (p<0.05). The consistency reliabilities of the Big-Five personality questionnaire were analyzed and deleted discordant items (Crobach’s Alpha= 0.67 to 0.82 after selection). The relationships between the personality/knowledge characters and the PBL performance, analyzed by stepwise regression, showed that the conscientiousness personality and knowledge (SPA) are positively related to the control/lead character in PBL, and the extraversion is positively related to the obey-rule character in PBL. The agreeableness and conscientiousness personality are positively related to the SPA. Conclusion: The knowledge and personality characters appear to influence the performances of students in PBL. The students PBL performance evaluated by peers have more discriminate power than these evaluated by tutors. More samples will be required to get more reliable results. Implications are drawn regarding the future development and application of this assessment tools in medical schools.
