医療プロフェッショナリズム概念の検討および評価尺度の開発 ... · 2019....
TRANSCRIPT
Instructions for use
Title 医療プロフェッショナリズム概念の検討および評価尺度の開発とその教育実践への応用
Author(s) 山本, 武志
Citation 北海道大学. 博士(教育学) 甲第12820号
Issue Date 2017-06-30
DOI 10.14943/doctoral.k12820
Doc URL http://hdl.handle.net/2115/67105
Type theses (doctoral)
File Information Takeshi_Yamamoto.pdf
Hokkaido University Collection of Scholarly and Academic Papers : HUSCAP
����
�
�
3
3
6
9
10
13
13
13
14
24
28
37
37
38
39
44
58
68
IPE
76
IPE 76
IPE
77
IPE
82
88
3 88
� ozf S�29n?2?���G2�?�a{\ IPE��8� ������ 96
o�c �JC�d:�;p� ��������������������� 112
�I� ��������������������������������� 115
Z�� ��������������������������������� 128
3
�� ���� ��� �� �
2011 i
ii Inteprofessional education IPE:
CAIPE Centre for the Advancement
of Interprofessional Education IPE
1 Journal of Interprofessioal Care
Reeves IPE
2 IPE
IPE 1960
3 1980 4
1970 5
IPE
1990 6 IPE
GP
GP IPE
2004 GP
GP JAIPE Japan
Association for Interprofessional Education 7
JIPWEN Japan Interprofessional Working and Education
Network 8
i 3 IPE 2007
ii IPE
4
2000 IPE
IPE
IPE
IPE
IPE IPE
6
IPE
GP
GP IPE
IPE
9 GP
IPE
IPE IPE
2013 Cochrane 15
2
IPE
Buring 10 IPE
(1) (2)
(3) (4) (5)
(6) 6
Kent & Keating11 IPE (1) (2)
(3) (4) (5) (6) (7)
7 Sakai 12
(1) (2)
(3) (4) (5)
(6)
5
IPE IPE
× ×
N o
IPE
× IPE
RIPLS Readiness for Interprofessional Learning Scale
13 N N RIPLS
14 ×
IPE o Chiba Inter-
professional Competency Scale (CICS29) N 12,15iii CICS29 IPE
N
N
2014 IPE
× IPE 2 2013
1 2013
×
N IPE
N N IPE
N
IPE
N ―
× N
IPE × 21 1
16 IPE × N N N
×
” ± ” 17 N N IPE
Chandratilake18 ×
iii 15 ― 1 N N
6
19 IPE
��� �������� ����
(1) �������� ��������
Profession
Carr-Saunders & Wilson 20
(1) (2) (3)
(4) 4
21 Lieberman22
(1) (2)
(3) (4)
(5)
(6)
(7)
(8)
23 Hall24
(1) (2)
(3) (4) (5) 5
Lieberman22 Hall24
20,22 Lieberman22 Carr-Saunders Wilson
20
20,24
7
± 20,22,25
N
N
Full-profession
N Semi-profession
N
N
26 27
N
(2)
N
1990 1990
28 1994 ―
1993 Harvard
Medical Practice Study29
1990
o o
N De-professionalizasion
N
N ×
(3) i
× 1970
30 1990 ABIM American Board of
Internal Medicine × 31
×
× 32 1990 ×
N 33
8
N
N N 32 N
× N N
× N N
34
o 35
N ×
35 ×
o N
N N
N
× 31
×
N ×
×
3 ABIM, ACP-ASIM: American College
of Physician-American Society of Internal Medicine, EFIM: European Federation
of Internal Medicine N ×
× 36
3 N 10
× N
P-MEX Professionalism mini-evaluation exercise 37 Doctor-patient
relationship skills Reflective skills Time
management Interprofessional relationship skills
4 3 ×
N ×
9
i
× × N
× N
× o ― N ―
× ABIM 1995
N × Arnold 38 N
N N ABIM 1990 N
× ×
ABIM 1995 1995 ×
N 39 ABIM × Altruism
Accountability Excellence Duty Honor and
integrity Respect for others × 6
N
ABIM × Arnold N Duty
0.6 Arnold
N Arnold 1 N 6 N
Aramesh 40 ― N
Arnold Arnold N
― 41,42 ABIM 2002
N ×
N 1995 6 ×
P-MEX37 92 N FD (Faculty Development)
×
142 N Doctor-patient relationship skills
Reflective skills Time management
10
Interprofessional relationship skills 4 24
N P-MEX 43 44,45
N N FD N 4
ABIM 6 N × N
×
46-50
× 51 52 N
×
N Professionalism
behavior 33 53
2016 ×
× N
×
N 40,54,55
× N
×
× N N
ABIM ACP-ASIM EFIM
×
N
N N
× ABIM ACP-ASIM EFIM 3
11
N
× N N
× ×
N × N
× 56
― N ― ×
×
― N N
× × N
× N
1990 × N
× N
×
N N
× ×
― ×
× ×
IPE 2014 N 2014
N ×
N ×
×
×
― N ×
× N × PDCA
Plan-Do-Check-Act ±
12
_+�_>�G12K(;`4�3a_(�G��`4�3a_(�G$�0�BK7�`4�3a
_]W\b d :��6 _]W\c d �'
#9`IPEaG�?
#9�?G>�`4�3a
#9�?G
&=`"�_<-a
�.V^UMSQYT[RX(�G&=`4�3_4�3a
�,G�.V^UMSQYT[RX>���GD/`4�3a
��)�C8@!#9`IPEaV^OZXD/`4�3a
�b.%12G� *PDCAPLN\H%12G5��F AEJI
13
i
N ×
× N
× 1990 ×
×
×
i M
× N
× × N
N N
N
web Pubmed Google Scholar
±
× professionalism
(1) ± (2) ±
N
MSW N
× (1)
(2) o
(3) ×
× N
N N 3 N
×
× professionalism code of ethics
14
N ―
(4)
N
i
4
3 N 11 2 ―
× 1
(1) ABIM ACP-ASIM EFIM 2002 57 (2)Good medical
practice (GMC: General Medical Council) 2015 58 ”GMP
2015” (3)CanMEDS 2015 physician competency framework
(Royal College: The Royal College of Physicians and Surgeons of Canada, 2015)59
”CanMEDS 2015” (4)
2008 60(5) ×
× ± N WS , 2015 61
TF (6) International code of medical ethics
(WMA: World Medical Association) 2008 62 ― N (7)
× (Arnold & Stern, 2006)31 7 N
Miller 1988 63 (11)Wheel of professionalism
in nursing N ”Miller ”
× N N (8) Code of
ethics for nurses (ICN: International Council of Nurses), 2012 64
”ICN code 2012” (9)The ANA nursing code of ethics (ANA:
American Nurses Association, 2015) ”ANA code 2015” 65 (10)
2003 66 3 N
(12) Physical therapy core values (APTA:
American Physical Therapy Association) 2012 67 ”APTA values 2012”
(13) Code of members' professional values and behaviour (CSP:
Chartered society of physiotherapy) 2011 68 ”CSP code 2011” 2
N
ĻA
°�ŕčňûĝėĨLßćQXIhG���m~v���y�H?GŘőÓŖH\[^��|q�
�5�ûð
Ń÷
ßćîBßćĝė
ßćB
ÐĻĴ
Òć
ïThŎĐ
ļ¾
ľ¤^�ĝ
ė
>�����
���3+8/)'4��5'8*�5,��4:+84'2��
+*/)/4+EľØݨčň�
ijģ¼ÒÞĝCľØF
>������!��
���3+8/)'4��522+-+�5,��.=9/)/'94��3
+8/)'4�!5)/+:=�5,��4:+84'2��
+*/)/4+EľØݨ±©CľØF
>������
���;856+'4��+*+8':/54�5,��4:+84'2��+*/)/4+����
D�~�
ݨ±©C�#ď
�j¹b��o
ØL¦ņ�
�55*��
+*/)'2��8'):/)+
�+4+8'2��+*/)'2��5;4)/2
�>�
Ø�ç��©C Ø�
���Ŗ
���Ö
Ň
��ğê?xp�?��nD��x��45<2+*-+��91/229�'4*�6+8,583
'4)����
ďZë�!',+:=�'4*�7;'2/:=�
���t���sDv��?�D��Dv~�?}D��Dq
��533;4/)':/54��6'8:4+89./6�'4*�:+'3
<581����ü
ŏjĿèSh��'/4:'/4/4-�:8;9:�
�� Ĵ]ĄģPi?���Ĵ
?��Ĵ
?���Ĵ
]«Ĥ?ÌÝ_��Ĵ
«ĤķLō
IgiXIh
�
�'4���!�� �
6.=9/)/'4�)53
6+:+4)=�,8'3
+<581
".+� 5='2��522+-+�5,��.=9/)/'49�'4*�!;8-+549�5,��'4'*'>��o
�|čň�Á©Co�|�
� �ʼn
²��Ö
Ň
��ŘőĥìĎjĢRX?´îBčňûBí©a^t�~����jĶ
»Sh�
��čňûïĭ^éνĄa^à¦jĢRX?´îBčňûBí©a^
t�~����jĶ»Sh�
��éĀ^ÇÑeèĔ§ĵ\ìĎa^t�~����jĶ»Sh
���Ĵ]�'4�
��!��D��DqLßć
Pi?�� Ĵ
?� Ĵ
]«ģPiXIh
��ã^ûÃŘő
äā%«
Ĥķ&
ıŁ�ã©
��� Ŗ
���Ö
Ň
A�ã^ºŁĥĊł
A´î]ĘShĊł
�A�ãĒÏ·^Ċł
�A�ã�®^¸ÄîZ^¸Ä
Aí©]ĘShĊł
� Ĵ]�ã^Řőjģc?���Ĵ
]�
^ŘőÓŖjßć@���Ĵ
]ŁûÃŘőä
āLĄģPi?���Ĵ
]«ĤķL³ÔPi
h
���m~v�
��y�^Ûó
ĪĜŇĺ�
ıŁ�±Â�±©EG���m~v���y�Â�^t�z�ux
jÅćQfJH$!{
xq�nDxF
� �Ŗ
���
�l
�
�í©]KNh�ã�
��í©ĥáńa^ÕÊ
��å¢jñNhâąZå¢Shâą
����ãZQX^üŏ]ĞShĮįĆ
�đúe}D�?ĘøÄ]KNh�ã�
���ĖŌ\¥Ğ¶^ñŋZĆÙa^Ę£
� �đúe}D�^�D{ŚD��
n��DZQX^ʼn²
���Ă·ĆZ´îĠý^æĦ
��ÍĂZQX^�ã
���Ě¡Ć^ġÀZĉ¯±ô
���éεőZp��kÅć
��Ĵ]ÚPiTG���m~v���
y�Â�^t�z�uxjÅćQfJHZ
ęSh�Dqv�~�^G�ã^t���
�vDZQX^���m~v���y�H
^z~v��YĶĻPiT°r�D�^�
�|q�?Kf`?ıŁ�±Â�±©^õ
Ć�ãp��kÂ�Éī��©]fh
Gp��kÆĔ^Tc^±ôŇĺH^İŋ
jĩ×QXòĈQTd^
EVWMF
�ºĹ�Ë
ē
ºĹ��'�ÿ
ŕù^řöĵŗ
��������(�t���sDv��Bxp�
��������)�ŘőĥőªKf`ŀĥőª
Ëē��Ě
¡Ć
����������D��y�
���������ċŅĊIJ
���������Őĕï¿
����_���Ĵ
]��wmq�B��
�m~v���y�jœUùO?�� Ĵ
]���m~v���y�^ÒćŎĐjÐĻ
QXIh
��4:+84':/54'2�)5*+�5,�3
+*/)'2�+:./)9
$582*��
+*/)'2��995)/':/54>�ă
¬�ã©F
����Ŗ
�^
¿ł
��ã^�ĸĥ\¿ł
�´î]ĘSh�ã^¿ł
��ĬŔ�ã]ĘSh¿ł
���Ĵ]ÜěPi?�ħ
^òĈL\PiX
IhEÛóòĈ_���Ĵ
�
�ã
�+*/)'2�
685,+99/54'2/93�/4�
:.+�4+<�3/22+44/;3
��'�6.=9/)/'4�).'8:+8Eþ���k�]K
Nh�^���m~
v���y�C�ã
ÈøF
���V
^Ëē
�^Ċł
��´î^ĽŐŊČ^Ëē
��8/4)/62+�5,�68/3')=�6':/+4:�<+2,'8+�
��´î^éŒĆ]¸ShËē��8/4)/62+�5,�6':/+4:�';:5453
=����í
©Ĉ¿�Ð
ĈĆ^Ëē��8/4)/62+�5,�95)/'2�0;9:/)+�
����m~v�
��y�^ģ¿
!:+84�����"���8452*�������
ē5
��ĭëĤÛû÷ćC¿åGO?]=v~ucmi{q}kx>3=İĬ¶Į>SRUv~ldo;MND<
�
�%"������/,-&)$��*!"�*#��.%& -�ę
»�±Ã �
İĬ¶Į�
������(",& �)��/,-"-��--* &�.&*)
��ę»�±Ã ��
�
�Į��¹
ĢQJUċĦ_
êġI]ėÖ
Pµå
�Ä?Z\Z§�YLKf`_·@
��ͯáWUgwmoy�o
���ÍUª´3�î3«ī_âàG3ħ±G3Ï]
����±ËìWUèčQêġèč
�ÇßQõÍWU�Ġ;ª´Q�îUâà3ďįU�Æ3¯áĄ6ëĤ
ÛĄåÿ_óE]<
���îPÊUº?f`UĂ�UKXU3İĬĄSÛ×�¡ZÚ£_¿
\3�Æ3�íI]4
��Ëì3¢�3�Ĭ3ýÈ�ĐWU¸¬_ĀHO3ëĤÛUàěT�ĥ
I]4
��gwzrna3»�3»½ĄSª´r9k_ğKIKXTõUëĤÛ
Q ĈI]
���±U�ü_ġ[BTG3Ì�æÀ_¦¿]4
� �ĎT¼Ĩ3¤ĎPV��Ď
�ăđC
Ĩ?[^O?KC� Ď
TÞ�²ēF^K
��±ÍUİĬ¶
ĮČĞ�± �
��� U
Ùė
QJU�ê
����ÍU«īUôÒ3�ÍQUÜĪ�¥3ĘćSf`Ă�3¯áØĜ
U̱3SR
���Ă�F^K�±WUèč3©ó�Ñ3·ĉ�ÔUéā3ýÈ:�
ÓUïñQ�Đ3öÛÐQU Ĉ
���ÇßUª´UĚÆ:ðà3ĕ·U�Æ
�� ��¡ģùWU�ĥ3�±ÛUÌ�¸¬QJ^_ĢÅIÌ�ãĆW
U�ĥ
���ĎT�±ÃUİĬ�āCãāF^3
���ĎT�±ÍUİĬ¶ĮQGO�ā6�
ùGKYU
��(
*!"'�#*,�+,*#"--&*)�'&-(
�&''",��������ę
»�
���M
UÒĩSÉ
Q�M
UIJ
É7�ø
�ćTAE]¢�����
±U��Ąsmde|b�p
IJ7�İ
Ĭ¶ĮUÕÏ��Ĭ
ıU�Đ6ÁĨQĔ�
�ĎTČĞ°đ�ą
þ����C
¿åF^
O?]
�,*#"--&*)�'&-(
���%1-& �'�.%",�+1� *,"�0�'/"-
��������(",& �)��%1-& �'��%",�+1��--* &�.&*)��ę
»�
��M
U�ü÷¨
Q��Å
Ē
�êġèč3�ī
õÎ�3��Ä
?Z\�f
`}�e3��ú
�ä3 �ç
ËF3��ë
ĤÛQGOUèĠ3��Ì
�Ąèč
���ĎT²ē3�Ď
T�ăF^O?]
�
�*!"�*#��,*#"--&*)�'���'/"-��)!��"%�0&*/,
������%�,.","!��* &".1�*#��%1-&*.%",�+1;�»<
��M
UòQ
��¹Ģ
�·�WUèč
�İĬĄÝ]Ė?
��³�ĄSh9tjUĂ�
��ú�äU�Ċ
� �ĎT¼ĨF^3�Ď
�ăđC®¾
ÁĨF^O?]
Ĭ�
ĭĝÂ
�
�±Ã
�%"����� *!"�*#�".%& -�#*,�)/,-"-2��
±ÃUİĬ
¶Į<
������).",)�.&*)�'��*/) &'�*#��/,-"-2;»½�±Ã �<
���
ĞĮ�
·ĉ�Ô
��±ÃQá8
��±ÃQËì
���±ÃQ�±ëĤÛ
���±ÃQ ĈÍ
17
N 2008 ”ASHP statement on
professionalism”69 10 N N
× N 1973
3 10 70
1997 N N ―
N
N N 13
× 13
N
N ”GMP 2015”
No.14 ”You must recognise and work within the limits of your competence
N ”
”CanMEDS
2015” ”(Physicians are able to) Identify opportunities for learning and
improvement by regularly reflecting on and assessing their performance using various
internal and external data sources”
N
N N 3
KJ 71 N
N
N
N
― N
N N
N N N
18
× N
N
N 3
4
13
N
N 90 21 7 3
× N 2
13 3
N × o
o o
o
3
―
×
N ”
”
N N
N
”CSP code 2011”
± N
N N
N N
± N N
Ŋ���]kOES/Ŀŝ�6īò %wŬ]k\?QJfUhLb�ł
�'(��Ęý/ä�Ė nė�ĺ.ðÞ"8
Ęý�©/ċň
F</%2/Ęý�©/ċň ä/Í�áŬ�F</%2/þù�©/ċňő�/§Ŝ/ćĄ
nė-wŬ/ij¦+$/ćĄB�]m*nė-ő�;ćĄ ôű"8�Ęýő��nė�©;ċň �Ý"8
ÄĄ/ªy4cmN�;|�ì�8Ļþë�/Įċ;Ì� ĬûĤ;�ų"8Ġ/â�Ļ�þë/áŬ�F<;�Ł ʼnŠ.�!)Úļ"8
ÜĒ�/�ç/|�µ�4uě;�å. nė.åÜ"8Ġþë.58F<�áŬ/Ċ�;Ĵ�.ŋ� ʼnŠ.�!)Úļ"8
âþë¨Ĺ
Ļþë/KDi �Ĩ� Ńů.³r;ŏ�ʼnŠ.�!)Ġ/Ļþë.ŲŢ�ŖÎ�Ěħ;Ì�Ļū.I_�S <TW>K;"8
þë�/Įċ;Ì� ĬûĤ;�ų"8Ġþë/Ĕřĉ4Ńů;»Ď38�+�*�8Ġþë.¬ŗ;|�µ��qü"8ŅĦ;Ì��å.åÜ"8
P�b/z{+ )h�O�JQ]�ďŀ;+8ġþë*§Ŝ"1��çúŖ/Ŀŝ+ņp/ŅĦ�*�8Ġ/wŬç�ʼnŠ-+�.ŲŢ�'�û«;vß"8
�ç/�ú;Ť� ) Ù�47/�8Ìĺ;+8�ç/Áąľĉ�ĉœ�æ�´ÒĴûĤ-,�.+6:9#.�ç+�:7;ß'
Ĕřþ+/Ų²�¨Ĺ
ġþë¨Ĺ
Ġþë+/¨Ĺ.Ö�"8t-8�Ĩ�4ÿł;ß&%ą+¨Ĺ"8
�ç+/ĵĐ-¥ť��¯;ŕ'
zą�+ )/�ç;Ť� �:8
�ç�/ÁąĴő�ĴÐt��Ĩ�;ğñ"8�ç/¹ţ ą�/¹ţ;ğñ"8�ç/Ōo ğ¾;ê8�îKN>i ¿Å ŁĩŃů-,/ÁąÐ;ËŪ %Ģ��*�8
�ç�â¶IJ*�85�.Û�"8�ç/âŦĉ;ğñ"8ĩã/�Ľ <TY<gmK�GmG�OmK�;Û�"8
�ç/�ģ;į�8I�ZK;ij¦"8�ç�Ġ/wØ4wŬĔřþ/r»;Œ��+;ğñ"8Æ7��&%+�.0čå.èÓ"8
�ç/ţ~ �ç/rÈ;ğñ %áŬ�F<;ij¦"8�ç+/ÿš�¯4X�SU�JQ];�Ũ %ø*áŬ�F<;ij¦"8�ç.:�74"� Č�-úŖij¦4ēŘ;Ì�
âŦĉ/ń� Ĕřþ+ )âŦ %�î �ĺ;Ì�âŦ�3%6"ďŀ;|�ì�8
�ç�âþë�ġþë+/ĚÃÔŞ
�çĪĀ/F</ij¦
�çĪĀé
�ç/��������ÉŎ�¸Ê-ûĤ�;Ñĥ.Í28�+.áŬ�F</öķ;ĸ)8
�ç.+&)ʼnŠ-+�.ŲŢ�'�û«;vß"8
�ç/âŦĉ;Í28 Û�"8Ĺ���
Mi\F<;��@mXl�"8
áŬ�F<.�"8ÑĂ/úŖ;íï Űõ.ĵŞ"8nė-wŬ;ij¦"8áŬ�F</·�/ō�åĉ;Ť� )�8
Í�KDi+ĩã.�(�ĔřþĴåĕ
Í�KDi+ĩã.�(�åĕ
Í�j^i/KDi+w�ĩã;ŕß $9;ń�"8��ĴÏ£.�(�%rÙ¶IJ åĕ;Ì�Çŧ/ŭ� Ç�Ĵ-F<;ij¦"8��/ńĶ Ă �ĩã/ęĜ/%2.º¢�ĺ;Ì�
Ŀ÷�÷ÕĴåĕâă/¿ĺ4Ìs.'�)/[<jZe�4\=�TWQE;¡28X\A�`mK;ā7Ŕ8âŐ/ĩã4Ńů�ś�/À��ōĝ;Č �Łã )�8
µĞ�î�Ddh<�ńĔřþ+ )µĞĴ.�î"8�+/ʼnŠĉ;Łã )�8Ĕřþ+ )Ċİ;Ğ�8�+;ı�¡28Ddh<]gm;ÔĊ åÌ"8
âÂ�Ť âă/¸ÊûĤ.ũr vß�Èø;Ć8à�.Č�*�8
GaeVF�Jfm�ó Ç�Ĵ-GaeVF�Jfm;Ì�°ĭ/×Ĉ
Ōĉ/�8Ìĺ ĩã;ŕ'};'�-� ÿš*�8ą*�8�+ĩĴ¼¤�;ŕ'
ŐŚ Ůx CRHh G�T
wŬĔřþ/�Ň+-8ą�±Ċ+ĩã�KDi
wŬĔřþ/�Ň+-8ą�±Ċ+æ�ĴKDi
Ōĉ�čå��Ù�47
ĵĐ-đ®4¿ş½�
ß��aGP>7B%Õð�,ˤ��VøGPF6?:MCO<J`Ù���
té�f_$��.»ì«!��%·é
e��,àÒ#å¡+�þ1*,0#�®ømĀ$Îb#Õð1m��b�$äÃ1� �õÎ#Vø�|%óñ��ã#Úâ1T����¼1�
~°©å%ϸ#óñ!ä� e�%©å�GN5E:�$g0.©å1h(�1�Þ�.Å«� pí�'�e�©å%Õð!ÝS%ÜÉ� �.
Vø»ì«!��%�\η×1[��
��%óY%�)$Vø»ì«%ÊR+ö¨1óñ�#�e�+�\!%¬ò%§$«s�²-ö���.�!1��Ö/.
ç+ûô�ù1ô]���\η×1¾ �.
ç+ûô�ù1�.
