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의과대학 문제중심학습에서 성찰 유형 및 문제중심학습 경험수준에 따른 성찰의 수준 분석 -비판적 성찰을 중심으로-

An Analysis of Reflection Level in Terms of the Reflection Style and the Grades in PBL(problem-based learning) of Medical School: Focused on Critical Reflection

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주제분류교육학

초록

본 연구의 목적은 문제중심학습(Problem-Based Learning)에서 3개의 성찰의 유형에 따른 성찰의 수준과 양상을 전체 또는 7개 단계별로 파악하고 이를 문제중심학습의 경험수준에 따라서도 살펴보고자 하였다. 총 169명의 S대학교 의과대학 학생들과 인턴, 레지던트, 임상 강사 등을 포함한 졸업생이 참여하였다. 문제중심학습, 성찰, 성찰의 3개 유형(내용, 과정, 비판적 성찰)과 관련된 다양한 연구 자료들을 통해 7개의 대분류 항목을 마련하였고 35개의 소분류 항목을 두어 7점 척도의 질문지를 완성하였다. 3개 유형의 성찰 중에서 내용 성찰의 수준이 제일 높았고, 다음으로 비판적 성찰의 순이었으며, 과정 성찰의 수준이 제일 낮았다. 이로써 의과대학 학습자는 내용 성찰을 더 많이 하는 양상이 나타났다. 내용, 과정 및 비판적 성찰 간의 상관분석을 통해 3개 성찰 유형들 간 상관이 높았고, 성찰의 상위 단계인 비판적 성찰은 과정 성찰과 상관이 가장 높았다. 문제중심학습 7개 단계 내에서는 1단계(문제 기술), 6단계(자율학습)와 7단계(팀 활동)에서 비판적 성찰의 정도가 상대적으로 낮았다. 전체 단계에서는 6단계와 7단계의 3개 성찰의 수준이 높아지는 양상을 나타냈다. 문제중심학습 경험수준을 나타내는 학년 간 성찰의 정도에 통계적으로 유의미한 차이가 있었지만 전체적으로 경험수준을 망라하여 3개의 성찰 유형별 수준에 있어서는 차이가 없는 공통된 양상을 보였다. 즉, 현재 문제중심학습을 교육과정으로 편성․운영하고 있는 집단(의학과 1, 2학년)의 성찰 수준이 학습 완료 후 제한적 적용을 하는 집단(의학과 3, 4학년)보다 높게 나타났다가 인턴, 레지던트 및 전임의 집단의 성찰 수준이 다시 높아지는 양상을 나타냈다. 비판적 성찰에서도 이와 비슷한 양상을 나타냈으나 의학과 3학년은 ‘문제 파악’, ‘개인별 이론 수립’, ‘LI(학습과제) 공식화’에서, 의학과 4학년은 ‘문제 파악’, ‘문제 기술’에서 비판적 성찰이 잘 이뤄지지 않았다. 향후 이들 결론을 뒷받침 해 줄 수 있는 질적 연구가 필요하겠으며 이를 통해 학습자들의 학년별 환경과 특성이 성찰 유형과 어떤 관계가 있는지를 살펴보는 보다 현실적인 연구가 필요하겠다.

Abstract

The purpose of this study was to find how the reflection is represented in PBL as well as how a real teaching-learning strategy can be designed to induce reflection. A survey was administered and 169 questionnaires were returned from undergraduate students, graduate students(interns, residents, and fellows) of S University School of Medicine. The questionnaire was consisted of 35 items within 7 categories. The questionnaire was designed based on various researches about PBL, reflection, and three types of reflection. The respondent data were analyzed by SPSS 12.0 to calculate the item means and by ANOVA including repeated measures, correlation for the group of participants. The findings from this study were as belows. First, the highest reflection was the content reflection among the content, process, and critical reflection. The second highest one was the critical reflection. The relationship between three types was very strong. Especially the critical reflection had a strong correlation with the process reflection. The degree of process reflection was significantly lower than the others. So, It is needed to facilitate the process reflection to induce and raise the critical reflection. Second, among the steps of PBL, the significant reflection occurred in the step 6(self-study) and step 7(group work). However, the degree of critical reflection was relatively lower than the others in the step 6(self-study) and step 7(group work). Third, there was little difference in the relationship between three types of reflection in each step, but its degree was so strong. The significant differences in the steps in total and each step were found among grades(levels of PBL experience)(p<.05). The affective sub-elements of three reflection types were found in each step. A qualitative research to collect the more practical information is recommendable in the future. The result of this study could give the implication to not only the medical school but also the general school that is just going to introduce the PBL.

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