本研究目的在於探討利用啟發式小組教學技巧，實施醫學倫理學教學的短期成效及影響成效之團體學習因素。本研究分別針對二個不同學年度修習醫學倫理學課程之醫學系六年級學生為對象;每組學生約20人，修習時聞為六週，每週四小時。討論過程由同學主持，以問題為基礎及案例為中心。在課程結束時，以自填問卷評量方式由學生評估學習成效、團體氣氛及團體互動。共計239名(第一年113名，第二年126名)學生完成問卷調查，經由二學年之239名學生研究結果發現，討論式小組教學適用於醫學倫理學之教學;就整體評量而言，兩學年的極多數學生認為醫學倫理教育對行醫生涯很重要(92％:98％)，大多數同學對課程內容安排(69.1%:73.8%)及進行方式(56.7％:69.9％)均表滿意;而多數學生覺得倫理知誠(70.8％:84.1％)、倫理推理能力(72.6％:89.7％)有明顯的收穫。連績二學年的成效評估顯示，教學成效穩定且在倫理知識與倫理推理能力方面的收穫，都有明顯的增加;在團體互動及團體氣氛方面，亦持績進步。利用逐步複迴歸，分析影響教學成效之團體學習因素，發現(1)同學的意兄，(2)以老師為榜樣，(3)團體參與感，及(4)在乎老師的看法四項因素，可解釋倫理知識收穫變異量的22.3％;而前四項.因素中之前三項及學習如何收集資料、面對面澄清問題與表達個人的看法等六項因素，可解釋倫理雅理能力收穫變異量的29.4％。由本研究知，影響倫理知識獲得及倫理推理能力的團體學習因素有其共同基礎，但亦分別有其特殊點。

　　　　　The use of small-group tutorials in medic-al ethics education has been emphasized recently. However, there has been little research on their effectiveness and associated group learning factors. The present study aims to evaluate the teaching effectiveness using a small-group tutorial method and its related group-learning factors rated by sixth-year medical students, who completed a course of medical ethics at the National Taiwan University College of Medicine in one of two academic years. The course was conducted as weekly four-hour discussions for six consecutive weeks. Each group of students contained approximately 20 members. Each two-hour session was facilitated and coordinated by tutors. Following a brief presentation during each session, all of the students were asked to give problem-based and case-centered examples as triggers for open discussion. Reliable self-rating questionnaire were used to assess teaching effectiveness, group interaction and group climate. Post-course questionnaire surveys of 239 students (N=113 for 1995; N=126 for 1996) of two consecutive academic years revealed that a great majority (92% in year 1 and 98% in year 2) of the students considered medical ethics education to be important for professional development, and 90% 96% suggested that ethics courses be taught during clinical training years. A majority of students was very satisfied with the course content (69.1O/o in year 1:718% in year 2) and the teaching format 56.7%: 69.9%). The students' ratings on effectiveness of the course indicated that 70.8% to 84.1% of the students reported significant gains in their general knowledge of medical ethics and 8 1.6% of them in the ability to perform ethical reasoning. Analysis of students' ratings of group-learning factors showed that group interactions improved by year. Stepwise multiple regression analysis demonstrated that 22.3% of the variance in gain of ethics knowledge was accounted for by four factors including "classmate's comments", "considered instructor as a model", "feeling of involvement in group interaction", and "concerned about instructor's viewpoints" And 29.4% of the variance in gain of ethical reasoning ability was explained by the first three of four aforementioned factors and another three factors including "learned how to collect information", "face-to-face" clarification of problems", and "express personal viewpoints". In conclusion, the two–consecutive-year study consistently demonstrated that students were satisfied with the teaching method and course content. The degree of teaching effectiveness was noted to have progressed by year as a result of improvement in group interaction and group climate. The present study provides valuable information and empirical data about teaching outcome and associated effective group learning factors in medical ethics education using a small-group tutorial method.