�/�/%»ì«$Ïñ�/.ç�lÁ1�.ûôÎ$ϸ!}�.T�xÌ1� ®ømĀ+{nA�=%^�2��%Äà´#¥ý%�²1�0#�ü¦{n1� ¨��e�&%ºê+ÔT#"�£â#ûôÎ#Ú÷1�
��Î#y�ëÇ&%iï�Îjg&%qú
H;�KA43%óñ!©åÍo%�-æ
H;�KA43&%¶���´#ÆZH;�KA43+��&%´b#©åÍo
�\%D�<1Ø���/$Z�.·×1��äy�Vø�á�±Ñ$���ô]���.
y�³�&%iï
äy�Vø�á�%�\³�%v²$iï�.³�ÎdÓ$iï�.
� !�«�%¬ògu1r).dÓ1� »ì«¿ª&%KQE�:?G1U��.
ÊW%äyVøá�dÓ$Æ�.ô]!�z
ÊWVø�äy�á�%dÓ$iï�.ÊWVø�äy�á�%»ì«��¹!%ÿw1).� Xµ�îèVc%À¯
�\η×1[��
9ILD@4�»ì«¢È��\&%�z
�«�%»ì«¢È&%kÂ��z
»ì«¢È%�ø�83%��§�^½$iï�.»ì«¢È!��%ÛÐ$iï�.
�~
_k
TN
W=
à½
4G
8P
'X
=@
Ýw
��
�$r
¯�
Á����
�������
�����r
¯@
�
ċă
±Ê
�r�
�t
�z
���
����!� �
����� ����
���ìû
�¢
�z
��������
��������������
èÓ
>Ô
�C
�Ā
�,
&&
**
ôÎ
@+
F¦
ê#
߶
Hø
9*
&&
**
**
vH
9.
>,
#Æ
Ă<
0F
Ë<
+F
3=
**
&*
&*
**
**
&&
ßç
��
4H
ø9
**
**
&&
µÉ
@�
¥Ä
Þ?
Ćo
5#
q²
%¤
ÂH
ÌF
**
**
&*
*
³�
?Ð
�<
+F
&&
£y
ç>
Pb
eY
O'
Rf
lH
¦-
&&
&*
*&
&
�â
@®
Í&
&*
Õü
Å=
5;
�Û
ç?
�»
6F
3=
@ò
āÎ
Hî
¶5
;,
F&
**
&*
&&
&&
Õü
Å=
5;
Ïã
HÛ
2F
3=
Hä
,�
AF
**
**
*
Md
hI
_g
lH
«Ï
5·
¦6
F*
&&
&
µÉ
@¦
pC
OI
?9
,;
@]
Ij
\e
'C
^J
'X
ZU
NH
�A
F&
&*
**
[^
K'
al
SH
ÇE
÷F
**
&&
**
**
*
µö
@ß
¶C
ïĊ
%þ
�@
|
%õ
ÚH
Ð5
1î
¶5
;,
F*
**
&*
**
*
§,
j`
i@
SM
i=
r�
߶
Hø
²5
#7
GH
ð�
6F
&*
&&
&*
**
*&
&&
x�
ç¨
�?
�:
,8
o°
�å
#·
ÖH
¦-
&&
**
&*
&*
**
&&
£ą
@Ĉ
,#
£y
ç>
OI
Hæ
�6
F*
**
**
*&
&
x�
@ð
é#
È5
,ß
¶@
ØÙ
@8
A?
��
�ê
H¦
-&
&*
&&
*&
&*
*&
**
´ć
�OI
?�
6F
©È
@Ã
ùH
º¼
5#
Č¿
?è
ÿ6
F&
**
&*
**
**
**
m×
>r
ćH
æ�
6F
**
**
**
**
*
´ć
�OI
@�
y@
õ�
·Î
Hă
{5
;,
F*
**
*&
&
Õü
Å=
5;
µĄ
58
�»
#�
êH
¦-
**
**
**
µĄ
/B
8D
6Ò
íH
u0
¹2
F*
*
(9
:1
)
ă�
ćú
rć
Õü
Å@
�ñ
=>
FË
��
Ï=
߶
%S
Mi
rć
Õü
Å@
�ñ
=>
FË
��
Ï=
¸z
çS
Mi
ôÎ
%Ĉ
¶%
Ñ·
4
µ¡
�ă
Pb
eY
O'
Rf
l�
¾&
�Û
�»
%M
dh
I}
ð&
ëÀ
%À

·Ö
öý
ĉs
LV
Qh
P'
Xr
¯�
¢¯
§,
SM
i=
߶
?�
:1
Õü
Åç
·Ö
§,
SM
i=
߶
?�
:1
Õü
Åç
·Ö
µĄ
Î@
ð�
á�*
�P'
X?
�č
6F
�9n
Â@
SV
'W
cl
W/
ܪ
6F
""
*�P
'X
?�
č6
F�9
@S
V'
Wc
lW
/Ü
ª6
F
ij���
u|i`mIĘê=WCb-nIMď�¥±.EF7/
�*�Ó¸í
����
���$����
���ÓMô¯
ŔŋÕø
������
� ��
��
���& %$�����
��������Ī
Ŀ¡Ã
«�
����"## %
������������
�áM' ##�� "$!.
ÅĶ+·ÆKñđ/YÌĒLÉ
PV<ILÛő�a
ZMìġYĢGV
00
00
00
00
00
�áMŊ�)�áM�ÄYČé>CÛő+aZY
Ğ©@V
00
,0
00
,0
,0
00
�áIMõň¥±Rq-mo-ekuY�Ŏ>C
îHÛő�a
ZYĞ©@V
00
00
00
0,
00
�áLX5UR@2)þ�KðĽĞ©RĄŁYÈ
3,
00
00
0,
,0
00
�áLIDGIJŇKI7LŖʼn6E9ñ®Y�Ú
@V
0
�áM¦ĐYĜ4Vd-sfYĞ©@V
0
�á6čM�ÓR�őąłôM�ºYĺ9<IY
Čé@V
00
0
ÂU61DCI7LNÿßLâÏ@V
00
,
g{taZYÖ�+\~q}-@V
,0
00
0
�á6ܾ¶ĝH7VS3LÖ�@V
,,
0,
0,
00
,,
�áMÜōûYČé@V
,0
00
00
0
ĖÝM�ħ)ZnrZy~f.b~b-i~f/
YÖ�@V
0
�áIMĠĂK¨Ō+¥±YļE
00
�á¤M½ùğĹ�ğË���
ĕ£YČé@V
00
0,
00
00
0,
,
�áM¹Ŋ)ù¤M¹ŊYČé@V
00
00
0,
,,
�áMĵ�)Č»YäV
00
00
0,
0,
0,
,
�çfh[{)¼Á)ĬĖĮœKJM½ùËYÇ
ŏ>Cď�6H7V
00
0,
,,
0,
,
�áM�ðYŋ�>G)Ô2RUM1VÈĤYI
V0
,0
,,
,,
�áM½ùĨû�û
Ļ+à�´ÍğñđKJ/LI
TXWAL�áI¥XUYÚE
00
0,
00
00
0,
,
čôåIM«ģLÑ�@V
00
0,
00
00
00
0
�KV�ĕ£RõĭYÚDCùI«ģ@V
,0
00
j-wM��I>Gz-i-eku�ā
īYIV
,0
,,
00
0
ĎôåHªń@O7�áðĽMĩŅIİ�Mįē
6H7V
00
,0
00
00
čM�őá6IJŇKI7LŖʼn6E9ñ®Y�Ú
@V
0
ôå¤MěýYÈ2)°ĚñđY¢ŗ@V
00
,0
čôåMąłûRĮœYºĀQV<I6H7V
,,
0,
0
čôåL¯ŀY�7µ:+�ò@VįēYÈ2�
ßLß×@V
00
0,
,,
×ă¤M�áM�7µ8R�ĊY�ßL)�ćL
ß×@V
,0
čôåLSVaZ�Û
őMü�Yğ�LĴ�>)IJ
ŇL�?GÕĦ@V
,,
,,
ĥôåMf_{)�ĕ£)ĮœL³�Yķ3
,0
00
00
00
00
0
IJŇL�?GčMĥôåLŖʼn�Ľ
Ê�ĉ
ĔYÈ3
,0
00
00
ĥŐLdv-m)Znp[fY@V
00
00
À÷M�Rx~h-Y�7æ;V
00
,0
00
ĥôå¤MěýYÈ2)°ĚñđY¢ŗ@V
0,
čMÜ.ĥ/ôåMÛő�a
ZY�Ĭ>)IJŇL�
?GÕĦ@V
,0
,,
,,
,,
ÞMÉ2Ûő�a
ZMCPMôï�¬Mýı
00
0,
0
Ĺ�MªńMú÷
00
,0
]-u~H�ćKĹ�Yú÷>ëŕ@V.ĈóĹ
�/
00
00
�ć�¬Yýı> Ø@V
00
00
0
ĈóMÞ�Ć)�ć�ĤLèÙ@V
00
00
00
0
.EF9/
¡ÃÓ
ŋ�őľÒ
�á+Üôå+Ď
ôåIMĉ¿Ðņ
�áėöã§
�áėöã§
�áMÜōûYÉ
PV)Ö�@Vģ
75;
�ù¤I>GM�
áYŋ�>)¥X
V
ąłôIMŖ²+
«ģ
Ďôå«ģ
Üôå«ģ
ĸŃ
Œ�
^lcz
b-n
�Ó
Ĉó�¬Mýı
aZMCPMĈó
�¬Mýı
�ćK�őMĞ©
IBMú÷
ę�0
�b-nL¥Ŗ@VE
�îMfl-mx~m6ċÎ@V
((0�b
-nL¥Ŗ@V�E
Mfl-mx~m6ċÎ@V
ċ���
ip
aY
eC
öÍ
7Q
=[
)f
CG
ñ|
��
*?
@4
+
�&w
¶�
����
����!�
����w
¶G
Õ�
Ĩġ
¸Ú
��w�
�y
��
����
� ��#�"!
����������
���ĂĔ
�¥
��
����� �"
�������������
æĘ
ÕË
óG
¾ĥ
�ZU
GÁ
¨Ñ
��è
F�
Ĝ:
P,
(,
,,
æĘ
ÕË
óC
9A
Gć
üF
�Ĝ
:P
,(
(,
,,
((
¦É
C¿
ÕÇ
GÖ
ğ�
�S
�K
P�
ÿS
¬/
(,
((
(
æĘ
Õê
ÔH
Gl
qh
)]
bi
Sv
¼:
P,
(,
((
õx
wĥ
�čº
G�
ÿF
�Ĝ
:P
((
õx
wĥ
čº
Gæ
ĘÕ
�¹ä
CG
Ĭ�
S×
KP
,(
¦É
zà
�ěē
w�
Gë
Ù(
,(
,,
,,
,,
�
Gg
)_
Są
À9
;Q
F|
0P
âĄ
S¼
?,
,(
((
,,
,,
,
wĥ
�~¥
�čº
Üý
F?
.A
ġ�
9A
.P
,(
(,
,(
(
�
�wĥ
�čº
GÃ
�Þ
´G
�Ý
F�
Ĝ:
P,
,(
((
Þ¾
ú�
ÿF
�Ĝ
:P
((
°±
úE
�ª
ėò
HG
�Ĝ
(,
((
(
¦ú
��
HG
�ħ
((
j^
'l
dV
UH
Gá
Â'
¦ß
Eñ
|(
,
j^
'l
dV
UM
©¯
HG
�
EÓ
đù
�(
(
;Q
<Q
Gæ
ĘÕ
Fû
Ğ7
QP
Ē%
�ì
SÆ
P,
,,
,(
,(
,,
Ĩġ
úF
ûã
C¢
0P
u·
�ø
S¬
/,
(,
(,
,(
Øĥ
�ĭ
M
�d
)`
G�
8T
%;
Gï
Čß
EÎ
ĪG
³Ý
S¬
RE
.,
((
,(
ĩÏ
�
S¬
/Ò
®%
�Ä
HG
åĖ
MĀ
uE
D%
ÌĎ
EĨ
ġú
EĆ
ĤS
¬/
,,
,
�Ä
GÓ
đ�i
nW
h]
)F
�R
PÓ
đS
�J
�SÆ
Ċ:
P(
,(
,,
((
((
ðÕ
ÇB
�Ě
:I
4�
ÄÓ
đG
āĝ
Cĉ
tG
Ĉô
3B
4P
((
(
¿¤
GĠ
{G
=K
Fw
ĥæ
ĘÕ
Gõ
sM
ģÒ
SĠ
Ğ9
E.
(,
(,
,(
((
�Ä
MÃ
�C
GÖ
ğG
ÑF
Õ�
3Ý
Oģ
>A
.P
6C
SÈ
5ă
QP
,,
,,
�Ä
2N
Čþ
Eđ
ÊM
Åī
SL
NR
E.
(,
Øĥ
�ĭ
Fú
�E
āĝ
S�
9%
�Â
FĐ
îS
¬/
(,
((
,,
,
§Ģ
úE
wĥ
»¡
GĠ
Ğ%
¦ď
EĆ
ĎS
uÀ
9=
Âç
S¬
/(
((
,,
,
�ĕ
½�
�F
15
Pæ
ĘÕ
C9
AG
âĕ
,(
((
�¥
¶ġ
�ĥ
Ēµ
Ďę
Ħx
Xc
\o
[)
fw
¶
$$
,�[
)f
F�
Ĭ:
P�?
G^
c)
el
qe
3î
²:
P
ĒM
Ĩġ
«Ħ
Sġ
�9
%Ã
�ú
âĄ
Sé
/:
P
ĒM
Ĩġ
«Ħ
SÆ
P
£Û
Óđ
Gû
ãE
ĠĞ
CĐ
¥
wĥ
æĘ
ÕC
9A
GÃ
�ú
âĄ
S}
=:
÷�,
�[)
fF
�Ĭ
:P
�?r
ÑG
^c
)e
lq
e3
î²
:P
�
úâ
ĄS
}=
:
[k
mg
cV
%æ
ĘÕ
Ëó
%Ã
�H
G
�
¿Õ
ÇG
æĘ
ÕË
óH
G�
í'
�
(
õx
GĐ
�w
ĥč
º�
ÿF
ñ:
Pġ
�C
�
�ª
Þ´
HG
�Ĝ
j^
ld
VU
GĠ
ĞC
Óđ
ù�
G-
24
%�& �! �������� ����"�(
13
1990
5 GMC ” Good
Medical Practice” ”Good Medical Practice” 1995
1998 2001 2006 2013 5
”CanMEDS” ”CanMEDS” 1996
2005 2015 3
3 2002 ” ”
ABIM 1990
”ABIM1995”
1995
7 ”ANA code” 2001 2015
7
1990
(1) �!�)'��#��������$�"���
”ABIM1995” 1980 integrity respect
compassion humanistic qualities
1
25
1995
(2) M
2 9 ”CanMEDS 1996”
Evidence N
Evidence-based medicine EBM 2002
”ICN code 2012” Evidence-
based practice EBP 1995 ”ABIM1995”
× N Excellence
”GMP2006”
EBM EBP N ”ANA
code 2015” ” ICN code 2012” ”CSP code 2011” ”APTA values” 2012 2003
N N ”ANA code 2001” ”Miller
”
EBM 1991 Guyatt72 editorial
N 1995 73 1997
Evidence-based nursing EBM
EBP × ”CanMEDS 1996” EBM
EBM EBP N 2000
×
1 N
Professional autonomy N
N 74
”ANA
code 2015” N N
26
”CSP code 2011”
× N
N
(3)
N N 3 19
” ” N N
”GMP 1995”
involved N 2000
o ”
” 1 N
× N
”ANA code 2015”
N ±
2000
N
(4)
2 16
1995 ”ABIM1995”
×
”GMP 1995” ×
× 2000
20
N N ”CanMEDS 2015” o
N N χ
”ICN code 2012”
27
Yamamoto 15 6
Team management skills
Attitudes that improve team cohesion 2
Interprofessional education
collaborative(IPEC)75
Teams and teamwork
”CanMEDS 2015” collaborator
Hand over
”GMP 2015” Continuity and coordination
(2008)
”GMP 2006” ”CanMEDS 2005”
76
(5) �������
2 ”CSP code 2011” 3
”ANA code 2015”
28
N ”CanMEDS
1996” ”GMP 2006”
2000 ”To err is human” 77 1
N o
21
(6) 2 2
4
2000 ”ANA
code 2015” N
78 ×
(7) 2 8 X
N
N 3
1990
20 N ×
(1) i
― × ―
× ( 2) ―
× N N
N
N ―
×
29
2 2
1990
20
20
�"�5-G�$DEJ����D'�#SO`
8<SO`D
%0F�C?�5-#�3
c.d
Q[]XVM;�5-6 ;'�HG1�
�I� *7K /A;'�#2�K=BJ
���%�+��)*-
�� �)��20/13�%���+�2�$4
��2���2��)+����3���"4
���!�.�('3�".#&(��,+ �4
�:9�&(F>@J�"ZaYNUR^W_T\��
)+!�G���5-DG4�b��
�,��GPL��
30
79
80 81-83,iv 84
85
1990
2000
iv
81
31
(2) �� ��������������� �������
�������
86
AIA American Institute of Architects ”2017 Code of
Ethics and Professional Conduct87” ” 88”
3 4
5
3 3
[
] 3
1
3
1
•BuťÝðťîWĦ
•ÛdÇ«
•ʼnŚŞŕňŦŌşŤ~â
•ÍÎRÖťņŝšŁĉ²
•(¹ť¹^³Wøĕ
•ēĜŎņŢݼðIJIĭģ
`ĈسWø
•Ûnuij²�
•ÛØÃij`ĈØčEĵijecĖó©
•GHij��6±Á¿ 3IJ_ĩļ«çİó©
•�h�Æĵij\�
•řŎŜŒłŁij.®İwJ��ijěĻ�
•�ĸ�«ÐĐĿSļ
•�wJijÿ,ı.®İ�ò
•6±`ĈØİħĮij¾�³ô�Ŀ�īĩ
•ňŁijīķijËÒ¬Lij�!
•T%ı6±ij��İĪij�üŨ
•v×�qijňŁ
•v×ijÛnuĿēķļĚ
��ĩļ"ĢĠĤ
•�ĊİħĮijv×Ŀ
«çħĚċľļ
•OØÃ9"
•ÛØÃ9"
6±`ĈØijIµİıļ
�myݾ�³ŎņŢ
`ĈسWøÚ1
ʼnŚŞŕőłĚ`ĈØčEĚ¾�ĵijó©
�ĸ�«ÐĐĿ«çħĚ
¾�³ô�Ŀ%ĝĩļ
v×�q�Õ
ËÒ¬Lij�!
`ĈØİijû�ť9"
Fėũ6±`ĈØijŘţŗńŐŌşŔšŏśijåÊ
6±`ĈØijIµİıļ
�myݼðťŎņŢ
vםÛØÃťOØÃİij
¸�®
¾�³ô�Ŀ�īĩ
•TVħīØK¬Lij��
•>Ø×ij�Ù
•¾�Ġĺijë-Ė�®Ŀpļ
•�×ijó©IJ�xĿ|ĝ
•�×ijÞ�§Ŀ¥�į.®ħ
ıĜ
FĘũjÈZijŘţŗńŐŌşŔšŏśijåÊ
>#ĵijô4
ŧ�.ijaĄİ}íĕ
¬Lĵijô4
Ĕ�Î=ÚıŒŋŃŤİĉ²ĕ
•¼ðİŎņŢ
•8÷uĔ@�qĕ
•Û¦ť�5³āĿaĄĩļ
•�
•Ċija:ĖT%ĖfÁĿ�
@ħīŒŋŃŤ
•�%�ĵijó©
ŧ�ij+ąİijû�Ũ
%ܳıô4
ŧ¼ðijÏ�ťü�Ũ
•ŇŠŃŁŤœĵijP�
üŇŠŃŅŤœij>x¥ģŘţōńŇœ
ij¶³ĸ%[ĿN�ħıĜ
•.´¸;ĿĂĤĚĶīĚĉ½ĩļ
•ʼnŚŞŕňŦŌşŤIJğĜĮîWį�·
įěļĥİ
•ŇŠŃŅŤœIJÿ,IJwJĿ�ĞÎĤ
ļ
•Â7uĔ�đĿpļīķijwJijÂ7ĕ
ŇŠŃŁŤœĵij
ô4
•�·Ě&�Ħ
•a:ĚîW
`ĈØİħĮij
ô4ŧ�·ťîWĕ
¾�ĵijô4
ŧ�ijÉÀĿ<Ĥ$ĽĚ&'ij.´IJP�ĩļŨ
•�Î=Úı
ŒŋŃŤťĉ²ťWø
•�ĿSļ
üÞ���ĿSļ
ü&Ø×IJ�ÅıöĻ§ĸ�|ĜĿħıĜ
üê�á¤ĸ�×ij�.Ŀ�YħıĜ
üĒXĸĎ®�ġ&àijT%ĿYĩļá¤Ŀ�ÓħıĜŨ
•�zpםã£×ťÑt�ij¥�ŊŦŖŎIJo�ĩļ
•jÈIJ_ĩļ«çİë�Ŀpļīķij 3Ŀáĝ
•?ìĚ�®Ěi¢Ě
B�
•��Ěþ�ıá¤Ŀ
2ćħıĜ
•ºWĿaĄħĚîWĠĬ&�IJØ4Ŀáĝ
•ß ijČùĿĪĪijĠħĚß ijé�Ŀ�*ħıĜ
•ä-ij&�ğĹĴÿ�{ÎĢijWª
•ã°×ťãAij�.İ.´Ŀ�òĩļ
•úĸĠIJý¡ıģ��IJ»{ĩļ
•råı� ijï�Ŀáĝ
•<�ijÌ�Ŀ�éħıĜ
•Û¯¨ÄijÄKĿ��ĩļ
•�đ×ij�.Ě�lı.´ĿWªĩļ
•�đ×ijxsĿaĄĩļ
•ÿ,ıJăĿ�½ĩļ
•õ1ij�ħĜijīķij/gĿ�½ĩļ
•�đ×IJJAĖ9ñħıġĺ��Ŀ)«ĩļ
�myĚB�
`ĈسWøĔI�³�ij
�òݾ��ÕijWªĕ
U&ÔĠĺQDĦĽī�ďĿáĝ
�ĸ�0ĿĀSĩļ
�đ×İijċ�IJğĤļæn
�ijkòMݸIJ
?ìİ�ÕĿĄŀĨļ
FęũkòMijŘţŗńŐŌşŔšŏśijåÊ
�myݼðťŎņŢ
�đťÛØÃť�ØÃİijċ�
¾�³ô�Ŀ�īĩ
Ûnu
ŧÛ¯Ě¨ÄĚÛ�Ũ
ä-UĚ�^UÅİ
ÿ,ıċ�ĿÏ�ĩļ
ċûØCij�b
Ø4�¼ĻpīÂ]ij��
�wJij�ò
��èĆijÇ«
35
/
×
/
/
o
N N
± ±
±
(3) i
× N 89
2007
90 2015 91
−
× N
× × 1 N CLA Collegiate
Learning Assessment CLA CAE Council for Aid to
Education N CLA
PISA Programme for International Student Assessment OECD-AHELO
A ssessm en t o f H ighe r Educa t ion Lea rn ing O u tcom es
OECD-AHELO N
4
N
N PROG Progress Report on Generic Skills
92 PROG
2
36
93
3
PROG
2
OECD-AHELO
PROG 2
91 1
2
(early
exposure)
37
i P
×
―
N ×
N 6
N × N
× ×
N
2
N 25
×
N 3
.P&-%� �)$*�(3I�4G
�KN���Q/�����!�*������#�
��!(&�+7@���5M��CHA�
:E5M4G :E5M4G
=O?�BF?4<�&,!�"�5M���LD6�5M��
,'+�:E��5M�19�
,'+�:E��5M 19�
=O?�BF?4<�LD6��5M��
������ ������������
�������������
>��:E2J�&-��
C0�H;
C8;
38
N
N
N 94 ×
N Student Physician SP N
95 o 96 N
N N
―
× 1 N
× 2 N 2 ×
N ×
97-99
N ×
N 1
N 2 N
×
× N N × 2
90 N 1 1 N
N
(
) N
N N
3 N
N 7
5 2 ×
N 259 ×
N × 3-4 100
53 1
30 2 31 N 8
39
259
� � �'��% �����&�#�(�����
1
(1) ��
1) ������
2016 4 A 6 B
2) �"
A 8
679 A
35 B 110 A
8 IPE
B
IPE
3) !�$�
1 35
259 35 1
±
1 1
1
3 7
3 6 14 35
4 3
7 21 1
7
Ū��}ƔhugH\SparVlū�Ûſ�ht]U_�tis���Ûſ�
P�` K]Qr ƕ~ ŲƁ� ĕ³=ƐĒ3�$(ÉƈÅ�=ĿőCü@!0�/�@ ōĩ2Ī·=ÉƈÅ�� ůÓ�²ƊCĝ3, .�@� X�Snsm^FE3ŭĢ3¿ @ŒÖC#2�
� Ƅğ�>ėƌ"A�ƌ?3"A.�@�C,�2��ėƌ/�@ğ/�@!0
B�>2�!05B�>2�0Ä3É�@ łŌÄ"Cŵ,
ôŲ4ÁÔĕĿ3�,<¨Cţ+.�@ôĝ4ÁÔĕĿ3Ƒz#�|ð�ÒđCĠ@
�Ù«��Ă�÷Ă4�æñÞ35�6(;4ĉŨ��,</�.�@
� ôŲ4Ś�4UOTo�sC�÷3Šx#.�@ Ċľž4ğ0ļ*� .ƜC%@!0�/�@�� ıþ4ť�CÃ2�>�Ɯ%@!0�/�@�� ıþ4ƜCú>&3਱�ų�!0�/�@�� �Ɯ4ıþ3¯�Có#2�>ų�!0�/�@
�� îÆ=Ď]U_�2�.<Ś��Ă%@Ă���@ĮƀĖ0#.½ķŌ3�Ă%@!04ũƉĢCŝõ#.�@
�� �Ă¾�CƐ..'AC÷Ø%@!0�/�@� ôĝ4čƋIJ3: .�ß23C%8���B�@� ôĝ4ģňCij%�ř�4�ŕ3å�#.�@�� ē3Èĕ3ŹĴ#2�ÒđĘC<+.�@
�� ĺğ�>4êŋ=ū�CĀ ƆA@!0�/�@ôĝ4Éŕ=Ø{3,�.4fEteo�=gF�`c\MC¬;@
� ôĝ4Èâ4şƖ='4Ê�CĤ�3Ãħ<@!0�/�@�� öš4Ç�Cę?Ŵ?�'4Î3��%!0�/�@
��áĚ4}��}Ɣ3£%@łõC�Ěų=]te214m^FE�>śþ#.�@
òƔ�OE3£%@áĚ4ĔŶCāĄ#�Ƙď3ōƇ%@
Ü�ULs0łõ3¥-�ĮƀĖŌ÷į
Ü�ULs0łõ3¥-�÷į
�� WKw`JfbJw0��Éƈ4zźCĬŽ/�@�ù�ĺ4}è=}ƔĮƀĖ4zÃCų�!0CĹĆ%@
�ùŅĘû«
�� WsgOE=Iwdvmw_4�Ş3,�.ĬŽ/�@WsgOECë��Iwdv�%@
�ù4ôƏĢCÜ;@�ë�%@Ŕ��
�� ĺ��4�ĥ04𢣸C�9�Õń%@!0�/�@ĺĖÿ04°Ŕ3å�%@
� Ns�h3� @r�Z�S\h4ü?ŷ�B�@[�l4��0#.r�Z�S\h�ĨŜC0@
� ĺ��4�ĥ��D/�@Įƀłõ=ULs3£Ę��@ĺĖÿ4ĮƀĢ=şƖCÃħ<@!0�/�@
��ĺù4ûņ=�Ł¡3ţƒ#2�>�ôŲ4zÃCûņ%@!0�/�@
ŖĖÿ4ULs��Ł¡�şƖ3¼zCű�
�� ��ř4�ĥ0Í�3Č Ý�@£¸CÕń#.�@ŖƓ3Rj�_�E`cGUC%@
� ÎŢ74êŗ�²�3ħ´Ō3£B?(�0é�ÎĞ4²�=mwY�C��Ā @
��Ƅğ=�Ķ3ľ#.�ôŲ��D/�@ĮƀŲƁ3,�.¶ĽŌ3ĬŽ/�@
Ðă0ôĖÿ4ėƌ£¸C±;@�ŕCØ�
ôĖÿ4ĮƀĖĄŀ74§ĵ�ÚÂ
��Ŭ�ř4}Ɣ) /52��Ń~/Ŏ�"A.�@ŵÁ�ŕ=Űí�}Ɣ3,�.£Ę��@
Ń~}Ɣ�ŵÁ�Űí4�ŕ3¦ƅ%@
��}Ɣìī�Ŭ��ĜƔċ�y�4ŵÁ�Űíìī/Ŕ�.�@ĮƀĖ3,�.ł+.�@
Ń~}Ɣ�ŵÁ�Űí4ĮƀĖ�ìī04ƙ»Cě;@
�� ł?Ř(ĺğ4ŧŻCĭľ3ƚ>"2�ôė��@�ù4ĔŶ�hqGcS�3£B@ĔŶC¤:�Cýŧ%@
ËğĔŶ4ōĩ2ƍƇ0ŵÏ
��ćƋï3,�.�ƉŏC�"�. À3Ɖƃ#.ğ3Ő�@!0�/�@
ĜƔ©ƛ3Ō�2řƆC©#��÷3ŵĸCØ�
� čƋ�}Ɣąïù32@0��ô�C<+.�Ś�Øŕ#.�@µżñ¢�3� @ĮƀĖ0#.4Ĩż
�œ%@}ƔhugH\SparVl�Ş
�ù�ôĖÿ�ĻĖÿ04ıÍãƇ
ø�ŌĨŜC�(%
ÛſÛſ��
ŭĢ4�@Øŕ�ŝõCŵ,
ñ¢3Ĥ�/�@
Ñ�Ō2PkobO�SpwCØ�
¹Ň4çġ
LnrEhqwCãģ#÷Ø%@
ĮƀĖ0#.ģňCķ @!0Cʼn�¬;@
ôĖÿŔ
Ń~4ŵÁ}ƔŰí�ŕ3ľ%@Ǝ�0ÚÂ
}ƔĮƀĖ0#.4ø�ŌĨŜC�(%
Pkob]F�ĮƀĖĄŀ�ø�74ÚÂ
Ÿ=ƗƎ×ƕCƎ�#�ø�ŌĨŜCİ�%@
ôŲ4łõ=şƖ�Ƃ�4Ê��ŮĴCĤ#�ŝ
}ƔĮƀĖ4¥Ŧ02@ğ�ºģ0ø�ŌULs
�ùŅĘ4OE4Ŋ®
ĮƀĖ04ƙ»�°Ŕ
ĻĖÿ°Ŕ
}ƔĮƀĖù4¥Ŧ02@şƖ
ŭĢ�Ħ÷"�é�=?
ôÌ�Ǝ
PkobO�SpwªĈ
½ķ�Ă�LnrE�Ť
řĐ�ĐäŌ÷į
41
35
( ) ( ) ( )
( ) ( )
4) ����
35 ±
35 35
IT Item-Total
± ± ±
IT ± 0.3
± 1
35 0.3
1 0.3
0.3
KMO(Kaiser-Meyer-Olkin)101 Bartlett
0.8 p<0.05
/ Games-Howell
t Welch
IBM SPSS Statistics 22.0 p<0.05
42
5)
N
N N
N ―
― N N
N (1) N (2)
N ― (3) (4)―
N
PC ― ―
N ― 10 N
― ― ―
27-2-58 N
(2)
1) : P
A 98.4 668 679 A
97.1 34 35 B 91.8
101 110 A 9
64.2
A
66.3
5 6 35
IT
N
3
N 4.17 0.89
33
4.10 0.90
2
#3K��(�<�����+;86.1,IBF@?AGFCE/J
�� =@>DH ; *
� :��� /./ /0-4
9�!� /47 0/-.
9��� 61 /.-1
9��'� //2 /2-0
9� ���� 2/ 3-/
9� � �� 45 6-1
9����� 63 /.-4
9������ 21 3-2
9�%&�$��� 44 6-0
9�)���"�� 12 2-0
�� �� 1/6 17-4
�� 263 4.-2
§Õĸ%�ħıĦĎĜĕĭġĮĘĩ± É�û5qÇ®ĶħİĝėğĴİĨįĹķ
�
ÚÙÉ�
I3�
Üx��F
8�
ĴK#sÚÛ�Ä
Ð �|Ą�6úTìð¤¼àĄZLĊ*ćé÷åöæć ÓÎÑÑÜÏÎÕÓ ÏÎÓÐ
Ñ HJàhËĊ¹úôèõàć ÒÎÏÏÜÏÎ×Ò ÏÎÓÓ
Ò ĚĵĕīįĪĞčČú/Wúyèćb�Ċëùà ÓÎÐÖÜÏÎ×Ø Í ÏÎÑÒ
Ó (�äą�ÊêĈÝÊĆúêĈõàć ÒÎÑÓÜÏÎÖÑ ÏÎÔÔ
Ô ĉäąùàé÷üĉäąùà÷µ¥úâć ÒÎØØÜÏÎ×Õ ÏÎÒ×
Õ £�û�M�Zúàôă{Ċ¾óõàć ÒÎÔÓÜÐÎÏÒ ÏÎÒÕ
Ö ¶�Ĵ��Ĵ<�ûÂ:o�úü;ýðĂû��åàôăöæõàð ÒÎÕÑÜÏÎØÔ ÏÎÓÑ
× £�ûmÞûėĔĖĬĵįĊ�<úaeëõàć ÒÎÔÑÜÐÎÏÑ ÏÎÔÔ
Ø �@Èû�÷`ò¬èõ³Ċíćé÷åöæć ÒÎÑØÜÐÎÐÓ ÏÎÔÏ
ÐÏ �_û)TĊ©ùåą³íćé÷åöæć ÓÎÏÏÜÏÎ×Ð ÏÎÓØ
ÐÐ �_û³Ċ½ąîút{Oç�çé÷åöæć ÒÎÖØÜÏÎØÐ ÏÎÓÑ
ÐÑ ³û�_ú�YĊ�ëùåą�çé÷åöæć ÓÎÏÒÜÏÎÖÑ ÏÎÓÓ
ÐÒ ²ÌĄDĝėğåùçõămÞ;�íć�[åßć ÑÎÖÔÜÐÎÏ× ÏÎÓÔ
ÐÓ ;�®�Ċ�õõïĈĊ<¦íćé÷åöæć ÑÎÖÖÜÐÎÏ× ÏÎÔÒ
ÐÔ £¹ûBr�úāèõÝ�ùúĊíÿæäåĉäć ÒÎÓÔÜÐÎÏÏ ÏÎÔÒ
ÐÕ £¹û]ÀĊ�í;�7û}$ú'!ëõàć ÑÎÖÑÜÐÎÐÕ ÏÎÓÑ
ÐÖ Gú��ú~¸ëùà-�SĊăóõàć ÒÎÓÓÜÏÎØÒ ÏÎÓÖ
Ð× ��äąûcfĄ± Ċ+è>Ĉćé÷åöæć ÒÎ×ÕÜÏÎ×Ð ÏÎÓÑ
ÐØ £¹û�1û¢ ĄïûÅ�Ċz�ú©�ăćé÷åöæć ÒÎÒ×ÜÏÎØÐ ÏÎÓØ
ÑÏ 9gû&0ĊdĆ»ĆÝïûPú}äíé÷åöæć ÒÎÖÔÜÏÎÖÑ ÏÎÔÑ
ÑÐ piû%;Ĵ%�úÄíć�·ĊÝi�ĄĝİĤùøûĪĞčČäą�_ëõàć ÒÎÏÏÜÏÎØØ ÏÎÓÓ
ÑÑ ęđijĠĐĥĢĐij÷àá¤ûX.Ċ´nöæć ÒÎÔÒÜÐÎÑÖ ÏÎÒÓ
ÑÒ ęįĦĔČĄďijģIJĪijğûvUúôàõ´nöæć ÑÎÐÐÜÐÎÏÐ ÏÎÒØ
ÑÓ �;�û;�÷û�ÃÄ�ĊáĀçw�íćé÷åöæć ÒÎÐØÜÏÎØÑ ÏÎÔÓ
ÑÔ ēįĵħúãèćĮĵěĵĕĜħû*Ćjåĉäć ÑÎ×ÔÜÐÎÏÔ ÏÎÔÓ
ÑÕ �;�û;�å;ċöàćAÁ�·ĄėĒįúÄSåßć ÒÎÖÔÜÏÎØÔ ÏÎÒ×
ÑÖ ��û�NĄ �«ú¾\ëùåąÝ£�ûX©Ċ�Níćé÷åöæć ÒÎÓÕÜÏÎ×Õ ÏÎÔØ
Ñ× ;��û;�÷�àú"è,âćÄ�Ċw�ëõàć ÒÎÓÓÜÏÎØÓ ÏÎÔÒ
ÑØ PºþûcCĴh¡ú�u�úÄĉĆðà÷Vá ÒÎÒØÜÐÎÏÑ ÏÎÓÔ
ÒÏ (�Ą=lú@ëõÝ£�å;ċöàćAÁ�¿úôàõ���ú´nöæć ÒÎÒÏÜÏÎØÔ ÏÎÔÒ
ÒÐ�Æ�û%�ñèöüùçÝ24öEÂêĈõàć��}$Ą��Ĵ%�úôàõÄ
SåßćÒÎÔÓÜÏÎØÕ ÏÎÓÒ
ÒÑ%�k¯Ķ�ÆĴ°�^ķ7û��Ĵ��k¯ö�àõàćAÁ úôàõ�óõà
ćÒÎÏÕÜÏÎØ× ÏÎÓÖ
ÒÒ �ĆRð��û�?Ċ�@ú�ąêùà£�åßć ÓÎÐÐÜÏÎØÏ Í ÏÎÑÖ
ÒÓ �r�úôàõݨ�Ċãêâõ��ú¨�ëõ�ú�âćé÷åöæć ÒÎÐÏÜÏÎØØ ÏÎÔÔ
ÒÔ BrÝ%�Q��úùć÷àᣪĊăóõÝmÞ¦$ëõàć ÒÎÖÏÜÏÎØÒ ÏÎÔÐ
44
IT
3 r=0.23 33 r=0.27 0.3
2) ���&��$��������%� ��#�
IT 0.3 3 33
11
24 5 7 8 KMO 0.892Bartlett
p<0.001, 2=5365.3, df=276
5
9 10
B A
��� ���&��$��������%�"�'� �
1
(1) ��
1) ������
2016 9
2) �!
C 131 40 C
À�BO
ČŒũŭşőŷ
ŕŮŵŶŗŏűŹ
ÀBO
Č�ÿĀ�Ĺ
�Âč
À�BO
ČQÌubč
ÀABO
ČÒ^Á§č
À�BO
ČŒũŭşśŊŦ
űŗļĹĀkč
đđ
4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
ŒũŭşőŷŕŮŵ}×
�ÏĹN3
³zĹäŇ÷łĭĸ��eĦÎĦĨĶĤĵĥń
Đďėē
ĎĐďĐĘē
ĎĐďĐē
ĎĐďĐđĒ
ĐďĐēĕ
đĒ
4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
ŒũŭşőŷŕŮŵ}×
�ÏĹN3
�äĹ³zĸ$tŇ·ĪķĤłÎĦĨĶĤĵĥń
ĐďĖĕĔ
ĐďđēĖ
ĎĐďĒĖ
ĐďĐēĒ
ĐďđĔĔ
ēē
¸�°í�Ň�įĬ
�Ł�§ÊĆҧÜĪĜ¸
�°í�Ň"ĠĬń
��rHĹö)ķ+©Ķ�
ê
qÍĹrHČťůŋŠŕŷĸĀņń
rHŇ?ľčŇR¼Ĭń
µŃjį �Ĺ¼WŇÆYĸ łĩķğÒ�ĤĞń
ĐďĕĐė
ĎĐďĒĖę
ĐďĐĘ
ĐďĐĐĘ
ĐďĐĘ
đĘ
4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
&´Ŷ´X°Sï
ÒðĹÝ2ŁÖ¤ĸijğĴĹţʼn
ŲŢŭŷŁŤŊŷŝŠŚŐŇ�Ŀń �ģłĹ��Łâ�Ň;ħUŅńĨĶĤĵĥń
ĐďĕĐĕ
ĎĐďĐĕĕ
ĐďĐē
ĐďĐēđ
ĐďĐėĕ
đĐ
4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
ŒũŭşőŷŕŮŵ}×
1�°ķŒũŭşőŷŕŮŵŇÖĠ³zĹ9mŇÚķĤł�äĬńĨĶĤĵĥń
ĐďĔėĖ
ĐďēĘĕ
ĎĐďĐė
ĎĐďĐĒē
ĎĐďĐĕę
đ4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
@pŶæSĩŶoğŁŃ
ö)ķ�ôŁÝÔõğ
¥�Ł¿IĸmīįÝÔõğŁubŇ:ńĨĶĤĵĥń
ĐďĔĔē
ĐďĐėē
ĐďĒē
ĎĐďĐĐđ
ĎĐďĒđē
ĒĐ
4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
&´Ŷ´X°Sï
Ò(ŵéŁÑ.Ŷg-Ĺā«Ŷ�
îŇ�ĪĦåéĪĴğń
L�Ĺ6BŇ�ŃñŃĜĮĹiĸ�ģĬĨĶĤĵĥń
Đďēđĕ
ĐďĐēĕ
ĐďĒĔ
ĐďĐėĘ
ĐďĐēĒ
ę4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
ŒũŭşőŷŕŮŵ}×
1�°ķŒũŭşőŷŕŮŵŇÖĠ*YĄĹ�Ķ{ıÜħĴäŇĬńĨĶĤĵĥń
ĎĐďđēĒ
ĐďĘĔĒ
ĎĐďđĒ
ĐďđĕĖ
ĎĐďĐēĔ
ĒĔ
qÍŶÒнŶKнĶĹ³
�©
ZýÐĶĹó�Ŷ5
Kн5
нĶĹ5 ĸ7/Ĭń
Q»ĹQ¨ĶĹ�ÿĀ�ŇĠĽĦ�ÂĬńĨĶĤĵĥń
ĎĐďđđĘ
ĐďĖėę
ĐďĒĐ
ĎĐďĐĔĒ
ĐďĐđē
ĒĘ
qÍŶÒнŶKнĶĹ³
�©
ZýÐĶĹó�Ŷ5
Òн
=!ĸŔŨŷŜĜʼnŝŠŋŗŇĬńQ»&ĹQ¨Ķğĸ0ħ<ġńĀ�Ň�ÂĪĴğń
ĐďĐĕđ
ĐďĕĔđ
ĐďđĔ
ĎĐďĐĖė
ĐďĐĖ
Ēė
qÍŶÒнŶKнĶĹ³
�©
ZýÐĶĹó�Ŷ5
Òн
=нĹŗŏűĜ��ÛĜÑ.ĸ�
sŇ|Ġ
ÍĹ�dŁ��ÛĸøwĪķĤłĜÒ(ĹsÚŇ�dĬ
ńĨĶĤĵĥń
Đďđđ
ĐďēĘĖ
ĐďĒĕ
ĎĐďđĐĒ
ĐďđĖĖ
ēĔ
¸�°í�Ň�įĬ
�Ł�§ÊĆҧÜĪĜ¸
�°í�Ň"ĠĬń
4®ZýÐĶĪĴŸ�°
í�Ň�įĬ
á®ßûĸ°¶ķ&UŇßĪĜ¶S
ĸ�PŇÖĠ
'��ĸijğĴĜÙ£ŇĢĩġĴâĸÙÄĪĴ�ĸ�ġ
ńĨĶĤĵĥń
ĐďĒĔė
ĎĐďĐĕ
ĐďĖđ
ĎĐďĐĒĔ
ĎĐďĐęĔ
Ē4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
@pŶæSĩŶoğŁŃ
@pĹĞńÖ2ĜåéŇ�ij
`ağ�ĈŇðĸijħĴğń
ĐďĐēę
ĐďĐĕė
ĐďĕĔ
Đďđđĕ
ĎĐďĒĐĕ
Ēē
qÍŶÒнŶKнĶĹ³
�©
ċqÍ�kĹőʼnĹ��
qÍĹÒhpŇĊĿńĜ�
�Ĭń ĥģħ
řűŤőʼnŇ��ŶōŵšŴŷĬńřűŤőʼnŁōŵšŴūŵŜĹ�nĸijğĴç�ĵĥń
ĎĐďđĔĕ
ĎĐďĐĐĖ
Đďĕē
ĐďĐēĒ
ĐďĐęĔ
đĖ
4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
ÇÈQÌŶŏŬŰʼnþ¯
ZýÐĶĪĴxüŇÈħńĨĶŇò
ğ�Ŀń
ÒðĹxüŇ�ĬQ&JĹ�2ĸ7/ĪĴğń
ĎĐďđĖę
Đďđĕĕ
ĐďĔĐ
ĐďĐęĖ
ĐďĐĘĘ
ēĐ
¸�°í�Ň�įĬ
ŒũŭşśŊĜZýÐăCĜ¸
�ļĹì¦
ÒнĹZýÐăCļĹ_
]Ŷì¦
#ÕĶÒнĹ�ćĀ�ŇeĿń
�2ŇÖĠ
8�ŁT�ĸYĪĴĜÒ(ĤQňĵğńZý(ùĸijğĴ
%�°ĸç�ĵĥń
ĐďĐėĒ
ĐďĐĖė
Đďēę
ĎĐďĐĔĔ
ĐďĒĔđ
đē
4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
ÇÈQÌŶŏŬŰʼnþ¯
ZýÐĶĪĴÇÈ°ĸQÌĬńĨĶ
ĹlÙpŇåéĪĴğń
ãĉŁ[śŗŜĤķĦĴŀ�ĝQÌĬńÌvĤĞń
ĎĐďđĐĔ
ĎĐďĐēĖ
ĐďđĒ
ĐďĖĖė
ĐďĐĕđ
đĔ
4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
ÇÈQÌŶŏŬŰʼnþ¯
ŏŬŰʼnťůŵŇ�xĪSÖĬńQÌÞªŇ¿ĴĴĮŅŇSÖĬńĨĶĤĵĥń
ĎĐďĐĖ
ĎĐďĐĒĖ
ĐďĒĐ
Đďĕę
ĐďĐėę
ė4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
Ò^Á§
�ÿĸ�¶ĵĞń
èËŶ¡ÌŶSÌĹþM�,ĸĺQĻįĿĹ��Ĥğijŀ
ĵĥĴğń
ĐďĒĔĕ
ĎĐďĐĖ
ĎĐďĐđ
ĐďĔėę
ĎĐďĐēĒ
Ę4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
Ò^Á§
�ÿĸ�¶ĵĞń
Ò(Ĺ�ĝĹŗőŖŭŷűҶSĸ~�ĪĴğń
ĐďĒēĕ
ĐďĐĖę
ĐďĐĐ
ĐďĔėĕ
ĐďĐĐē
Ė4®ZýÐÍĹG±ĶķńÑ
.
4®ZýÐĹG±Ķķń�
�fxĶ¸�°ŗŏű
Ò^Á§
ÒðĹ�c¥uĸ¬sĪĜÉ�Ŷ>
�ŇDń
Ò(Ĺ�c¥uĸğijŀ�ŇøIJĴğń
ĐďĐēĔ
Đďđę
ĎĐďđĐ
ĐďĔĒ
ĎĐďĐĔĖ
ēđ
¸�°í�Ň�įĬ
ŒũŭşśŊĜZýÐăCĜ¸
�ļĹì¦
EFĹ��4®º¹�2ĸ
YĬń§ÜĶì¦
EF4®Ŷ��Ŷº¹Ĺ�2ĸV�
Ĭń
Ă&Ĺ4®İħĵĺķĦĜEFĵ\þĩŅĴğń���
2Łº¹Ŷ4®ĸijğĴĀkĤĞń
ĐďĐĘĘ
ĎĐďĐĕē
ĎĐďĐę
ĐďĐĘĔ
Đďėđđ
ĒĖ
qÍŶÒнŶKнĶĹ³
�©
ZýÐĶĹó�Ŷ5
Kн5
нĹZýpŁÑ.ŇÚ¾ŀń
ĨĶĤĵĥń
Q»ĹQ¨ĤQňĵğńZýµéŁŗŏűĸĀkĤĞ
ńĐďĐėĔ
Đďđēę
ĎĐďĐđ
ĎĐďĐĔĒ
ĐďĔēĒ
ēĒ
¸�°í�Ň�įĬ
ŒũŭşśŊĜZýÐăCĜ¸
�ļĹì¦
EFĹ��4®º¹�2ĸ
YĬń§ÜĶì¦
EF4®Ŷ��Ŷº¹ĹZýÐŶ�
àĶĹó�Ň�Ŀń
4®�àŸĂŶá®yŹ�JĹ��Ŷº¹�àĵ ğĴğ
ńZýÐĸijğĴµIJĴğń
ĎĐďĐđę
ĐďĐĐĒ
ĐďēĔ
ĎĐďĐēđ
ĐďĔĐĔ
ą²
BOëÓú
Œŷŝ
Øėź4®ťųŤŌŚŕŮŞŰŘŪâ�ą²ĹBO(�ĹÅ�ČťŲśŗŜŶŲŧűŻŹ
ą²ěĚ
(ù
ĆF
ŎśœŰ
|�*1
®íýĀ÷ìĉ
îāćĈðëăċ
|�*1
®�§¨�Ù
b~¯
|�*1
®2�I>¯
|)*1
®�;}l¯
|�*1
®íýĀ÷ôèû
ăðÜÙ¨D¯
sNÙ�å áÍØ`cAÆ�ÆÈÖÄÕÅã ²±¹µ °²±²ºµ °²±²µ °²±²³´ ²±²µ·
��ÙsNØ�HåvÊ×Äá�ÆÈÖÄÕÅã ²±¸·¶ ²±³µ¸ °²±´¸ ²±²µ´ ²±³¶¶
tâCÏ�Ùz6å�7ØgáÉ׿��ľ㠲±·²¹ °²±´¸» ²±²º ²±²²º ²±²º
�ÃáÙRUà��å'Ç5äãÈÖÄÕÅã ²±·²· °²±²·· ²±²µ ²±²µ³ ²±²¹·
sNÙ%Eå�×Äá��ÌãÈÖÄÕÅã ²±¶¹¸ ²±µº· °²±²¹ °²±²´µ °²±²·»
kdà{-ØEËÏ���¿àI>å&ãÈÖÄÕÅã ²±¶¶µ ²±²¹µ ²±´µ °²±²²³ °²±´³µ
/VÙ"*åSâ�â¼ÎÙBØeÃÌÈÖÄÕÅã ²±µ³· ²±²µ· ²±´¶ ²±²¹º ²±²µ´
�7ªÙ�ÖOÑ�ÇÔ�åÌãÈÖÄÕÅã °²±³µ´ ²±º¶´ °²±³´ ²±³·¸ °²±²µ¶
2yÙ2mÖÙ�§¨�åÀÝÆb~ÌãÈÖÄÕÅã °²±³³º ²±¸¹» ²±´² °²±²¶´ ²±²³µ
2y�Ù2mÖ�¿Ø�Ç(Áã¨�åb~ÊÔ¿ã ²±²·³ ²±·¶³ ²±³¶ °²±²¸¹ ²±²¸
�Ù�@à���Ø¡KÊ×Äá¼��ÙG�å�@Ì
ãÈÖÄÕÅã²±³³ ²±µº¸ ²±´· °²±³²´ ²±³¸¸
�]�ØÓ¿Ô¼�jåÂÉÁÔ�iØ��ÊÔ�Ø�Á
ãÈÖÄÕÅã²±´¶¹ °²±²· ²±¸³ °²±²´¶ °²±²»¶
<=¿W¬å�ØÓÇÔ¿ã ²±²µ» ²±²·¹ ²±·¶ ²±³³· °²±´²·
òăùìçàêćøĆÿćõÙaFØÓ¿Ô�[ÕÅã °²±³¶· °²±²²¸ ²±·µ ²±²µ´ ²±²»¶
��ÙL¤å�Ì2�.Ùe Ø#�ÊÔ¿ã °²±³¸» ²±³·· ²±¶² ²±²»¸ ²±²ºº
$�à4YØ7ÊÔ¼��Ä2æÕ¿ã8¥�¢ØÓ¿Ô
� qØ�[ÕÅã²±²¹´ ²±²¸¹ ²±µ» °²±²¶¶ ²±´¶³
�à9ôðõÄ×ÆÔßZ½2�Ìã�Jľ㠰²±³²¶ °²±²µ¸ ²±³´ ²±¸¸¹ ²±²·³
2��nå{ÔÔÎäå3�ÌãÈÖÄÕÅã °²±²¸ °²±²´¸ ²±´² ²±·» ²±²¹»
��Ĉh�Ĉ3�Ù¦0\�ØÚ2ÛÏÞÙf�Ä¿Óß
ÕÅÔ¿ã²±´¶· °²±²¸ °²±²³ ²±¶¹» °²±²µ´
��ÙZ½ÙðìïĀĉăåu3ØPTÊÔ¿ã ²±´µ· ²±²¸» ²±²² ²±¶¹· ²±²²µ
��Ù�?kIØ¿Óßcå¡ÒÔ¿ã ²±²µ¶ ²±³» °²±³² ²±¶´ °²±²¶¸
o©�Ù!pÐÇÕÚ×Ƽ+,Õ:¦ÉäÔ¿ã��e
àxwĈ!pØÓ¿Ô¨Dľ㲱²ºº °²±²·µ °²±²» ²±²º¶ ²±¹³³
2yÙ2mÄ2æÕ¿ã8¥t�àðëăبDľ
ã²±²¹¶ ²±³µ» °²±²³ °²±²¶´ ²±¶µ´
!pX�Ċo©Ĉ�pMċ.Ù��ĈxwX�Õ�¿Ô¿
ã8¥�ØÓ¿ÔtÒÔ¿ã°²±²³» ²±²²´ ²±µ¶ °²±²µ³ ²±¶²¶
�¹Č!púąùéóîāöĂñþ��«rÙ*1�^Ù�_®úĄôðõĈĄüăčċĊQ�ċ
«r
*1��£
§�c4�xvÊ,fÆÈÕz
�
�c4�xÊ,fÆÈÕ�
V<FÆl�eäÞý
&Bā�2¼āA²ÑÔ
&BʱÕ��¯��Ø�Â
çĂãùýøíÚÙÉ&BÉXºÕHnؽȲ
¨�c4�xvÊ,fÆÈÕz
�
�c4�xÊ,fÆÈÕ�
V<FÆl�eäÞý
&Bā�2¼āA²ÑÔ
(ضȲ¯� ŸÕ�űÕ
Ȯ
�¶Ó� ¼Ö¯ ÔɼÖIJÕ
©�c4�xvÊ,fÆÈÕz
�
�c4�xÊ,fÆÈÕ�
V<FÆl�eäÞý
&Bā�2¼āA²ÑÔ
je�~¼Ø�Â
׶ÓȲ»ÆË׶ÓȲÆ�~É�´Õ
¥©
�c4�xvÊ,fÆÈÕz
�
�c4�xÊ,fÆÈÕ�
V<FÆl�eäÞý
qr1uāÞùüÙ�d
ÞùüÙõûĀØ F½2�¾Õ|�Ê5S�ÉκįÈÉؾ͸¶·×¶Õ
¥ª
�c4�xvÊ,fÆÈÕz
�
�c4�xÊ,fÆÈÕ�
V<FÆl�eäÞý
qr1uāÞùüÙ�d
4�xƽÄF�ØrºÕ»ÆØ�
²ZÏÕ
9É_^É]�½È²$�@ØÐÁIJÕ
¥¬
�c4�xvÊ,fÆÈÕz
�
�c4�xÊ,fÆÈÕ�
V<FÆl�eäÞý
�iāi3e2�
|�Êj�Ñz�ā=�Ê�bā�
�ØY½¹��½Ä²Õ
|�Ê_*Êz�Ñ¿Ê�bØYkÉ�oÐջƷŸ
Õ
¦¥
�c4�xvÊ,fÆÈÕz
�
¡²äÞýÆj�É,ù2
�
¡²äÞýÆj�É,ù4
�xe2�
[cāàÙÉ�¾ÕRMÊD-Ø!
�½¯{:É�a¾Õ
RMÊ�1ā�cÉ�¾Õj�دMwÑìþòÈÇÊø
íÚÙ¶Ó�G½Ä²Õ
¦¦
Cvā|xmā/xmÆÊh
� a
¢Cv�@ÊàÙÊJ�
Cv�@�t
Cv·Ê�8Ñ�c4�xÊE
�Øw¹»ÆØ6�¾Õ
æÝĀïÜóñÜĀƲ³�}ÊE%Ø�PŸÕ
¦©
Cvā|xmā/xmÆÊh
� a
4�xÆÊ�Kā��
/xm��
êĂ÷Ê�'ƽÄüĂéĂãëõ¤
��ØÆÕ
ßýĂõɵºÕüĂéĂãëõÊ"ÔN·×¶Õ
¦¬
Cvā|xmā/xmÆÊh
� a
4�xÆÊ�Kā��
|xm�
>�ÊLyÑøĀèĂØ;¸#ºÕ>�ÌÊI7āLyÉoWeÉ�×ÔÀ²ÆA³
§©
l�e��ØUÀ¾
\Ñ�`s�Ø`�½¯l
�e��Ø�³¾Õ
�c4�xƽÄÊl�e
��ØUÀ¾
��Q�.ɵºÕ4�xƽÄÊ
��
5S¯�c?�vÉÈÕƲ³|�ØÐÁįO°��½Ä
²Õ
�«Ą�cõÿôÛëãúðüå÷���gÊ)0�TÊpUÉÒÔ�.¼ÖÀ¥¥�g£õþìäîāþöýąă
�g®
��
�+
Ýìâü
áĂï
�g
x� B�6@5)0-<3=/:yFY�&lJJG}D^}tr������#
6?1.2!?8>�$
�lJB
JG
�lJ�
JG
�lJ`
JG
�lJK
WJG
�lJ�
d{_J
G
�lJ�
de�J
G
�lJ�
J�~J
G
�lJZ
O�~J
G
�lJS
VpH�
~JG
�lJz
i`GE
gG
����������� ��
������������
��������� �
�����������
��� ������
mCD^
�,9;4+"-<A!.*>$
�����
�����
������
������
������
�����
muD^�fMNP&Xo�
�������
������
�����
������
������
%�����
�lJBJG��l
J�J
G��lJ�d{_JG��l
J�de�JG��lJSV
�~JG
�lJ�de�JG%�l
JKWJG
m[D^��Jbks�
�������
��������
�����
������
�������
%�����
�lJBJG��l
J�J
G��lJKWJG��lJ�
de�JG��lJ�J�~
JG��lJSVpH�~J
G��lJzi`GEgG
m]D^�aTL��
����� ��
� � � ��
� ������
� � ����
� ��� ��
�����
�lJ�JG��lJ`J
G��lJKWJG��lJ
�J�~JG��l
J�d
e�JG
mUD^
�,9;41(7>.'&Ne�
�������
�������
������
������
�������
�����
lJ!JG
D^
�#CRvn|
\|h$
jcwI
#���
���������~$
49
NK HK����� � ��� �
M67E��,.'�� /4�!�1�
��� ���� ����
MT7E�J;<=�AO� ��� ���� ��MC7E��9GLR� ��� ���� ������MD7E�F?:Y� ���� ���� ����M@7E��,.'$�*1!��<I�
���� ��� ����
���>P�
U���5Z)3(�# /&0"-V8BX�KW7EWSQ��� ����)2$!%�2+1��
7EKW
3)
N N 1
× N 24
× 11 35 N 11
5
ID15
N ×
o ID102 N
ID2 ID23
ID30 N
ID34
N N
3 2 ID1
ID2
2 ID105
N ID106 ×
ID26
N
Ť����ƊjwiO_Xrdt[nť�Ûŷ�ŴŃá�vku���Ûŷ�
U�c P`Vt Ƌ� ūź
�� ıÿ8ş�JÄ6 D�Ɣ)F$4 3!FÒ�ʼn6UmqeT�XryJØ�
�� ıÿ8ƔJûD*7ଶ"ŭ"$4 3!F� �Ɣ8ıÿ7´¢Jó'6 Dŭ"$4 3!F��� ôū8Ê�,�$4JƓƅʼn7ć<F$4 3!F� ĉĹŶ8Ğ4ĸ.�#2ƔJ)F$4 3!F
� ïÇBĎ`Zb 6"2Aŕ��ă)Fă£ �FĭŹĕ4'2¾ĵʼn7�ă)F$48ţƁġJŘ
õ'2�F�� �ă¿�JƆ22+GJøØ)F$4 3!F��� ôĜ8čƂIJ7?#2�ß67J)<!� I�F
� ôĜ8ĢńJij)�Ŕ�8�ő7ç�'2�FĭŹĕ4'2ĢńJĵ#F$4Jņ�°@F
�� ôū $G�D�:<!�ĻJ>0#F$4 3!FĭŹĕ4'2¾ĵʼn7�ă)F$48ţƁġJŘ
õ'2�F ôū8ÁÕĔĺ7�0A¬Jŝ/2�F��� ÁÕʼn6Ĥ�ă£JĜ70#2�F
�Ù¯��ă�øă8�èñÞ79�:,@8ĈŢ �0A3!2�F
� ôū8ŕ�8ZTYq�uJ�ø7śz'2�F
�� ĶĞ�D8ìňBť�Jā#žGF$4 3!FôĜ8ÊőBØ~70�28hLvgq�BiM�cf_RJ°@F
��� ôĜ8Éä8ŚƌB+8Ë�Jģ�7ÄħAF$4 3!Fôū8ľõBŚƌ�Ż�8Ë��ŨĴJģ'"Ř
õ'2�F
�� öŜ8È�JĘEŮE�+8Ï7��)$4 3!Fôū8ľõBŚƌ�Ż�8Ë��ŨĴJģ'"Ř
õ'2�F� Ĕ·BƆĒ7�(,ÊƀÆ�BĺōJýF$4 3!F Ŋĩ6Ī¸BÊƀÆ�
��� �0AģŅ3�F$4Jė #2�F�J0�6��Ėƃ3!
FĞ3�F$4
�� ĶĞ8¬ð.J3!F-#ƅ�'C�4Ō@2�F�J0�6��Ėƃ3!
FĞ3�F$4� I�D6�$49I�D6�4ų7Ê�F ľʼnų%Jů0
��âę8����Ɗ7§)FľõJ�ęŭB`vg658oaML�DŖÿ'2�F
òƊ�TL7§)Fâę8ēűJĂą'�Ǝď7
Ŋſ)F
�� øĮ3ţƁ4%GF3�H�ľõB®ĆJŕ�ăœ'2�FÜ�vku8ZQu4��ľõJůð'�+GJ
Ş«)F
��� ēűJœF,@8ƓŬa�\k�ZJİå)FZQu �F��ʼnà²7©1�,}ëÀŇ�øĮJØ�
�Ķú8üŁB�Ľ¥7ŝƈ'6 D�ôū8}ÄJüŁ)F$4 3!F
ŒĕĀ8ZQu��Ľ¥�Śƌ7½}JŪ�
� ��Ŕ8�Ĥ4Î�7Č#Ý�F§¹JÖŀ'2�FŒƉ7Wl�b�Lcf
NZJ)F
� Ķ��8�Ĥ48Ц§¹J�="Öŀ)F$4 3!FĶĕĀ48µŐ7ç�)
F
���Su�jx�RJ� 7ĝ@F,@795�',DC��ľ/2�F
^�n8��4'2t�]�X_j�ĨŗJ4F
�Ŧ�Ŕ8�Ɗ-#396"�Ŀ�3ŋ�%G2�FůÁ�őBũî��Ɗ70�2§ė �F
Ŀ��Ɗ�ůÁ�ũî8�ő7ªŽ)F
�Ɗíī�Ŧ��ěƊĊ�{�8ůÁ�ũîíī3Ő�2�FĭŹĕ70�2ľ/2�F
Ŀ��Ɗ�ůÁ�ũî8ĭŹĕ�íī48Ɛ¼J
Ě@F
���÷Ŧ8òƊ�TL-#396"�Ŀ�38ůÁ�ő�÷Ŧżų�ő7A§ė �F
ÑĄ�Ĥ�żų��8ijĝ
��� Ŀ�3ŰD)¡ú%K8Ĥ�JNo�Y)F$4 3!FĿ��Ɗ�ůÁ�ũî8
�ő7ªŽ)F
��� ôū8Ƅ�8,@7ĶĞJƄſ'29�#6�4ë�ôÍ8Ƅ�8,@7�ƊĭŹĕ8Ŀ|BƆĒJƄ
ſ'6�
�ƊĭŹĕ4'28ù�ʼnĨŗJ�,)
ľEœ,ĶĞ8šŵJĬĹ7ƑD%6�ôĖ �F¡ú8ēű�jsNfX�7§IFēűJ¨?�Jþš)F
ÌĞēű8Ŋĩ6Ƅſ4ůÐ
��`ZbBÓŏïŸ653�� �/2AŨģJØ/29�#6�4ë�
ěƊƒBña�\8�&K�+8ĶŨģ6ċƏ8åĢJØI6�
ŲBƍƅ×ƋJþF
��Ûŷ�����������9jv`Zb8�êūĦ3ãſ%G2�6�Ûŷ�Ûŷ��������9ŴŃá3ę,7ņ�%G,Ûŷ
�Ŏ)F�ƊjwiO_Xrdt[n�řÛŷ���
Ûŷ
�ƊĭŹĕú8©Š46FŚƌ
�ƊĭŹĕ8©Š46FĞ�»Ģ4ù�ʼnZQu
UmqeT�Xry®Ćºł8éĠ
Ò�ʼn6UmqeT�XryJØ�
¾ĵ�ă�QptL�Ş
QptLjsyJåĢ'øØ)F
ñ¦7ģ�3�Fôͤƅ
ôĜ8ÁÕĔĺ7Ƈ}'��ð�ÔđJğF
ŔĐ�ĐæʼnøĮ
ŧġ�ĥø%�ë�BE
Ü�ZQu4ľõ7©1"øĮ
Ü�ZQu4ľõ7©1"ĭŹĕʼnøĮ
¡ú�ôĕĀ�ķĕĀ48ıÎåſ
ù�ʼnĨŗJ�,)
ĭŹĕ48Ɛ¼�µŐ
ôĕĀŐ
ķĕĀµŐ
Umqe`M�ĭŹĕąļ�ù�;8ÚÂ
Ŀ�8ůÁ�Ɗũî�ő7Ĺ)Fƅ�4ÚÂ
ŲBƍƅ×ƋJƅ�'�ù�ʼnĨŗJį�)F
51
ID109 ID110
×
ID21
N
N ID103
ID104 2 N
N N N
ID111 N
ID112 2
ID19
ID20
N
24
N 5 N 4 12
× N 35 35
N
N KiSS-18102( 4) KiSS-18
N 18
KiSS-18
― ×
1 1
×
N × 1
― KiSS-18
KiSS-18 5 (5 )
(4 ) (3 ) (2 )
(1 )
52
4)
N 0.4 N
N KiSS-18
N t (Welch )
N
N KiSS-18
N KiSS-18
×
0.5
N Cronbach’s
coefficient N
5)
(2)
1) : P
C 88.5 116 131 C
97.5 39 40 12 144 58.3
41.7%
KiSS-18 62.65 10.44 60
― 99,103,104 ―
13 35 IT
N 33
4.22 0.89 112
4.47 0.82 2
IT 33 r=0.33
112 r=0.41 2 0.3
53
�&'B�����6��� �!4/&))"@���>=:<&A
�� 798;? C ���
5����
�� 0������� &%* ,'$.
0���� (. ',$&
�� �� -) *-$(
� +% )&$,
1322#&- &)( +'$+*5&%$))
2) ���������������� �����
33 112
5 30
7 14 15 KMO 0.839 Bartlett
p<0.001, 2=1384.8, df=435 7
KiSS-18 16
C
C
KiSS-18 C
7 KiSS-18 (r) 0.23 0.76
(r=0.76) (r=0.23)
(r=0.23) 17 30
KiSS-18 0.71
7 ( ) 0.63 0.86
¡ÌÎĬ&�ĝĦĜČĖđĢĚģĔğª Å�ö4lçĪl®oĨĥĞĤĭī
ÌË �Zö)Oć£ôàā¬èăäòàñáă ÏÊÍÓØËÊÑÔ ËÊÏÒ
ÌÌ �Zö¬ć¹āéõptJâ�âäòàñáă ÏÊËÑØËÊÒÐ ËÊÎÓ
ÌÍ ¬ö�Zõ�Tć�æôàā�âäòàñáă ÏÊÌÒØËÊÑÓ ËÊÏÍ
ÌËÌ ��ö¦ÜëÜäòć¯~�õ¶ùăäòàñáă ÎÊÑÓØËÊÔÎ ËÊÐÏ
Ô �?Äö�ò[í¥ãð¬ćèăäòàñáă ÎÊÐÓØÌÊËÌ ËÊÐÒ
ÌÎ «ÈÿBėēęàôâðþhÚ;�èă�VàÛă ÍÊÑÓØÌÊËÍ ËÊÐÏ
ÌÏ ;�§�ć�ððêĄć<�èăäòàñáă ÎÊÍÏØÌÊËÍ ËÊÑË
ÌÐ �´öAm�õüãðÙ�ôõćèùáßàĆßă ÎÊÏÒØËÊÓÔ ËÊÑÏ
ÌÑ �´öX»ć�è;�7öw%õ(!æðÜă ÎÊÌÔØÌÊÍÒ ËÊÏÓ
ÌËÍ ��àäĄßā;øùáÇćûïãăäòàñáă ÎÊÑÒØËÊÓÔ ËÊÐÑ
Ñ ��ö�H|UõÜïþtćºîðÜă ÎÊÐËØÌÊËÔ ËÊÏË
Ò ±�Ĩ{�Ĩ<�ö½:i�õ÷;øëýöx�àÜïþñáðÜă ÎÊÍÔØÌÊËÐ ËÊÐÏ
Ó ��öhÚöēĐĒġĩĤć�<õ]aæðÜă ÎÊÒÎØÌÊËÌ ËÊÐÌ
ÌËÒ �H�ô�w�Vć´õïãðÜă ÎÊÍÎØÌÊÌË ËÊÎÑ
ÌÓ ��ßāö_bÿª ć+ã=Ąăäòàñáă ÏÊÍÏØËÊÑÌ ËÊÏÔ
ÌÔ �´ö}0ö� ÿêöÁ�ćs�õ£�þăäòàñáă ÎÊÓÎØËÊÒÒ ËÊÏÏ
ÍË 9dö'/ć`õĂÙêöKõwßèäòàñáă ÎÊÔÍØËÊÒÌ ËÊÑÐ
Ì |vÿ�6õOçë¦�¸ÜÿUGć*ăäòàñáă ÏÊÌØËÊÓË ËÊÐÎ
ÌËÐ Üïþs�ñÛăäòćMàãðÜă ÎÊÔÏØËÊÔÐ ËÊÎÑ
ÌËÑ ��öt^íćñáăìã~¥æĀÝò#ýðÜă ÏÊÎÏØËÊÑÌ ËÊÏË
Ð ĆßāôÜäò÷ĆßāôÜò°�õ¦Þă ÏÊÌÌØËÊÒÒ ËÊÏË
ÍÌkfö&;Ĩ&�õ¿èă�²ćÙf�ÿėĥěôóöĠĘĊĉßā�Zæ
ðÜăÍÊÔÎØÌÊËÎ ËÊÎÐ
ÌËÎ <³ñN¢òåĄăñÛąÝ�²ÿ\ ćhÚ�LæðÜă ÎÊËÐØËÊÔÑ ËÊÐÑ
ÌËÏ R5ćLăëýö¯eĘĩĕĞĩēćc�èăēčĤàÛă ÎÊÍÑØÌÊÍÏ ËÊÍÑ
ÍÒ ��ö�Iÿ �¤õºWæôàāÙ��öS£ć�Ièăäòàñáă ÎÊÔÍØËÊÒË ËÊÑÎ
ÍÓ ;��ö;�ò�Üõ"ã-Þă¿�ćq�æðÜă ÎÊÔÒØËÊÓË ËÊÏÐ
ÍÏ �;�ö;�òö�¾¿�ćÝúâq�èăäòàñáă ÎÊÒÔØËÊÓÓ ËÊÑË
ÌËÓ ďĤĩĝħĩĎć�yõ·ýăëýõ÷óÝæëāĀÜß�îðÜă ÎÊÑÑØËÊÓË ËÊÑÑ
ÎÌ�Â�ö&�ìãñ÷ôâÙ13ñC½åĄðÜă��w%ÿ��Ĩ&�
õïÜð¿MàÛăÎÊÍÏØÌÊËÓ ËÊÐÌ
ÎÍ&�g¨Ī�ÂĨ©�Yī7ö��Ĩ��g¨ñ�ÜðÜă@¼�õï
Üð�îðÜăÎÊÍËØÌÊËË ËÊÏÑ
ÌËÔ��öu�ĨĐĉìãñ÷ôâÙ13ñö��w%Ĩ���Àw%õþ¿
MàÛăÎÊÎÍØÌÊËÐ ËÊÏÒ
ÌÌË 13ñjāèQ�åĈö�wćċĠĩĒèăäòàñáă ÎÊÍÏØÌÊËË ËÊÐÏ
ÌÌÌ ��ö��öëýõ��ć��æð÷ÜãôÜòPÝ ÎÊÓÑØÌÊËÔ ËÊÍÔ
ÎÎ �ĂLë��ö�>ć�?õzāåôÜ��àÛă ÏÊÍÍØËÊÓÔ É ËÊÎÎ
ÌÌÍ ėēęÿ,Æ«.ôóñÙ�àÛîðþ�sć�îð÷ÜãôÜòPÝ ÏÊÏÒØËÊÓÍ É ËÊÏÌ
�
ÖÕÅ�
E2�
Ørx�D
8�
ĨF$nÖ×�¿
�HU
ę�Ċċ�ň�
Éƌ
ÇHU
ę欳VÑĚ
�HU
ęţżƀųŮśŹ
ƄŨŋňċkĚ
ÇGHU
ę¹]³YúĚ
�HU
ęºôń|ÞĚ
Ç&HU
ę�©Ɖ¾�³
ø�Ě
�HU
ęØcÈ©Ě
ğĞ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ţżƀųŢƊŦƁƈ|Þ
4�³ņţżƀųŢƊŦƁƈŘÝĮ¸yň:mŘâņıœ�ìĺŕĵńıŃIJŕ
ĞĜĦĢğ
ĞĜĞĥģ
ěĞĜğğ
ěĞĜĞĦġ
ĞĜĞġ
ěĞĜĞħġ
ěĞĜğĞĢ
ğĠ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ţżƀųŢƊŦƁƈ|Þ
�ÔňT6
�ìň¸yŇ'sŘ½ĸņıœÓijĵńıŃIJŕ
ĞĜĥğğ
ěĞĜĠĠğ
ĞĜĞĢ
ěĞĜĞħģ
ěĞĜğĞğ
ĞĜğĥĤ
ĞĜĞĢĠ
ğĞĦ
pÒƉØÕÃƉRÕÃńň¸
�«
_ĈÕńňþ�Ɖ8
RÕÃ8
ŬƊŽň�DńĸłƃƊūƊŦŭ
Ÿĝø�Řńŕ
šƄƊŸƇƊŠŘ)¢ŇÿŏŕļŏŇʼnŅĮĸļœŒĭİ
ºĿłĭŕ
ĞĜĥĞĥ
ěĞĜĞĞĥ
ĞĜĞĦ
ĞĜĞħ
ĞĜĞĤħ
ěĞĜĞĢħ
ĞĜĞģĠ
ĠĦ
pÒƉØÕÃƉRÕÃńň¸
�«
_ĈÕńňþ�Ɖ8
ØÕÃ
@"ŇťŻƊŰĪŚűŴŜŨŘĺŕVÁ(ňVªńĭŇ2Ĵ?įŕċ�Ř�Éĸłĭŕ
ĞĜĤĥĠ
ěĞĜğĤĦ
ěĞĜğģ
ĞĜğĞġ
ĞĜğĞġ
ěĞĜĞġĢ
ĞĜğĢĠ
ğĞğ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ţżƀųŢƊŦƁƈ|Þ
4�³ņţżƀųŢƊŦƁƈŘÝĮØ*ňåĭļĭĵńŘñ©³ŇüŌŕĵńıŃIJŕ
ĞĜģĤ
ĞĜĠĞĦ
ĞĜğĥ
ĞĜĞğħ
ěĞĜğġħ
ěĞĜĞĥħ
ěĞĜğ
ğ7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
CoƉîYĶƉnĭőŔ
Ă+ņ�ĀőåÚāĭ
¦�őÆPŇmĹļåÚāĭőteŘ<ŕĵńıŃIJŕ
ĞĜģĢĤ
ĞĜĞĥĦ
ěĞĜĞģ
ěĞĜĞĦĠ
ĞĜĞğĢ
ĞĜğģĤ
ĞĜğĞĤ
Ġĥ
pÒƉØÕÃƉRÕÃńň¸
�«
_ĈÕńňþ�Ɖ8
ØÕÃ
@ÕÃňŨşƄĪ��ãĪÖ0Ň
�rŘ{Į
�Òň�gő��ãŇăvĸņıœĪØ*ňrâŘ�gĺ
ŕĵńıŃIJŕ
ĞĜģĠĢ
ĞĜĠĢĥ
ĞĜĞĢ
ĞĜğģĤ
ĞĜĞĠĤ
ĞĜĞğġ
ěĞĜğġ
ħ7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ţżƀųŢƊŦƁƈ|Þ
4�³ņţżƀųŢƊŦƁƈŘÝĮ,^Đň�ńzľäĴłìŘĺŕĵńıŃIJŕ
ĞĜģğĦ
ĞĜĞģħ
ĞĜĠĦ
ěĞĜĞĤ
ěĞĜĞĠĢ
ěĞĜĞģĢ
ĞĜĞĤĢ
ğĞĠ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ÌÍVÑƉşſƃŚĉ²
_ĈÕńĸłÌͳŇVÑĺŕĵ
ńňláoŘíôĸłĭŕ
Ø*ıĵŖİœVŊŌIJïĕŘōŀĴŕĵńıŃIJŕ
ěĞĜĞħĦ
ĞĜĥĢğ
ĞĜĞĠ
ĞĜğġ
ĞĜĞħ
ěĞĜĞħĦ
ěĞĜĞğ
ğģ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ÌÍVÑƉşſƃŚĉ²
şſƃŚŸƂƈŘ�wĸYÝĺŕØûň`�!ŇŎĴłĪ ņŇŘĺŌIJİıŗİŕ
ĞĜĞġĦ
ĞĜĥĠĠ
ĞĜĞġ
ěĞĜĞğġ
ěĞĜĞğġ
ĞĜğģĠ
ěĞĜĞğ
ğĤ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ÌÍVÑƉşſƃŚĉ²
_ĈÕńĸłwćŘÍĴŕĵńŘ
ýĭ�ŏŕ
ØûňwćŘ�ĺV(Qň�5Ň91ĸłĭŕ
ĞĜĞĥĤ
ĞĜĤģģ
ěĞĜĞĢ
ĞĜĞĢĠ
ĞĜĞğģ
ĞĜĞġĤ
ěĞĜğġħ
ğĢ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ÌÍVÑƉşſƃŚĉ²
şſƃŚŸƂƈŘ�wĸYÝĺŕVÑæ¬ŘÆłłĻŖŘYÝĺŕĵńıŃIJŕ
ěĞĜĞģĠ
ĞĜĤĞĦ
ěĞĜĞĥ
ěĞĜğĢĢ
ĞĜğğġ
ĞĜğĦĢ
ĞĜĠħĥ
ğġ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ÌÍVÑƉşſƃŚĉ²
_ĈÕńĸłÌͳŇVÑĺŕĵ
ńňláoŘíôĸłĭŕ
ëėőaŮŨŰıņijłŐ�īVÑĺŕÑuıĬŕ
ěĞĜĞğĥ
ĞĜģğĦ
ĞĜĞġ
ěĞĜĞħĤ
ĞĜğĤĦ
ĞĜĞħĤ
ĞĜğĤğ
ġğ
¾�³ø�Ř�ļĺ
ţżƀųŮśĪ_ĈÕďIĪ¾�ŋň÷
§
LMň��7±À¿�5Ň
^ĺŕ©äń÷§
LM7±Ɖ��ƉÀ¿ň�5Ň[
�ĺŕ
°Ď(ň7±ĽĴŃʼnņijĪLMŃbĉĶŖłĭŕ���5
őÀ¿Ɖ7±ŇŀĭłċkıĬŕ
ěĞĜĞġĦ
ěĞĜĞĤĦ
ĞĜħģ
ĞĜĞĥĠ
ĞĜĞĞğ
ĞĜĞĞĠ
ěĞĜĞĢġ
ğĞħ
¾�³ø�Ř�ļĺ
ţżƀųŮśĪ_ĈÕďIĪ¾�ŋň÷
§
LMň��7±À¿�5Ň
^ĺŕ©äń÷§
%Üߪĝ�Č7Vň�ÿ
¯°ň�±ƉŢŚĽĴŃʼnņijĪLMŃň���5Ɖ¯°�
Č�5ŇŐċkıĬŕ
ĞĜĞĠģ
ěĞĜĞĠĥ
ĞĜĥĦ
ěĞĜĞĦĥ
ĞĜğĞĥ
ĞĜğĠĢ
ěĞĜĞģĠ
ġĠ
¾�³ø�Ř�ļĺ
ţżƀųŮśĪ_ĈÕďIĪ¾�ŋň÷
§
LMň��7±À¿�5Ň
^ĺŕ©äń÷§
LM7±Ɖ��ƉÀ¿ň_ĈÕƉ
�èńňþ�Ř ŏŕ
7±�èƋ°ĎƉé±xƌ�Qň��ƉÀ¿�èŃ ĭłĭ
ŕ_ĈÕŇŀĭłºĿłĭŕ
ěĞĜĞğ
ěĞĜĞğħ
ĞĜĤğ
ĞĜĞĞĤ
ĞĜğĠğ
ěĞĜĞĤĥ
ĞĜğģĢ
ğğĞ
¾�³ø�Ř�ļĺ
ţżƀųŮśĪ_ĈÕďIĪ¾�ŋň÷
§
LMň��7±À¿�5Ň
^ĺŕ©äń÷§
LM7±Ɖ��ƉÀ¿ň�5Ň[
�ĺŕ
LMŃ�œĺpÒĶřňª�ŘŜžƊŧĺŕĵńıŃIJŕ
ĞĜĞĤ
ĞĜĠĞħ
ĞĜģĢ
ĞĜĞğĤ
ěĞĜğģġ
ěĞĜĞğģ
ĞĜĞĦĢ
ģ7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
CoƉîYĶƉnĭőŔ
º³òÛĶŘ�ŀ
ŗİœņĭĵńʼnŗİœņĭńòÛŇåįŕ
ěĞĜĞĤĤ
ĞĜğğħ
ĞĜĞġ
ĞĜĥĠ
ěĞĜğĢĤ
ěĞĜğĞĢ
ěĞĜĞĞģ
ğĦ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
(¹Ɖ¹]³Yú
Øûňå5őÝ¥ŇŀĭłňŶ
ŚƅŵƀƊőŷśƊűŴŭŠŘ�ŏ
ŕ
��İœň��őê�Ř=ĴZŖŕĵńıŃIJŕ
ĞĜğĠĥ
ĞĜĞġĠ
ěĞĜĞĦ
ĞĜĤġĢ
ĞĜĠĞĢ
ĞĜğĞĠ
ěĞĜğğğ
ğħ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
(¹Ɖ¹]³Yú
Ø*ňºôőÖ0Ɖi/ňčƉ
�ùŘ�ĸijíôĸłĭŕ
Øûň¨KňÖ0őĻňčŘ�¼ŇâÄŐŕĵńıŃIJ
ŕěĞĜĞħĦ
ĞĜĠĠĢ
ěĞĜğğ
ĞĜģġĥ
ĞĜğĠġ
ěĞĜĞğĤ
ĞĜğĞĢ
ğĞĤ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
CoƉîYĶƉnĭőŔ
FŘŀİņĭĪ�ĔŃIJŕ�ŃĬ
ŕĵń
��ň��ľŘŃIJŕĽĴ©äĸŒĮń3ŏłĭŕ
ĞĜĞĥĦ
ěĞĜğĦħ
ĞĜğğ
ĞĜģĞĦ
ěĞĜĞġħ
ĞĜğģ
ĞĜĞģħ
ğĞģ
7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
CoƉîYĶƉnĭőŔ
FŘŀİņĭĪ�ĔŃIJŕ�ŃĬ
ŕĵń
ĭŀŐ�·ŃĬŕĵńŘkıĴłĭŕ
ěĞĜğğğ
ěĞĜğĠ
ĞĜĞĤ
ĞĜĢĢħ
ěĞĜğĠ
ĞĜĠġĥ
ĞĜĠġģ
ğĞĢ
7±_ĈÕÒňNµńņŕ
Ö0
ĘĭŨşƄńºôŇNŁijYú
ĘĭŨşƄńºôŇNŁij_
ĈÕ³Yú
ÁV³�~ŇNŁĭļrn�
XĪYúŘÝĮ
qOŘjŕļŏňñ�ůƊŪźƊŨŘ��ĺŕŨşƄıĬ
ŕěĞĜĞğ
ĞĜĞĦğ
ěĞĜĞĢ
ĞĜĞĞĦ
ĞĜĤĢĢ
ĞĜĞğġ
ĞĜĞĤĠ
Ġğ
7±_ĈÕÒňNµńņŕ
Ö0
ĘĭŨşƄńºôŇNŁijYú
ĘĭŨşƄńºôŇNŁij_
ĈÕ³Yú
�±ƉŢŚŇċĺŕ��ňqOŘ
;ďĸĪ×dŇĂ«ĺŕ
��ň7VƉ7±ŇċĺŕºôŘĪ�ÓőŮƅŵņŅňž
ůśŚİœ#yĸłĭŕ
ĞĜĞĞġ
ĞĜğģĢ
ĞĜĠĞ
ěĞĜĞĠĥ
ĞĜĤĠĠ
ěĞĜğġĤ
ěĞĜĞğĦ
ğğğ
¾�³ø�Ř�ļĺ
�ő�©ÏĒŘ©äĸĪ¾�³ø�Ř
$Įĺŕ
7±_ĈÕńĸłň¾�³
ø�Ř�ļĺ
Øcň-´ňļŏŇ7±_ĈÕ
ňL�őÆPŘ-«ĸņĭØ*ň-´ňļŏŇ��Ř-«ĸłʼnĭĴņĭńnĮ
ěĞĜğĦġ
ĞĜğġĦ
ĞĜğġ
ĞĜĞĦĢ
ěĞĜğğĢ
ĞĜĤħģ
ěĞĜğĠğ
ğğĠ
¾�³ø�Ř�ļĺ
�ő�©ÏĒŘ©äĸĪ¾�³ø�Ř
$Įĺŕ
�ő�©ÏĒŘWŕ
é±çĆő»ÅůƊŪň�ķřĪ
Ļň���ņ�Ėň�wŘÝŗ
ņĭ
ŮŨŰő>ēëEņŅŃĪ�ıĬĿłŐ��ŘÝĿłʼnĭĴ
ņĭńnĮ
ĞĜğĞĢ
ĞĜĠġĠ
ěĞĜĞĥĠ
ĞĜĞĠ
ěĞĜĞĥģ
ĞĜģĥ
ěĞĜĞģ
ġġ
¾�³ø�Ř�ļĺ
�ő�©ÏĒŘ©äĸĪ¾�³ø�Ř
$Įĺŕ
��qOňĂ+ņ-«ń�
õ
pÒňqOęŸƂŜŴŦƊŇċŗ
ŕqOŘBŎĚŘWÂĺŕ
ºŔjļ��ňÂ\ŘË^Ň£œĶņĭØ�ıĬŕ
ĞĜĠġĠ
ěĞĜğĢġ
ěĞĜĞģĢ
ĞĜĞĤħ
ĞĜğĦĦ
ĞĜĢĠĤ
ěĞĜĞğġ
ĥ7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ØcÈ©
�ĊŇ�¼ŃĬŕ
óÐƉ¤ÑƉYÑňĉS�.ŇʼnVŊļŏň¡�ıĭŀŐ
ŃIJłĭŕ
ěĞĜĞĥĠ
ěĞĜĞĠĤ
ĞĜĞĦģ
ĞĜĞğħ
ĞĜğħĤ
ěĞĜĞģħ
ĞĜĥħĠ
Ĥ7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ØcÈ©
Øûň�f¦tŇ®rĸĪÎ�Ɖ
A�ŘJŕ
Ø*ň�f¦tŇĭŀŐ�ŘăĿłĭŕ
ĞĜğĥĥ
ĞĜğĥħ
ěĞĜğĠģ
ĞĜĞģġ
ěĞĜġĢĦ
ěĞĜğĠġ
ĞĜģğĥ
Ħ7±_ĈÕÒňNµńņŕ
Ö0
7±_ĈÕňNµńņŕ��hwń¾
�³ŨşƄ
ØcÈ©
�ĊŇ�¼ŃĬŕ
Ø*ň�īňŨŢŧƀƊƄŘ¼YŇ}�ĸłĭŕ
ĞĜğĤğ
ěĞĜĞģğ
ĞĜĞĤġ
ĞĜğĤğ
ĞĜĞĤĢ
ěĞĜĞĥĦ
ĞĜĢĢĥ
àğĢƍ7±ŸƆŷŝŭŦƁŲƃũŽê�đ¶ňHU*�ňÊ�ę�ð�ƉƅźƄƎƌ
đ¶ĩĨ
*Ą
ĒM
ŞŮŤƃ
ţƊű
đ¶
HUöÙą
��4<
ËÁÂ�õn
�ĭ
��4<
Ë©}�=�Ì
��4<
ËďĠģĚĖĈĞ
ĦĒøõÂLÌ
�34<
Ë�A�>·Ì
�4<
Ë�´ñZ£Ì
��4<
Ë�zĪ���
¶�Ì
��4<
Ë�G�zÌ
�Xõ-Mą¥óàĀ�®èĂäñàðáĂ ÏÎ×ÓÐ ÏÎÏÖÔ ÍÏÎÐÐ ÍÏÎÏ×Ò ÏÎÏÒ ÍÏÎÏØÒ ÍÏÎÐÏÓ
�®õ�Xô�Rą�æóàĀ�âäñàðáĂ ÏÎÖÐÐ ÍÏÎÑÑÐ ÏÎÏÓ ÍÏÎÏØÔ ÍÏÎÐÏÐ ÏÎÐÖÕ ÏÎÏÓÑ
čĦīĝĩīČą!uôºüĂêüôöòÝæêĀÿÜß
�íïÜĂÏÎÖÏÖ ÍÏÎÏÏÖ ÏÎÏ× ÏÎÏØ ÏÎÏÕØ ÍÏÎÏÓØ ÏÎÏÔÑ
=� õ={ñ�Üô(ã1ÞĂÂ�ąn�æïÜĂ ÏÎÕÖÑ ÍÏÎÐÕ× ÍÏÎÐÔ ÏÎÐÏÒ ÏÎÐÏÒ ÍÏÎÏÒÓ ÏÎÐÓÑ
�"õ¨ÜêÜäñą±z�ô¹ùĂäñàðáĂ ÏÎÔÕ ÏÎÑÏ× ÏÎÐÖ ÏÎÏÐØ ÍÏÎÐÒØ ÍÏÎÏÖØ ÍÏÎÐ
xrþ�9ôMçê¨ »ÜþSHą.ĂäñàðáĂ ÏÎÔÓÕ ÏÎÏÖ× ÍÏÎÏÔ ÍÏÎÏ×Ñ ÏÎÏÐÓ ÏÎÐÔÕ ÏÎÐÏÕ
��õ�Jþ��¦ô¼UæóàĀÙ�"õQ¥ą�Jè
ĂäñàðáĂÏÎÔÑÓ ÏÎÑÓÖ ÏÎÏÓ ÏÎÐÔÕ ÏÎÏÑÕ ÏÎÏÐÒ ÍÏÎÐÒ
#BÆõñYì§ãï®ąèĂäñàðáĂ ÏÎÔÐ× ÏÎÏÔØ ÏÎÑ× ÍÏÎÏÕ ÍÏÎÏÑÓ ÍÏÎÏÔÓ ÏÎÏÕÓ
�"àäăßĀ=÷ùá¯ÉąúîãĂäñàðáĂ ÍÏÎÏØ× ÏÎÖÓÐ ÏÎÏÑ ÏÎÐÒ ÏÎÏØ ÍÏÎÏØ× ÍÏÎÏÐ
�¸õDj�ôûãïÙ�óôąèùáßàĄßĂ ÏÎÏÒ× ÏÎÖÑÑ ÏÎÏÒ ÍÏÎÏÐÒ ÍÏÎÏÐÒ ÏÎÐÔÑ ÍÏÎÏÐ
�¸õV¾ą�è= :õs*ô,'æïÜĂ ÏÎÏÖÕ ÏÎÕÔÔ ÍÏÎÏÓ ÏÎÏÓÑ ÏÎÏÐÔ ÏÎÏÒÕ ÍÏÎÐÒØ
=�©}ą�ïïéăą>¢èĂäñàðáĂ ÍÏÎÏÔÑ ÏÎÕÏ× ÍÏÎÏÖ ÍÏÎÐÓÓ ÏÎÐÐÒ ÏÎÐ×Ó ÏÎÑØÖ
ÊþEĖĒĘàóâïýeÚ=�èĂ�TàÛĂ ÍÏÎÏÐÖ ÏÎÔÐ× ÏÎÏÒ ÍÏÎÏØÕ ÏÎÐÕ× ÏÎÏØÕ ÏÎÐÕÐ
�Å õ+�ëãðöóâÙ67ðFÀåăïÜĂ��s*
þ��Ī+�ôîÜïÂLàÛĂÍÏÎÏÒ× ÍÏÎÏÕ× ÏÎØÔ ÏÎÏÖÑ ÏÎÏÏÐ ÏÎÏÏÑ ÍÏÎÏÓÒ
��õq�ĪĎćëãðöóâÙ67ðõ��s*Ī���
Ãs*ôýÂLàÛĂÏÎÏÑÔ ÍÏÎÏÑÖ ÏÎÖ× ÍÏÎÏ×Ö ÏÎÐÏÖ ÏÎÐÑÓ ÍÏÎÏÔÑ
+�dªĬ�ÅĪ«�Wĭ :õ��Ī��dªð�ÜïÜ
ĂC¿�ôîÜï�íïÜĂÍÏÎÏÐ ÍÏÎÏÐØ ÏÎÕÐ ÏÎÏÏÕ ÏÎÐÑÐ ÍÏÎÏÕÖ ÏÎÐÔÓ
67ðgĀèO�åĆõ{sąĉĢīđèĂäñàðáĂ ÏÎÏÕ ÏÎÑÏØ ÏÎÔÓ ÏÎÏÐÕ ÍÏÎÐÔÒ ÍÏÎÏÐÔ ÏÎÏ×Ó
ĄßĀóÜäñöĄßĀóÜñ²¡ô¨ÞĂ ÍÏÎÏÕÕ ÏÎÐÐØ ÏÎÏÒ ÏÎÖÑ ÍÏÎÐÓÕ ÍÏÎÐÏÓ ÍÏÎÏÏÔ
�ßĀõ^`þ¬�ą/ã?ăĂäñàðáĂ ÏÎÐÑÖ ÏÎÏÒÑ ÍÏÎÏ× ÏÎÕÒÓ ÏÎÑÏÓ ÏÎÐÏÑ ÍÏÎÐÐÐ
�¸õy5õ�&þéõÄ~ąo�ô¥�ýĂäñàðá
ĂÍÏÎÏØ× ÏÎÑÑÓ ÍÏÎÐÐ ÏÎÔÒÖ ÏÎÐÑÒ ÍÏÎÏÐÕ ÏÎÐÏÓ
�õp]ìąðáĂëãz§æÿÝñ)üïÜĂ ÏÎÏÖ× ÍÏÎÐ×Ø ÏÎÐÐ ÏÎÔÏ× ÍÏÎÏÒØ ÏÎÐÔ ÏÎÏÔØ
Üîýo�ðÛĂäñąLàãïÜĂ ÍÏÎÐÐÐ ÍÏÎÐÑ ÏÎÏÕ ÏÎÓÓØ ÍÏÎÐÑ ÏÎÑÒÖ ÏÎÑÒÔ
P8ąKĂêüõ±bėīĔğīĒąa�èĂĒċĦàÛ
ĂÍÏÎÏÐ ÏÎÏ×Ð ÍÏÎÏÓ ÏÎÏÏ× ÏÎÕÓÓ ÏÎÏÐÒ ÏÎÏÕÑ
hcõ+=Ī+�ôÂèĂ�´ąÙc�þĖħěóòõĢ
ėĈćßĀ�XæïÜĂÏÎÏÏÒ ÏÎÐÔÓ ÏÎÑÏ ÍÏÎÏÑÖ ÏÎÕÑÑ ÍÏÎÐÒÕ ÍÏÎÏÐ×
�"õ$�õêüô�ą$|æïöÜãóÜñNÝ ÍÏÎÐ×Ò ÏÎÐÒ× ÏÎÐÒ ÏÎÏ×Ó ÍÏÎÐÐÓ ÏÎÕØÔ ÍÏÎÐÑÐ
ĖĒĘþ0È2óòðÙ�àÛíïý�oą¢íïöÜã
óÜñNÝÏÎÐÏÓ ÏÎÑÒÑ ÍÏÎÏÖÑ ÏÎÏÑ ÍÏÎÏÖÔ ÏÎÔÖ ÍÏÎÏÔ
�āKê�õ�@ą�BôvĀåóÜ��àÛĂ ÏÎÑÒÑ ÍÏÎÐÓÒ ÍÏÎÏÔÓ ÏÎÏÕØ ÏÎÐ×× ÏÎÓÑÕ ÍÏÎÏÐÒ
³�Īw�Ī>�õÀ;f%ôö=÷êüõt�àÜîý
ðáïÜĂÍÏÎÏÖÑ ÍÏÎÏÑÕ ÏÎÏ×Ô ÏÎÏÐØ ÏÎÐØÕ ÍÏÎÏÔØ ÏÎÖØÑ
�"õ�IxSôÜîýpą¼íïÜĂ ÏÎÐÖÖ ÏÎÐÖØ ÍÏÎÐÑÔ ÏÎÏÔÒ ÍÏÎÒÓ× ÍÏÎÐÑÒ ÏÎÔÐÖ
�"õeÚõĒĎđģīĦą�>ô[_æïÜĂ ÏÎÐÕÐ ÍÏÎÏÔÐ ÏÎÏÕÒ ÏÎÐÕÐ ÏÎÏÕÓ ÍÏÎÏÖ× ÏÎÓÓÖ
¤ÐÓĮ+�ĝĨĜĊĕĐĤęĥēġ¬�Ç�õ4<"kõ�lËi°mĪħğĦįĭĬ\�ĭ
�
4<µ�½
�� höÂí³§=}Þ:;EÛø höÂí³=}Þ:;E¸t�½:¦qÑQLa
N\^WM!P_d� �Î=�»
�� höÂí³§=}Þ:;EÛø höÂí³=}Þ:;E¸t�½:¦qÑQLa
Ö°�°�ѥáå=Ì¢AÛø�ïv=�r�ãÅH¾1-Ú¢1
8'E
� x§�¡³«�dz«:=Ä��ñ Âí³:=ú���Ô Ç³«�Ô Æ³«:=�Ô<�m2E
��� höÂí³§=}Þ:;EÛø �'QLa:Ì¢<}7-¥Ã
�'QLa:Ì¢<}7-Âí³Ñ¥Ã
�'b[a=QLa:huÌ¢Hé 1�4FHÝ~
2E
��� höÂí³§=}Þ:;EÛø höÂí³=}Þ:;E¸t�½:¦qÑQLa
¡�zô¡·=��²È<õf1�
g ��±H¹E
á���höYcXJSP_V`R]âl�ì)B>������ =ÉuunçÕÒ�����"êÏ��b[a�#
�Éuhuähun
�Éuðuä ˼ ®¼
������ ������ ��� �� �����Êjk��¸{|�=�Í#
���� ���� $����� ���� ���� ��
Ê×k���pÑu¬�
��� �� ����� ��� ��� ���
Ê�k��N\^WTIZaQ?=|µ�
���� ���� $����� ���� ���� ����
Ê�k��°�Ñ¥Ã�
�� ��� $����� �� ��� ����
�k��̢:��
��� ���� ���� ���� ��� ������
Êûk��ùô�¦qÑÁÙ�
���� ���� ���� ���� ���� ���
Ê£k��¡�zô�
���� ���� ���� ���� ���� ��
������ ��� ��� $����� ���� ���� ���
� �
Êjk��¸{|�=�Í� �ì� ���� ������ �� �
Ê×k���pÑu¬��ì� ��� ������ �� �Ê�k��N\^WTIZaQ?=|µ��ì�
�� ������ ��
Ê�k��°�Ñ¥Ã��ì� ��� ������ ����
Ê�k��Ì¢:����ì� ���� ����� ����Êûk��ùôÑ�¦qÑÁÙ���ì�
���� ����� ����
Ê£k��¡�zô���ì� ��� ������ ���
��ÕÒ"���ì# ���� ������ ����
k�ë ������ :=Ä||� ´ó¼�º�e�
�"×àê��Ð#
Éu�un
©Ó�k�
¥Ã9ßò:0FE9&G(Ì¢A�HØ ¬Õ18'E
��Ñ;¿w¬yH·<6.8'E
á��höYcXJSP_V`R]âl�ì=k�åÀ=�o<BD¯s0F5�ì�êÏ��b[a%#
�ì
á���höYcXJSP_V`R]âl©Ó�êÏ��b[a%#=������ :=Ä||�)B>´ó¼�º�e�º�
�ì�� åî ÷i KTO` N!U
¼ç
�"×àê��Ð#
Ī=üH¨C3<���-æ-/:+9,E¤Ü=�kH¶DèD�4=�<w*2/:+9,EÆun=u¿:=¸{|�H(@-�Í2E/:+9,E
58
( =0.86) ( =0.63) 17 30
0.90
× 1
2 2
1 N
2
o N
(1)
1)
― ―
2016 3 4 ― 9
2)
B ― ― 35 ― 352 v C
83 N 35 ― ―
N
N ― N
N N ― N
N C IPE
N N
3)
C ―
― ―
N
N × ×
N 2 50 N N × 259
v ― 2015 2016 N ―
N ―
59
50 2
N 1 1
× N 1 2
1 N
N 7
N 3 7
17 50 N N 18
50 22 N
N × 3 7 21
4
50
(5 ) (4 ) (3 ) (2
) (1 ) N
N 2 ×
― × N N
N P-MEX(Professionalism Mini-Evaluation Exercise)37
43 5 P-MEX 4 24
5
3 8 P-MEX
(4 )
(3 ) (2 ) (1
) (0 ) ― N
(4 ) (3 ) (2
) (1 ) N
4)
N t (Welch )
N
Ė���kĴWcV@LG^Q`JZėrĤ�ġö²�bXa����Ĥ�
E�P AMF` Ķl ěĦ
� Ø�7IJÖ.q!%¡ī��7óÿ=Ê:�,�+�: þæ-ç�7¡ī��
� ̧��ĭ=Ý.(�*�:
� K�G\a[N?>.Ęá.��:Ā©= -�
� ĨÞ�8Úį�;�į9.�;*�:o=(�-��Úį+�
:Þ+�:�,
� <�8-��,0<�8-�,��.¡�: ôý���=Ğ(
Âě/�¨Øó.�(6�=Č'*�:ÂÝ/�¨Øó.ijh �j¾�¦Õ=ß:
¬��pÍ�ÆÍ/z¹¿¯.0�1%5/Ïē��(6+�*�%
� Âě/Ć�/IDH]�a=�Æ.Ċe *�:
� Ðòģ/Þ,ñ&x�*ĸ=":�,�+�:
�� ëË/Ďq=�-�8wĸ":�,�+�:
�� ëË/ĸ=É8#.±���Ĝ��,�+�:
�� wĸ/ëË.��=Á -�8Ĝ��,�+�:
�� ½�7ÓMIO�-�*6Ć��Í":Í���'%èĥÙ, *�ïý.�Í":�,/ĔĬá=ć
à *�:
�� ��v=IJ**$;=ƫ":�,�+�:
�� ÂÝ/ÒĮì.4�*�°-.="2���<�:
� ÂÝ/âø=í"�ą{/�Ă.·s *�:
� ×. Ø.Ģî -�¦ÕÛ=6'*�:
�� ðÞ�8/¼ü7ėr=Ì�ĩ;:�,�+�:ÂÝ/¡Ă7«i.(�*/U>bT]�7
V?�PSLC=�5:
�� ÂÝ/ ´/ĉķ7$/¢y=ã�.�å6:�,�+�:
�� Äċ/�n=Ü9ĝ9�$/¤.��"�,�+�:
��� �tÑ/Đg=÷�%k��kĴôÃ=Íă *�:®�bXa/IBa,k�ôÃ=о �$;=
č�":
���mďý-Å�.(�*�ĕÏý-ÀĴĠ�D>/ğĠ=ô'*�:
¥ı/ĵ��¥uý-D>=û�":
��� ÀĴ�D>=«�³/fê�Ğ/�ġý-ª�ğ=İx *�: fê-kĴ=û�":
�()��
�Ĥ� ��8���3+0bXa�ö²+6¸Ī %�úĤ����đ0bXa�ö²ĄÂ/Ĥ
Ĥ�
Ĥ }ā":kĴWcV@LG^Q`JZ|Ĉ
kĴèĥÙÈ/�Ē,-:ĉķ
kĴèĥÙ/�Ē,-:Þ~�â,ÇwýIBa
Ęá�äÆ��»�79
Ęá/�:«Ă�ćÃ=Ğ(
£�İ¿�.ã�+�:
EY]RD�G^d�Î
¥uý-EY]RD�G^d=«�
�õ/ºà
B\`>W_d=µâ Æ«": �ï�Í�B\`>zč
èĥÙ, *âø=ï�:�,=ù��5:
ąÔ�Ô¶ýÆéÂě/ôÃ7ĉķ�ħ�/¢y�ęî=ã �ć
à *�:
®�IBa,ôÃ.�)�èĥÙýÆé
®�IBa,ôÃ.�)�Æé
Ş����Ƅr�qUf_zk|awş�ÛŲ!Ůļà�~s}���ÛŲ"!89*"
\ j Xg]| ƅ� ŦŴ
�� ¦ù@���PØƂ/4ñƄ�[R@ŬĕPÇň1M-<);*M
¦ù@����������!Ôţ�ÆÕ>Čij"PáĴ?ÜGM-<?ñƄ�[R@ĈŃPņ:M
�� ¦ù<ÁPĺ+4G@ŅƆP/:$M
¦ù<@ÁIn ik _frP¡Ɓ/4ĉ;ñƄ�[RPĿ¶1
M
� ¦ù?<7:O(LI1+�(8ě/$ģűP1M-<);*M¦ù?O(LI1$�ě¡>ċūĿ¶IģűPÙ
%
�� bX�jWplW�@�ėIûìPſ�/:$M¦ù)İ@�çI�ƄĥųĎ@�ÊPŨ+-<P
įĄ1M
��òŦ@õŕIv`A�éŌù?ŪE�.2?ūÞ/:$M!ūÞ1M-<);*M"
ÑL)#74<*?AĞ÷?úâ1M
b}q[RIV�n�x�i@�œ?8$:ģű;*Mb}q[RPê��V�
n� 1M
�� ¦ù)�èÅľ1M@?ŝż>ċūPĿ¶1M-<);*M¦ù)òÎÅľ;*MJ
%?ê�1M
��¦ù)òK£Q5L�ĸôPō4L;*MJ%?«OM-<);*M
ĸô@ ō�RjoR{�`!\�\ d�`"
Pê�1M
�� ¦ù@�ķ©IĜ¥ŖÄPđ+ĸMJ%?ŅG:$M¦ùª@ÌĖŀŧ�ŀß���ķ©PįĄ1M
� ¦ù@²ï6IØ&>=PŸĩ/>)K¦ù<«O7:$M¦ù@§ċPſ�/:�è$IL@#MÙŊP<
M
� İĎý<@Ėª«ÁP%D+Öĺ1M-<);*MİĎý<@¸ʼn?ä�1
M
�� İĎý@�ķ©Iďœ@�$PįĄ1M-<);*M�>M�ķ©IďœPï74Ė<¸ʼn1M
��e w?',M| d _frPŘ¯1MC*Č¼I�3@<L(4)Ŧ(M
e w@��</:| d _fr�ĠŒP<M
� İĎý@ĸôI`Y}�ĥųęPſ�/�ĪĶ1M-<);*MİĎý@ĥųęIŔƆPÊğHM-<);*M
��ŋ0Ďý@Ĥŗ�ŋƃ<�ñƄ�[R@#LŬ?8$:µƋ1M-<);*M
ŋĎý@`Y}��ķ©�ŔƆ?Ã�PŤ%
�� ò!ŋ"Ďý@ŋƃ<�Ï$?ć,Ý&M«ÁPÖĺ/:$Mŋƃ?^t i�Rjm
T`P1M
� ÐŗB@éŌ�»�?ğ¾ŀ?«OL4$<è%ÐĔ@»�Ix�c P
�*þ,M
��T�_h�i�RZ_h�i~t iPĿą1M-<@�´Pſ�/:$M
Ĩč@ö�Ħ��ħ¥Ŋ?ăî1M
�ħ>�Ƅ@Ŀ¶<3@ĘĔ
Ĩč¨¹@ĚŜ
� �řæů?IJ/:òē@ĥųęI¥ŊPģű;*MÓĀ<òĎý@ÁPºGM¥ŊPÙ%
òĎý@ĥųĎĂĵB@±ī�ÚÈ
�Ĺ�@Ŏę?9$:ł�.N:$M�ƄIũÆ¥Ŋ�ţí?8$:ĸ7:$M
Ĺ��Ƅ�ũÆ�ţí@¥Ŋ?®Ź1M
Š���@ũÆ��Ƅ�ţíëĢ;ʼn+ĥųĎ@°Ŕ�ŵ¤?8$:ĸ7:$M
Ĺ��Ƅ�ũÆ�ţí@ĥųĎ�ëĢ<@ƉÂP
đGM
òē@ĥųĎ</:@ŘË)�æůIø�?Ź&M�½@Ĵ*.Pſ�/:$M
u`xhSRB@Ğ÷�Óě>IJ�
u`�xhSR@žŻ<ċūĿ¶@#LŬ
� ÷ÿŇ;ĸLō4¦ù@ċūP�ŷĖI�Ĭ>=?ƌ.>$¦ù@ċū�r{Tm_ ?«OMċūP¬F�Püś1M
ÌĖċū@Łġ>žŻ<ũÒ
��ƄĥųĎ@ÉĆ*PžŻ/:ŢĪ�>ž�Pō>$!ĝŶ�ø(K@ťš¶ŹŇ"
òÎ@ž�@4G?�ƄĥųĎ@Ĺ�IƁĊPž
Ż/>$
¦ù(Kúƈ�ÀšPń.N:HÍó;*M¦ù(KŢņ>ūāIú
ƈPHKO>$
� ĒƄ³Ɗ?³ő1C*ŐźPſ�/�ŀ¡?³ő/:$MĒƄ³Ɗ?ŀ¡>ŐźP³/�¡÷?ũĮPÙ%
�ĎĊ@�?'$:H�ƄĥųĎ</:@ò¢Pï6ĭ,M-<);*M
¿Űðª�?',MĥųĎ</:@ĠŰ
�ÛŲ���(K���D;A~s}�ļà;HåŻ/4·ĽÛŲ���ŚA~s}ļàŏò@ÛŲ
ÛŲ��
ÛŲ �ņ1M�Ƅr�qUf_zk|aw�œ
ø�ŀĠŒP�41
\vylgS�ĥųĎĂĵ�ø�B@ÚÈ
ŭIƇſ×ƅPſ�/�ø�ŀĠŒPħ%1M
�ƄĥųĎ</:@ø�ŀĠŒP�41
Ĺ�@ũÆ�Ƅţí¥Ŋ?IJ1Mſ�<ÚÈ
¦ù�òĎý�ıĎý<@ĪÏãŻ
�¦ùĻĐ@[R@Ŀ¶
ĥųĎ<@ƉÂ�¸ʼn
ıĎý¸ʼn
òĎýʼn
¦ù@òƀęPÜGM�ê�1Mʼn*(,
¦ùĻĐû´
�Ėª</:@¦ùPſ�/�«OM
62
N P-MEX 2
N P-MEX 2
×
N Cronbach’s
coefficient N
IBM SPSS Statistics 22.0 N p<0.05 N
5)
(2)
1) : P
― 166 ( 46.0 ) C
74 89.2% 19 48.3%
51.7%
�'/?���!�3�����$20()-%=���;:79(>
�� 4658< 2 #
��;�� � =�����> ',) ,.&.
1�� "*�� -* )'&(
�� �� ''* *.&)
� '(( +'&-
20 50 IT
N 3 N
4.58 0.69 219
N 4.42 0.62 224
4.34 0.80 225 N
4.49 0.77 226
4.37 0.80 5
ÓĎČž-ūŷŪŒšřųŦŴŜůà�ƱļA�ăÛż�ä�źŶŬŵſŽ
Ʊ
ėĖƱ
Z?�
Ĝ� �V
F�
ź\*�ėě²þ
č ¤�ņ¾CĻfĬİÚÏóĠņo]ō2ŊĩĸĥķĦŊ ĐċČĕĜČċĒđ ČċĒČ
Ď Y[Ġ�ĈōîĻĴĨĶĠŊ ďċččĜČċĕĐ Čċđď
ď ŞŻřűŵŰţŐŏĻ8iĻ�ĨŊv¼ōīĺĠ ĐċđĔĜČċĒĕ Ċ ČċĎĎ
Đ 0Ĥň�ćĪŋĝćʼnĻĪŋĶĠŊ ďċđČĜČċēĔ ČċđĔ
đ ŌĤňĺĠĩĸĽŌĤňĺĠĸçÑĻÚĢŊ ĐċČđĜČċēĒ ČċďĎ
Ē Í!ļ�^¤oĻĠĴŅ�ōõijĶĠŊ ďċđĐĜčċČĐ ČċĐē
ē èÃź¡ÄźLÄļüH�$ĻĽIľİńļ �ĥĠĴŅķĦĶĠİ ďċČđĜčċČē ČċđĐ
Ĕ Í!ļ�ĞļśŘŚŲŻŵō´LĻu{īĶĠŊ ďċđĎĜčċČč ČċđĐ
ĕ "OĄļĸtIJÙĨĶâōĭŊĩĸĥķĦŊ ďċĐĕĜčċČď ČċĐđ
čČ ²sļ1fōÖĺĥň âĭŊĩĸĥķĦŊ ĐċČĒĜČċĔĐ Čċđđ
čč ²sļâōôňĮĻ��_ħÇħĩĸĥķĦŊ ďċĔĕĜČċĕč ČċĐĔ
čĎ âļ²sĻ�nōµīĺĥňÇħĩĸĥķĦŊ ĐċČĔĜČċēĒ ČċđĒ
čď áĉņTŢśŤĥĺħĶŅ�ĞIÄĭŊÄpĥğijİ ĎċĒČĜčċČČ ČċĐĕ
čĐ IÄÛ©ō¾ĶĶįŋōLÒĭŊĩĸĥķĦŊ ďċČČĜčċČĐ ČċđČ
čđ ÍîļQ��ĻŃĨĶĝĺĻōĭŀĦĤĥŌĤŊ ďċĎďĜčċČđ ČċĒď
čĒ Íîļrúō�ĭI�Dļ�+Ļ/'īĶĠŊ ĎċĕĕĜčċĎč Čċđč
čē XĻ¥¤Ļ�íīĺĠ6�dōŅijĶĠŊ ďċđĎĜČċĕđ ČċđČ
čĔ �Ĥňļx}ņà�ō3ĨNŋŊĩĸĥķĦŊ ĐċČĎĜČċēĐ ČċďĐ
čĕ Íîļ¥=ļÌ&ņįļÿªō�´ĻÖ½ŅŊĩĸĥķĦŊ ďċĐĔĜČċēĒ ČċĐĐ
ĎČ G~ļ.9ōyʼnñʼnĝįļbĻ�ĤĭĩĸĥķĦŊ ďċēĕĜČċēĐ ČċĒē
ĎČč �º�ļÀ:ōìĢİ-Iź-³êōÄcīĶĠŊ ĎċĎēĜČċĕď ČċĐĎ
ĎČĎ �ίĺ«jĻĴĠĶĝ� ¯ĺ��źŘŏļ��ō³ijĶĠŊ ĎċĔĕĜČċĕĐ Čċđđ
ĎČď �źŘŏōÒġāļJ�´�ļA�¯ĺÅĢ�ō¦ÙīĶĠŊ ďċĎĐĜČċĕČ ČċĒĔ
ĎČĐ jÆļĚęĘōÅqīİ�źŘŏļ�øō�ÜĭŊĩĸĥķĦŊ ďċďēĜČċĕē ČċĒĒ
ĎČđ jÆĸ�ćþ�ōÁħİńļ)&ōīĶĠŊ ĐċčĔĜČċēď ČċđĐ
ĎČĒ jÆĻĸijĶŌĤʼnņĭħĝĤĴ�īĠã�ōĭŊĩĸĥķĦŊ ďċĐĎĜČċĕĒ ČċĒč
ĎČē ŝ଻ŔũŧŔŹļm;ņ��ō¦ÙīĶĠŊ ďċĔēĜČċēĒ Čċđđ
ĎČĔ Í!ļG~ņŮśĽĝxSÆĻ,łĂĪĮĻB7īĶĠŊżB7ĭŊĩĸĥķĦŊŽ ĐċČĐĜČċēĐ ČċĐđ
Ďď ŝŵŪŘŏņœŹŨŸŰŹŤļ�gĻĴĠĶã�ķĦŊ ĎċĕĒĜčċčď Čċđď
ĎČĕ jÆĥmh�KĭŊļĻeÕĺkBōz�ĭŊĩĸĥķĦŊ ďċĐĎĜČċĕ ČċĒē
ĎčČ jÆĥÍňIŎıʼnĝ³êōcİʼnķĦŊŇġĻþŌŊĩĸĥķĦŊ ďċĐĎĜČċĕ ČċĒĒ
Ďčč jÆļ��Øņ§�Ë�ō�ħ³ŊŇġĻ)ńĶĠŊ ďċĕĎĜČċĔč ČċđĎ
ĎčĎ jÆļ�wIJņÅĢĺĹō�līĺĥňjÆĸþŌijĶĠŊ ĐċČĎĜČċēĔ Čċđē
Ďčď �È»ĸļýþ�ōġŁħ�ÁĭŊĩĸĥķĦŊ ďċēĎĜČċĔ ČċĒē
ĎčĐ �È»ļ��Øņ�gļòĠōRöĭŊĩĸĥķĦŊ ĐċČČĜČċēĒ Čċđē
Ďčđ ŠŻůĻģĨŊŴŻşŻřšūō®|ĭŊŀĦ¤�ņĝįļĸʼnĤİĥ!ĤŊ ďċčĔĜČċĕđ ČċĒĕ
ĎčĒ �È»ļ³êņśŖŵĝPûiō¦Ùīĝ²åĭŊĩĸĥķĦŊ ďċĒēĜČċĔĔ ČċĒē
Ďčē 5ĬÈ»ļ�ïź5�ĸĝ�źŘŏļğʼn�ĻĴĠĶëæĭŊĩĸĥķĦŊ ďċđēĜČċĕĐ ČċĒĒ
ĎčĔ Íż5ŽÈ»ļ5�ĸĝ�ĠĻ(Ĩ4ĢŊþ�ō�ÁīĶĠŊ ďċĔēĜČċĔČ Čċđē
Ďĕ bïĿļxSź�ÊĻ½�¯ĻþŌʼnİĠĸhġ ďċĕĐĜČċĔĐ ČċĐč
Ďčĕ őŹřţŹŤźŏŗřţŹŤŶŭŻŤōz ĭŊĩĸļmÃō¦ÙīĶĠŊ ĐċĐĎĜČċĒĎ Ċ ČċĐČ
ĎĎČ �ÎW�ĻOīĶÍîļPûiņ�+ōã�ķĦŊ ďċĒĎĜČċĔĕ ČċĒđ
ĎĎč >@ļ£iĻAĵĠĶUüĪŋĶĠŊ-ņ���+ĝ¹¸ĻĴĠĶ³ijĶĠŊ ďċčĐĜčċČĎ Čċđĕ
ĎĎĎ ¬Ā�Dļ��ź-ź¹¸�Þķ�ħPûÈļ�Ìźa%ĻĴĠĶ³ijĶĠŊ ďċďĐĜČċĕĕ ČċĒĐ
ĎĎď ÍîļPûÈĸīĶļ®ÚĥĝW�ņ· Ļ�ĢŊ`ąļEĦĪō¦ÙīĶĠŊ ďċĒďĜČċĔĐ ČċĐĐ
ĎĎĐ LÄ¿ķ³ʼncİjÆļkBōĝ0ņM�ĺĹĻâĪĺĠ ĐċďĐĜČċĔČ Ċ ČċĎĎ
ĎĎđ -PûÈļÉ�Ħō#¨īĶ�²fĺ#°ōcĺĠżÔÐ ·Ĥňļ¢8��¿Ž ĐċĐĕĜČċēē Ċ ČċďĔ
ĎĎĒ jÆĤň鶟÷8ō�ĪŋĶŅ<ðķĦŊ ĐċďēĜČċĔČ Ċ ČċĐč
ĎĎē ßÝùĻÝ�ĭŀĦ�Nō¦Ùīĝ¯´ĻÝ�īĶĠŊ ďċĒĔĜČċĔĎ ČċĒČ
ĎĎĔ ÈCļDĻģĠĶŅ-PûÈĸīĶļÍ×ōwIJÂĨŊĩĸĥķĦŊ ďċēďĜČċĔĎ Čċđč
64
IT 3 r=0.22 224 r=0.22 2
r 0.3
2) ��� 2 ��� ������������
2
IT 0.3
19
31 8 21 22 KMO 0.886 Bartlett
p<0.001, 2=3794.1, df=465 8
P-MEX 2 23
7 P-MEX 2
C
P-MEX
2 P-MEX 2
24 P-MEX
2 0.28 0.59
0.59 P-MEX
2 0.33 0.60
2 0.71 0.87
24 31 0.93
Ó�@O
ĪR!ŞĊţĨ
ňżŴ��Ʀ
Ó@O
Ītß�oţż
Ŵ��ī
Ó�@O
Īõ¼ÃPÝī
Ó?@O
Īđ�ƨ4�ī
Ó�@O
Ī Ĝĝ�ţ
Öī
Ó$@O
ĪŽƗƛƌƈŵƔ
ƟƂŦţĝoī
Ó�@O
Ī�¹ŅÌ�Ã
ĉ�ī
Ó"@O
ĪÈXÃTČī
ıįij
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
tß�o�Ü
tßţńĿłłĬľĿŁŃŀƥeÎƣ�fš´
yƦŲ�LŢĨũůպިÁƣżŴ
ţ±¯Ųiŝů
tßţĽļĻŲÞ{Œŗ¨ÁƣżŴţ�ęŲ�öŔůŐşŌ
Şōů
įĭĸĵĴ
įĭįķį
įĭįıķ
Ĭįĭįįij
ĬįĭįIJİ
Ĭįĭįįķ
Ĭįĭįİı
ĬįĭıįĴ
ıįIJ
3ÁZĚáßţGÅşšůå
,
ĨňƂźƟşÉĄŢGŜŎT
Č
ĨňƂźƟşÉĄŢGŜŎZ
ĚáÃTČ
R!š3ÁŲ��Ŕů
¨ÁƣżŴŲìʼnĠţR!Ê�ţG�ÚÞŊ�Ų¹óŒ
ŝňů
įĭķijĵ
ĬįĭıIJĶ
Ĭįĭįĸį
įĭįijĴ
įĭİĴķ
įĭįĶIJ
įĭİIJĸ
įĭįİĶ
ıįı
3ÁZĚáßţGÅşšůå
,
ĨňƂźƟşÉĄŢGŜŎT
Č
ĨňƂźƟşÉĄŢGŜŎZ
ĚáÃTČ
/·ţèňŅ/�ÚżŴŲ��Ŕ
ů
�çÚ¿tŢśňŝŅ¡Ãš¨Á©ƣżŴţ�©Ų
ÉŚŝňů
įĭĶĵį
ĬįĭıĴĵ
įĭİıı
įĭįįį
įĭįIJİ
Ĭįĭįĵķ
Ĭįĭįĵĵ
įĭİĵĶ
ıįĵ
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
tß�o�Ü
tßŢűŋŮūŔňŅ£ÊšuH�
�ūþ�Ųìʼn
tßŢşŚŝűŋŮūŔŎŅŋś£Œňþ�ŲŔůŐşŌŞ
ōů
įĭĴĶIJ
įĭıķIJ
ĬįĭįijĶ
ĬįĭİĵĴ
Ĭįĭįįķ
įĭįıİ
ĬįĭİıĴ
įĭıįĸ
ıįĸ
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
tßţælsŲĨũůŅ�
�Ŕů�ōŋŏ
tßŌæa§SŞōůŬʼnŢ��Ŕ
ů
tßŌwr§SŔůţŢpðšuHŲ��ŔůŐşŌŞō
ůįĭĴIJĴ
įĭIJİķ
įĭįįĵ
įĭįıĸ
Ĭįĭİİĸ
įĭįĵı
Ĭįĭİijĵ
įĭįĵij
ıįĶ
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
tß�o�Ü
tßŌ�ţ3cū3ÁZĚáţw
ñŲàŎŐşŲ[ĕŔů
ƄŹƢƊŸƑƌŸƢţwBū��Ų¹óŒŝňů
įĭijIJij
įĭıĸı
įĭįĴĴ
ĬįĭįİĶ
ĬįĭįijĶ
įĭįĵIJ
įĭįĸĸ
ĬįĭİĶį
ıİİ
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
� ĜşŒŝţtßŲ¹ó
ŒŅĝűů
tßĜţ� Ã�2Ã`¾Ņ��
òŲ[ĕŔů
tßţ��òūºªä�Ų«ŎÉůŬʼnŢ.ũŝňů
Ĭįĭİijĸ
įĭķĵķ
įĭįĴį
ĬįĭįIJĵ
įĭįĵĸ
įĭįIJĴ
ĬįĭįIJı
Ĭįĭįĵı
ıİı
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
� ĜşŒŝţtßŲ¹ó
ŒŅĝűů
tßţxuŲ¹óŒŝŅrňūŮţ
Ňůì0Ųşů
tßţ¥�řūÞŊšŠŲvŒšŌŭtßşĝűŚŝň
ůĬįĭİıĴ
įĭĶIJIJ
ĬįĭİĵĴ
įĭįĶı
įĭıįķ
įĭįıĸ
įĭįĶį
įĭįIJİ
ıįĴ
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
tß�o�Ü
tßşţ�Ħĝ�ūƎƤƉƋƤƀƇ
ƓŲÊÒŒŗ�ިÁĮżŴŲ��
Ŕů
tßş�Ħĝ�ŲÖŎŗũţ.,ŲŒŝňů
įĭıĴIJ
įĭĵĶķ
ĬįĭİİĴ
Ĭįĭİıĸ
įĭİıij
ĬįĭİİĴ
įĭİĶİ
ĬįĭįĴĵ
ıİį
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
tßţælsŲĨũůŅ�
�Ŕů�ōŋŏ
ÉĄţ¶nŅŴƊƏŴƝƢƂƥŽƢ
ŽƤƆƢƂƦŲ��Ŕů
tßŌæŭPųŘŮŅÉĄŲnŗŮŞōůŬʼnŢĝűůŐş
ŌŞōů
įĭįĶIJ
įĭĴIJį
įĭİIJĵ
įĭİĴĵ
ĬįĭİĴĸ
įĭįĸĵ
Ĭįĭİįĵ
įĭįĵIJ
İIJ
3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
ØÙPÝƣźƚƞŴěÂ
ZĚáşŒŝØÙÃŢPÝŔůŐş
ţpðsŲûĄŒŝňů
ùħū]ƈƂƉŌšŎŝŪ�ņPÝŔůÝzŌŇŚŗ
Ĭįĭįıĵ
ĬįĭįIJij
įĭķIJı
ĬįĭįİIJ
įĭįIJĶ
įĭįıĵ
ĬįĭįIJIJ
ĬįĭįIJij
İij
3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
ØÙPÝƣźƚƞŴěÂ
źƚƞŴƓƝƢŲ�|ŒTìŔůPÝõ¼ŲÒŝŝŖŰŲTìŔůŐşŌŞōů
ĬįĭįĴĵ
ĬįĭİĶIJ
įĭĶįIJ
Ĭįĭİıİ
įĭİıĴ
įĭİĶİ
įĭįİĵ
įĭıįij
Ķ3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
æaÕ¹
�ĜŢ£ÊŞŇů
ĂÜƣ®ÝƣTÝţěN�*ŢŤPťŗũţ�ŌňśŪ
Şōŝňŗ
įĭıİķ
įĭįijı
įĭĴijij
įĭįĶij
ĬįĭįİĶ
Ĭįĭįĵķ
įĭİįİ
Ĭįĭįĸı
ķ3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
æaÕ¹
�ĜŢ£ÊŞŇů
æ&ţ�ņţƂżƁƛƤƟŲÊTŢ��Œŝňů
įĭİįİ
įĭİĶı
įĭijıIJ
įĭİIJį
ĬįĭįįĴ
ĬįĭįijIJ
įĭįĶĴ
ĬįĭįķIJ
ıİķ
tßƣæáÐƣKáÐşţÇ
��»
ZĚáşţđ�ƣ4�
æáÐ�
:�ŢſƖƤƉŅŴƊƍŶƂŲŔůæƥ:ƦáÐţ:�şŅ�ňŢ-ŏ9Ŋůĝ�Ų ÖŒŝň
ůĬįĭįıIJ
ĬįĭįĶķ
Ĭįĭİİį
įĭķĶį
įĭİIJĸ
ĬįĭįIJĵ
įĭİİĵ
Ĭįĭİįĸ
ıİĶ
tßƣæáÐƣKáÐşţÇ
��»
ZĚáşţđ�ƣ4�
æáÐ�
:áÐţƂźƟŅ��òŅå,Ţ�
wŲ�ʼn
:œáÐţ Ďƣ:�şŅ¨ÁƣżŴţŇŮ�Ţśňŝąā
ŔůŐşŌŞōů
įĭįĴĴ
Ĭįĭįijķ
įĭįįĴ
įĭķIJIJ
ĬįĭİıĶ
įĭįijĶ
ĬįĭįijĴ
įĭįĵı
ıĸ
tßƣæáÐƣKáÐşţÇ
��»
ZĚáşţđ�ƣ4�
æáÐ�
mĒţ�ãūƙƢƅƤŲgō8ŏůmĎŦţ�\ƣ�ãŢÑ�ÃŢĝűŮŗňşrʼn
Ĭįĭįķİ
įĭįķİ
įĭİĶĶ
įĭĴıĵ
įĭİIJĵ
Ĭįĭİijĵ
ĬįĭįĵĶ
ĬįĭİİĶ
ıİĵ
tßƣæáÐƣKáÐşţÇ
��»
ZĚáşţđ�ƣ4�
KáÐ4�
�áÐţZĚsūå,ŲñÑŪů
ŐşŌŞōů
�áÐţÉĄūƂźƟŅZĚsŲ¹óŒŅÇĀŔůŐşŌ
Şōů
įĭİįı
įĭįĴı
ĬįĭįĴı
įĭĴįĸ
ĬįĭįĸĴ
įĭİķIJ
Ĭįĭįİĵ
įĭİIJĸ
ĸ3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
ŽƗƛƌżƤƀƜƢ�í
/�ÚŽƗƛƌżƤƀƜƢŲìʼn(Yģţ ş~řóŏŝúŲŔůŐşŌŞōů
įĭįIJij
įĭįįĶ
įĭİįķ
ĬįĭįIJĸ
įĭĶijį
įĭįĴķ
įĭįıij
ĬįĭįĵĶ
İį
3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
ŽƗƛƌżƤƀƜƢ�í
/�ÚŽƗƛƌżƤƀƜƢŲìʼnÇ}ţ7qŲñšŌŭ�úŔůŐşŌŞōů
Ĭįĭįįĵ
įĭıĸIJ
ĬįĭİIJĵ
įĭįĴķ
įĭĴĶij
įĭįĶij
ĬįĭįĴĵ
įĭįĶĵ
ij3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
=sƣüTőƣrňūŮ
>ŲśŋšňŅ�ĦŞōů ŞŇů
Őş
6 ŋŭ�ĦőŰŅĦŮŢőŰŝňů
įĭįıĸ
įĭİĶĸ
įĭİĸIJ
įĭİĸij
įĭĴįij
Ĭįĭİĵķ
ĬįĭįĴĶ
įĭįıİ
ııİ
Ì�Ãĉ�Ų�ŗŔ
ŽƗƛƌƈŵŅZĚáĢAŅÌ
�ŦţĈµ
EFţ��3ÁÎͪ0Ţ
YŔů¹óşĈµ
EF3Áƣ��ƣÎÍţª0ŢW�
Ŕů
EFţ³sŢGŜňŝ^ěőŰŝňů3Áū��ª0ŅÎ
ÍŢśňŝÉŚŝňů
įĭįIJį
ĬįĭįıĶ
įĭįijIJ
Ĭįĭįİį
Ĭįĭįİİ
įĭķķĵ
įĭįįķ
Ĭįĭįĵĸ
ııı
Ì�Ãĉ�Ų�ŗŔ
ŽƗƛƌƈŵŅZĚáĢAŅÌ
�ŦţĈµ
EFţ��3ÁÎͪ0Ţ
YŔů¹óşĈµ
EF3Áƣ��ƣÎÍţZĚáƣ�
÷şţđ�Ų«ũů
Àğ�Jţ��ƣ3ÁƣÎÍ�÷Ş�ŎZĚáţ¢åƣk+
ŢśňŝÉŚŝňů
įĭįijı
įĭįIJĸ
įĭįĵĸ
ĬįĭįĸĶ
įĭįIJĶ
įĭķİį
įĭİijIJ
Ĭįĭįĵĵ
ııį
Ì�Ãĉ�Ų�ŗŔ
ŽƗƛƌƈŵŅZĚáĢAŅÌ
�ŦţĈµ
æáÐţZĚáĢAŦţd
_ƣĈµ
#ëşæáÐţ�Ħĝ�Ųhũů
ª0Ųìʼn
�çb¤ŢYŒŝæčţZĚsūª0Ųþ�Şōů
įĭįıį
įĭİİij
ĬįĭįĴĵ
įĭıķij
įĭįĴĵ
įĭijįı
ĬįĭįIJĸ
įĭįĶĶ
ııĴ
Ì�Ãĉ�Ų�ŗŔ
©ū�¹ÚĥŲ¹óŒŅÌ
�Ãĉ�Ų!ʼnŔů
3ÁZĚáşŒŝţÌ�Ã
ĉ�Ų�ŗŔ
æaţ)ÄţŗũŢ3ÁZĚáţ
E�ūÒIŲ)»Œšň
3ÁZĚáţâ�ōŲ)»Œŝ�Çqš)ÄŲnšňƥï
ê�Ìŋŭţ²=��ÔƦ
įĭİİĸ
Ĭįĭİİĸ
Ĭįĭįĸı
įĭİİį
įĭįİı
ĬįĭįĴı
įĭĶĴĵ
įĭİĴĵ
ııĵ
Ì�Ãĉ�Ų�ŗŔ
©ū�¹ÚĥŲ¹óŒŅÌ
�Ãĉ�Ų!ʼnŔů
3ÁZĚáşŒŝţÌ�Ã
ĉ�Ų�ŗŔ
tßŋŭ�išHĔūăËŲŪŭű
šň
tßŋŭăËƣĘ=Ų¬őŰŝŪCďŞōů
Ĭįĭįĵĸ
įĭįİĴ
įĭİİIJ
įĭİıĵ
Ĭįĭįıĵ
įĭİįĵ
įĭĵIJĸ
ĬįĭįIJIJ
ııij
Ì�Ãĉ�Ų�ŗŔ
©ū�¹ÚĥŲ¹óŒŅÌ
�Ãĉ�Ų!ʼnŔů
� uHţē'š)»ş�
Ć
tßţuHĪƓƝŶƍƀƤŢĝűů
uHŲ;ŨīŲQÏŔů
TÝÔŞÉŮnŗtßţuHŲŅ6 ūU�šŠŢúőš
ňĬįĭİįIJ
įĭıİį
įĭįijĴ
Ĭįĭİĸķ
Ĭįĭįİij
įĭİıij
įĭĴIJĸ
įĭįİĸ
İĸ
3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
%ÈƣÈXÃTČ
æ&ţÉĄūå,ƣk+ţнƣ�
ċŲ£ŒŎûĄŒŝňů
æčţ¸Dţå,ūŖţнŲ£ÊŢñÑŪůŐşŌŞō
ůįĭįijĶ
ĬįĭİIJı
Ĭįĭįĵĸ
ĬįĭįĶį
įĭİįĵ
įĭįIJĸ
ĬįĭįĶİ
įĭķįij
İķ
3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
%ÈƣÈXÃTČ
æčţô0ūì°ŢśňŝţƑŴ
ƠƐƛƤūƒŵƤƊƍƇŻŲ¦ũů� ŋŭţ��ūø�Ų8ŏVŰůŐşŌŞōů
Ĭįĭįĵı
įĭįIJij
įĭįĴIJ
ĬįĭįIJİ
Ĭįĭİİĵ
ĬįĭİıIJ
įĭİĶĵ
įĭĵijİ
ıįķ
tßƣæáÐƣKáÐşţÇ
��»
ĩtß�oţżŴţ��
tß�o�Ü
ýŮŌŇŚŗşōŢŤüTŢăÛŔ
ů
æ&ţM�ūƗƂŤŅ�\ßŢ1ŧġőŕŢH<Œŝňů
ƥH<ŔůŐşŌŞōůƦ
Ĭįĭįĵij
įĭIJijį
įĭįĵİ
Ĭįĭįıķ
ĬįĭİĴı
ĬįĭİıĴ
įĭıĵİ
įĭijĴİ
ıį
3ÁZĚáßţGÅşšůå
,
3ÁZĚáţGÅşšů
�j|şÌ�ÃƂźƟ
%ÈƣÈXÃTČ
æ&ţÉĄūå,ƣk+ţнƣ�
ċŲ£ŒŎûĄŒŝňů
M�ţ5@Ų�ŮĐŮŅŖţmŢªŋŔŐşŌŞōů
įĭįĴĶ
įĭįĶIJ
įĭİIJĸ
įĭİįij
įĭıįı
įĭįįį
Ĭįĭįıij
įĭijıĸ
@Oćéė
îıİƧ3ÁƓơƒŷƇƀƜƋƞƃƘø�ĤÆţ@O&�ţ×�Ī�ÿ�ƣƠƕƟıƦ
ĤÆĺĹ
&Ė
ĥF
Źƈžƞ
ŽƤƊ
ĤÆ
��5@
ßB�ĉÈĎÞ
óĤĞc�ł
�5@
ßV§�QĎĤ
Ğc�à
��5@
߸��A¥à
�45@
ßÎeń+�à
��5@
ß�ÔÕ�Ď
x¡à
��5@
ßĥĶĸİĬğĴ
ĻĨđĎÕQà
��5@
���
Ç�à
��5@
ß�G�DÉà
V§ĎïîíĜ¦[ýĂ��ĿĤĞĎiÑĜv¹ÿęûĊ÷
ĉøęãâìéè ãâãëã ãâãåë áãâããç áãâãæä áãâããë áãâãäå áãâåãè
��ĿĤĞĜ±ôØĎB���Ď;r�ȦõiĜ�·ý
Ĉóęãâëçé áãâåæê áãâãìã ãâãçè ãâäèë ãâãêæ ãâäæì ãâãäê
�®�Č�VčĆóĈðy��Č���ĿĤĞĎi�Ĝ
�ąĈóęãâêéã áãâåèé ãâäåå ãâããã ãâãæä áãâãéë áãâãéé ãâäéê
V§čĊąĈěöĘĕÿùðöĆ{ýó¾nĜÿęûĊ÷ĉ
øęãâèêæ ãâåëæ áãâãçê áãâäéè áãâããë ãâãåä áãâäåè ãâåãì
V§÷YT~CÿęĎčR´ČW<Ĝc�ÿęûĊ÷ĉø
ęãâèæè ãâæäë ãâããé ãâãåì áãâääì ãâãéå áãâäçé ãâãéç
ĪĢľĮġıİġľĎY6ĕ�mĜ�·ýĈóę ãâçæç ãâåìå ãâãèè áãâãäê áãâãçê ãâãéæ ãâãìì áãâäêã
V§Ď��¶ĕ��«pĜ�ù�ęĖôč'ēĈóę áãâäçì ãâëéë ãâãèã áãâãæé ãâãéì ãâãæè áãâãæå áãâãéå
V§Ď}`Ąĕ¦õČċĜ�XýČ÷ėV§ĊÕěąĈó
ęáãâäåè ãâêææ áãâäéè ãâãêå ãâåãë ãâãåì ãâãêã ãâãæä
V§Ċ�ÜÕ�Ĝ¡ùĂēĎ'%ĜýĈóę ãâåèæ ãâéêë áãâääè áãâäåì ãâäåç áãâääè ãâäêä áãâãèé
V§÷ėAĝăĘð�ÄĜPĂĘĉøęĖôčÕěęûĊ
÷ĉøęãâãêæ ãâèæã ãâäæé ãâäèé áãâäèì ãâãìé áãâäãé ãâãéæ
¼ÝĕKĬĨĭ÷ČùĈĔlñA¥ÿę¥Z÷òąĂ áãâãåé áãâãæç ãâëæå áãâãäæ ãâãæê ãâãåé áãâãææ áãâãæç
A¥¸�Ĝ�ĈĈāĚĜD±ÿęûĊ÷ĉøę áãâãèé áãâäêæ ãâêãæ áãâäåä ãâäåè ãâäêä ãâãäé ãâåãç
¤Ŀ�¥ĿD¥ĎÓ?o#čďAĐĂēĎ��÷óĆĔ
ĉøĈóĂãâåäë ãâãçå ãâèçç ãâãêç áãâãäê áãâãéë ãâäãä áãâãìå
ĎlñĎĨĤħĸŀĻĜ�Dč^dýĈóę ãâäãä ãâäêå ãâçåæ ãâäæã áãâããè áãâãçæ ãâãêè áãâãëæ
Ł1ł¨�Ď1�Ċðóč&ú0õęÕ�Ĝx¡ýĈó
ęáãâãåæ áãâãêë áãâääã ãâëêã ãâäæì áãâãæé ãâääé áãâäãì
1þ¨�Ď�ËĿ1�Ċð��ĿĤĞĎòĘičĆóĈÅÁ
ÿęûĊ÷ĉøęãâãèè áãâãçë ãâããè ãâëææ áãâäåê ãâãçê áãâãçè ãâãéå
OËđĎaJĿhªč�w�čÕěĘĂóĊTô áãâãëä ãâãëä ãâäêê ãâèåé ãâäæé áãâäçé áãâãéê áãâääê
¨�Ď�ÄĕĨģĻðIÒUĜ�·ýð�ÀÿęûĊ÷
ĉøęãâäãå ãâãèå áãâãèå ãâèãì áãâãìè ãâäëæ áãâãäé ãâäæì
!HÚĎ�Ċ]Ą·úĈ½ĜÿęûĊ÷ĉøę ãâãæç ãâããê ãâäãë áãâãæì ãâêçã ãâãèë ãâãåç áãâãéê
�\Ď.SĜµČ÷ė�½ÿęûĊ÷ĉøę áãâããé ãâåìæ áãâäæé ãâãèë ãâèêç ãâãêç áãâãèé ãâãêé
-�öė�ÜüĚðÜĘčüĚĈóę ãâãåì ãâäêì ãâäìæ ãâäìç ãâèãç áãâäéë áãâãèê ãâãåä
9:Ď�Uč;ćóĈLÓüĚĈóę*�ĕ���(ð�
�čĆóĈ�ąĈóęãâãæã áãâãåê ãâãçæ áãâãäã áãâãää ãâëëé ãâããë áãâãéì
�×�=Ď��Ŀ*�Ŀ��jºĉ�ùIÒ¨Ďz¬ĿN$
čĆóĈ�ąĈóęãâãçå ãâãæì ãâãéì áãâãìê ãâãæê ãâëäã ãâäçæ áãâãéé
�®M|čHýĈÊĎIÒUĕ�(Ĝ¾nĉøę ãâãåã ãâääç áãâãèé ãâåëç ãâãèé ãâçãå áãâãæì ãâãêê
*�IÒ¨Ď©qøĜ"�ýĈ��SČ"�ĜPČóŁ³
°��öėĎ�3�� łãâääì áãâääì áãâãìå ãâääã ãâãäå áãâãèå ãâêèé ãâäèé
V§öėÃ�ĿÐ3Ĝ�üĚĈĔ7Ìĉøę áãâãéì ãâãäè ãâääæ ãâäåé áãâãåé ãâäãé ãâéæì áãâãææ
D¥ ĉ�ĘPĂV§ĎW<Ĝð-�ĕEkČċč½üČ
óáãâäãæ ãâåäã ãâãçè áãâäìë áãâãäç ãâäåç ãâèæì ãâãäì
ÊĎ�8Ϭ%ĕāĎÖ�Ĝ{�čµ�ĔęûĊ÷ĉø
ęãâãçê áãâäæå áãâãéì áãâãêã ãâäãé ãâãæì áãâãêä ãâëãç
�öėĎafĕ»�Ĝ/úFĚęûĊ÷ĉøę áãâãéå ãâãæç ãâãèæ áãâãæä áãâääé áãâäåæ ãâäêé ãâéçä
Ď>gĕĶĨďðaJ§č)ĒÙüĀč<2ýĈóę
Ł<2ÿęûĊ÷ĉøęłáãâãéç ãâæçã ãâãéä áãâãåë áãâäèå áãâäåè ãâåéä ãâçèä
>gĎ,5ĜbĘÍĘðāĎOč�öÿûĊ÷ĉøę ãâãèê ãâãêæ ãâäæì ãâäãç ãâåãå ãâããã áãâãåç ãâçåì
²åäŃ*�ijĽIJĠīĦĹįĺĩķ»�Û�Ď5@ sĎ£tßr¿uĿļĵĻåłŁ_¢ł
Û�
5@ƯÏ
â)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
.YŅºBùŅXïđĔ Ì!ćdÉđ´¬Ëï ��đ�8ĈVûÿ´¬Ëïđ^MĘ,ĕøĆôąõĕ
ã)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
.YŅºBùŅXïđĔ.Yĉîĕ®%í¹¾Ę�
ĂKLïlÜĘÅĈĂ÷Ąïĕ
ä)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
.YŅºBùŅXïđĔ.Yĉîĕ®%í¹¾Ę�
ĂĨņĤĻŀĺĭĚęĈ.YĈ{÷ĕb�Ęúćï
æ)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
.YŅºBùŅXïđĔ ��½ùĘ�Ă ėóēćïøĆĊėóēćïĆ½Ĉ´ñĕ
ç)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
«H��«Åĉ�N�^Ĉ�\úí
¡cŅ-�Ę4ĕ« ĉ�N�^ĈïĂĐ~ĘÎāĄïĕ
ââ)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
ĢĸļıġņĤĽńa¯ �¨ĉ=' �`ĉ¸ĘÍēýĈw~Oö§öøĆôąõĕ
âã)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
ĢĸļıġņĤĽńa¯ �¨ĉ=' �¸ĉ�`Ĉ�]Ę�úćôē§öøĆôąõĕ
âæ)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
� @¥ŅğĻĿęÔ
�
ğĻĿęĴľńĘ�_úB®
üĕ«ÅĉFs�ĈĎ÷Ąí�ćĈĘüČõóôėóĕ
âç)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
� @¥ŅğĻĿęÔ
�
EÓ©ĆúĄ_ÒĘ ÷ĕø
ĆĘÆï�ďĕ«Åĉ_ÒĘ�ü@�:ĉ�%Ĉ+$úĄïĕ
âè)�EÓ©¦ĉ6�Ć
ćĕª#
)�EÓ©ĉ6�Ć
ćĕ�xP_Ć���
ĥğŀ
� @¥ŅğĻĿęÔ
�
EÓ©ĆúĄ_ÒĘ ÷ĕø
ĆĘÆï�ďĕJĈ��Ĉ�Ãúćï-�UĘĐāĄïĕ
ãáâ)�EÓ©¦ĉ6�Ć
ćĕª#
ÝïĥğŀĆ�¾Ĉ6
ăöBÄ
ÝïĥğŀĆ�¾Ĉ6
ăöEÓ©�BÄ
ÝïŁĵŀĉĥğŀĆ)@
�¾Ę�cúíþĖĘ�g
üĕ
l�qĉ�3ĘÂñÿ)@Ņ)��¾Ę¥TúĄïĕ
ãäZ¦Ņ«©�Ņ;©�Ć
ĉ����
ÞZ¦�Uĉġęĉf
Z¦ĉ«RYĘÝď
ĕíjhüĕ�õó÷
ħŀijġęĘjhŅĝńIJ
ŃņüĕħŀijġęđĝńIJŃĺńĮĉyWĈĂïĄ»oąõĕ
ãâäZ¦Ņ«©�Ņ;©�Ć
ĉ����EÓ©ĆĉÇiŅ*� ;©�*� ©�Ćĉ*�Ĉ+$üĕ ©�Ćĉ�ÕÖ�Ęðčöz�üĕøĆôąõĕ
ãâåZ¦Ņ«©�Ņ;©�Ć
ĉ����EÓ©ĆĉÇiŅ*� ;©�*�
�ćĕ��²đ�WĘcā
ÿ�Ć*�üĕ©�ĉ��²đ�WĉÊïĘGÏüĕøĆôąõĕ
ãâæZ¦Ņ«©�Ņ;©�Ć
ĉ����EÓ©ĆĉÇiŅ*� ;©�*�
ĪņĹĉ�/ĆúĄĿņĩņ
ĤīĴàÀĘĆĕ
ĪņĹĈò÷ĕĿņĩņĤīĴĘ�güĕČõ��đíþĉ
ĆĔóÿô óĕ
ãâêZ¦Ņ«©�Ņ;©�Ć
ĉ�����£�9ĉm�
A�ć)�ĉf Ćþ
ĉeÈ
�£ĉÁk0íA��%Ĉ
S�üĕ
ěńĤĭńĮŅęĠĤĭńĮŁĶņĮĘf�üĕøĆĉ\¤Ę
�³úĄïĕ
ããä ���ÀĘuÿüĢĸļıĬĚíEÓ©Ø
2í��ċĉ¿�
ķĥŅĺĭĚęĉ"�Ć
[7f ĉîĔn
ķĥĺĭĚęċĉºBŅ�|
ćDV
«ÅĉEÓ©ĆúĄĉ�´ôíI}đ��Ĉ�ñĕQÙĉ
<õùĘ�³úĄïĕ
ããè ���ÀĘuÿü
�đ��¢ÛĘ�³
úí���ÀĘ�ð
üĕ
)�EÓ©ĆúĄĉ�
��ÀĘuÿü
¶�µÑĈ��ć�Cʵ
úí�BĈ�?Ę®ð¶�µÑĈµ�üČõ�CĘ�³úí��Ĉµ�úĄïĕ
ããé ���ÀĘuÿü
�đ��¢ÛĘ�³
úí���ÀĘ�ð
üĕ
)�EÓ©ĆúĄĉ�
��ÀĘuÿü
(&pÕ:Ĉò÷ĕEÓ©
ĆúĄĉÀ&
©8ĉ:ĈòïĄĐ)�EÓ©ĆúĄĉ«±ĘcĀ ÷ĕ
øĆôąõĕ
°ããň)�ĴłijĜīĤĽİĿĦĹ·�Ú�ĉ1> tĉ�uĈĒĔ×:ùĖÿâêÚ�ßr¼vŅŁĵŀãŇ
Ú�ìë Ð Û5 ĞĬģĿ Ģņį Ú�
68
��� ��
1 2 2
1
2 2
(1) ������������ ����������
1
7
8 4. ) t9X <
pn
4. ) 4. ( 4. 4.: E
( <=
: E) ) = ( ( =
:) =
: 7( ( = ) (
:( = =
: M CP= )
: 9= ) ) =
:)
2 103 < )
2 103 < -
9 56<
56<
69
3 2 3 28 p
)- ) -
8
- ( -
8
- ( -
8 4
- (( -
8 - -
8X
) - ( -
8 7 - -
8
( - ( -
9 ( - -
6 P E M r7 X 555< 0 .1
0 .1
(
2
8 1
2
1 1 2
25
3
1 14 1 18
2 9 1
1
1 2
Ƅ����ƮkyjL^WtcvYpƅ�ĐŮ9ëƗ5�ƮkyjL^WtcvYp�T�b�9Ŗ�ªÆ�
Ɗƚ ư� P_Uv T�b xlw�ĐŮ�ƔŤò�
xlw�ĐŮxlw�ĐŮ�kx_Xa�
�Ʈńƙĩ9¬ƀ57DIJ�Èĸ5şĊ�XQw
�Ʈńƙĩ9¬ƀ57DIJ�Èĸ5č�
ŪXQw
Ɔķ�ĽČ'�þ�@C
ūŀ7ŁÅ@ØơÕ� � �Ɔķ9�Déű�şĊGƐ1 ���G1�7��Īƣ4!DIJ4�D&5 � �şŪÔ¹'GƐ1 � ��
ĉÛ¦Ʀ ĉİ9ÏæĦŘ8ƫ�)��Ć�ãģGijD �� �ć©8Ļ�4�D � �
TosdS�Wt{´ĝ
â�Ū7TosdS�Wt{Gé� ��� �Çţ9üĶ �� ��
�
Ìő�Ė�QrvI�Ž
ńƙĩ5)3ÌőŪ8�Ė+D&59ƃƢķGŹĊ)3�D � �ńƙĩ5)3ĸŦGő%D&5Gŧ�¶>D � ��QrvIku{Gøĸ)Čé+D � ��
ŶĢ�ĢúŪČŅĉİ9Øű@é�81�39iIxhs�@jJ�be^RG¶>D � �fjN�n{XGĬCƏDĉƊ9şĊ@ŻƱ�ƛ 9Ù��ƇŏGĻ)#ŹĊ)3�D �� ���
ì�XQw5şĊ8¬2#ńƙĩŪČŅ
ì�XQw5şĊ8¬2#ČŅ
ì�xlw9XQw5��şĊGƐĆ)�-EGŽ®+D � ���Ūð¸8¬2�/�þÍŨ�ČŅGé� �âƩ9Ư��â�Ū7SIGũ»+D
|Ň7�ƮGũ»+D �ĈƮ�SI9Î�9Ƈ�ČķGƦ�)3�D
���9ŽŬ�ĭ)�şĊ9ʼnŌ9/>8Ò·¡űGé�ĈƮ�SI8ª+Dóĭ9ĥƑGĕę)�ƳĠ8ūƠ+D �
ĉƨķ9Ž® ńƙĩ5)3ĉƨ)/�Ė�¡űGé�ĉƨ ?/B+ĿŸG�!Ĕ%D
¢Ď�ĉĩē�ŕĩē59ŊÜøƠ
¢Ďšī9SI9ũ»
¢Ďšīđµ
¢Ď9� �����äƈ�Ïæ7ĦŘ�Góř8ì>D&58ĈƮ�SI9ġŭGů3D �¢Ď9ƥ��¢Ď9�ãGœĜ)/ĈƮ�SIGũ»+D¢Ď59ĪƣªÆ@f�ac�W^kG�ƪ)/ģ4ĈƮ�SIGũ»+D
¢Ď9¯ŗGť�DV�hXGũ»+D¢Ď Ŕ9�ý@�Ʈńƙĩ9�ÓGƌ#&5GœĜ+D ��
�¢Ď8F�C@+��Ļ�7ĥƑũ»@ŃƖGé� �¢Ď8503ƃƢ75!8ƷƤ 1#ĦÁG�Ć+D
¢Ď9ĉƨķGœĜ+DşĊ9�Ŵ�IbgIu{X�T{T�\{X�GĀ�+D �
ßC �0/5!8:ĽČ8ď÷+D �ZwjSIGĀ��M{fz�+D �¢Ď ĉÛÍŨ4!DA�8Ā�+D �
¢Ď59ūŀ7ºƧ�ªÆGƐ1
�IJ©5)39¢ĎGƦ�)�ªFD
¢Ď©9ÚIJŪƋ�Ūñ���ިGœĜ+D �¢Ď9Ðƥ�IJ©9ÐƥGœĜ+D
¢Ď9ĉƨķGì>D�Ā�+DŰ!�
%
¢Ď9£ĥGƦ�)3�þ�@C9�DéűG5D �¢Ď9ÚIJŵķ�ķƎ�č�ËõŪĦŘ76�85BFE,8¢Ď5ªFCGĆ1
¢Ď9Ɔ}�œÖGĒD�ĖX[Kw�ØÞ�ŹşŻƱ769ÚIJñGèƬ)/Ŗ� 4!D
�
�ŕĩē4¼Ɯ+<!¢ĎĥƑ9ŶƟ5ſ~9žŜ 4!DŔ9�ƮĎ ƃƢ75!8ƷƤ 1#ĦÁG�Ć+D
ńƙĩ59ƷÉ�½Ű
ŕĩē½Ű
Ŕĩē59½Ű8û�+D � ��7D�ި@ĪźGĆ0/IJ5½Ű+D �]�p9��5)3v�\�W^k�ĿŸG5D �
Ŕĩē8ÂƕG�!Ì$��ħ+DžŜGé��Č8Čā+Dāł©9¢Ď9�!Ì"@�ŋG�Č8�|Ň8Čā+D
ĩē©9ŤĺGé��ÄŢĦŘG§ƹ+DŔĩē9ńƙķ@ŻƱGÓľ?D&5 4!D �
Ŕĩē8ADSI�ĈƮ9ĸ�GŪ�8ƅ�)�ƃƢ8�*3ÿų+D �
ĉĩē½Ű
Ųĩē9XQw��ި�ŻƱ8Ê�GƉ� � �ƃƢ8�*3Ŕ9Ųĩē8ƷƤ�Ƒî�ŊŝGé�
Ųĩē©9ŤĺGé��ÄŢĦŘG§ƹ+DŔ9ĉ�Ų�ĩē9ĈƮ�SIG�Ź)�ƃƢ8�*3ÿų+D
Ųƭ8Vm�a�IbeKXG+D � �Ýı9À�@q{[�G�!Ĕ%D �
�
��
|Ҥ¾GĺƂ)¥ă+DňĨ9ċ�ņ�|Ň¡ű8ěą+D �
ňĨ¤¾9ĺƂ
SI9/>9ňĨ¤¾9ĺƂ
ċ9ì�ĈƮ�SI9/>9ĩĤ¤¾9ĺƂƋ�9¼Ɯ9Ĵı
|Ň7�Ʈ9ũ»5-9Ĵı
O�k{4|Ň7Ƌ�GĴı)ğƵ+D�ňĨƋ��
�ńƙĩňĨ;9q{e�W^kG�Ć+D
Š�9ƐÏ�ƮƈĂ¡ű8Ŗ+DƦ�5
êÑ
Š��Ʈ�ƐÏ�ƈĂ9¡ű8ƞ+D � �Š��Ʈ�ƐÏ�ƈĂ9ńƙĩ�āł59ƷÉGĮ>D
ĉĩē9ńƙĩęś;9±Ő�êÑ
ńƙĩęś9ĈƮ�SI9ċãģ��ņ8ƞ+Dńƙĩęś5)39ŽŬ8ƞ+Dáė5ĉĩē9ĪƣªÆG¿>D¡űGé�
nX�q`JI9ƥƠ5ĥƑũ»9�C
nX�q`JI;9ĽČ�áĻ7Ŗ� �nX�q`JI@åî;9Ļ�7ĥƑũ»
ïöŪ7ÏæƘŚ;9ƞáŪ°ª;9½Ʊ
ÏæĹù;9ƞ
ƐÏ��Ʈ�ƈĂ9č�Ĺù9Èĸ8ƞ+DĹĈŪ¡ű8ƞ+D
ÚIJĥƑ9ūŀ7ƥƠ5Ɛà
¢Ď9ĥƑ�kuKeW�8ªFDĥƑG«=�GĒƁ+D � �ŕĩē4¼Ɯ+<!¢ĎĥƑ9ŶƟ5ſ~9žŜ 4!D
ƒ@ƲƦçưGƦ�)�č�ŪĿŸGŇ
�+D
ƒ@ƲƦçưGĒD
-E.E9ńƙĩ8ūƠ'EDƒ�²ŎGĒDƲƦŪ8ūŀ5Ø�D�þÍŨGé�įƮ³Ƹ@Ò·`�[9�(H�-9ŔƇĻ7Ğƴ9øĸGéF7� �
�
�
���ĐŮëƗ8��3�ëƗ Ŗ�+DT�b8�ů+D�����ĐŮëƗ8��3�ëƗ Ŗ�+DT�b8�ů+D�����ĐŮëƗ8��3ôƠ'E7�0/�ëƗ Ŗ�+DT�b8�ů+D
�įƮ³Ƹ8Ū�7ŶƟG³)��Č8ƐŒGé�âƩŪ7�ƮĄ×9ƥƠ�áƍ7żƊG�Ċ)/ČŅGé�
�Ʈńƙĩ5)39č�ŪĿŸG�/+
ĉÛ9ƥ�9/>8�Ʈńƙĩ9Š}@ƪĤGƥƠ)7� � �¢Ď@č�59Īƣ9ģ8ĩ ĸCƪ03�D&5GĔ%ŷED¢Ď�BƇů7ƑĘ@ďƶG?BF7�
č�ŪĿŸG�/+
Tosd_J�ńƙĩęś�č�;9ê
Ñ
�������
Ãƕć©�8�%Dńƙĩ5)39Ŀƕ �
ƳĠÒ·Gé�Ĥí�¢Ď;9ŃƖ@Ų�76�ĚƊ7ƲƦŪ7żƬGé�
ƐÏ��Ʈ�ƈĂĵŮ81�3Ʀ�)3�D
� �áė�ļ�ƝƓ��9ōı �č�9d�YGŹĊ)-E8��DĿŸGĆ1
�
�������
�
�
�
�
��
71
1 2
9 2 1
1 4 1
3 2 4
1
2
1
2
1
1
1 2 2
ABIM 38
P-MEX 37 26 ABIM 38 Altruism
Respect for others Excellence Honor and
integrity 3 Altruism Respect for others
2
Excellence
Honor
and integrity
P-MEX3 7 Doctor-patient relationship skil ls
R e f l e c t i v e s k i l l s T i m e m a n a g e m e n t
©���H
³9E8+2/A5B1>�� ���
��� ��
���#S¤k�#¨V
H³9E8+2/A5B1>���D;C��
�����
����
�
Lt
��'¡¯�´ID;C�
Lt
��'¡¯�´ID;C�
H³9E8+2/A
5B1>���D;
C��"���T�
�'Lt
Lt
��'¡¯�´ID;C�
H³9E8+2/A
5B1>���D;
C��"���T�
�'Lt
Y~��#-)#�_
E�C?4C#�o��r"
&'aJ�vN
�sLt
Y~$#c��fG
�¢Lt
n�0,C �y"]��
|�
Y~���^
�¢Lt
Y~6�1$#�O
�¢Lt
�¢Lt
�Y~��#-)�_�
Y~��#-)#�_
�|�
�¢Lt��¦Lt
�p¥µ
�p¥µ
�¦Lt
�qLt
�gP�W��
H³�®�#]§ !'�
Ud� }Q�0,C
¬#��
�zLt
x[Z±¥µ
x[Z±¥µ
�qLt
�sLt
�·e�`��
�®� #·e`�
�[\b#k�
�sLt
H³~[\b¥µ
²$#fG
�sLt��jLt
�jLt
��[\b#k��
H³�®�#]§ !'�
Ud� }Q�0,C
Y~��#-)�_
�¢Lt
�¸Lt
�.=@63*:C0$#\
��
�I#«hH³ªwX�"
��'±R mi
�zLt
�¶±�}Q��£�
¬%¶±l´(±R��}
Q��£(���'
�¦Lt
��p�|��
H³�®�#]§ !'�
Ud� }Q�0,C
�KLt
�F��{#n�-)�_�
�M�
�|�
°��^�7@�<61
>
Hu�Y~\bk�¥
µ
73
Interprofessional relationship skills 4 24
2 Doctor-patient relationship
skills Reflective skills
Time management
Interprofessional relationship skills
2 2
2
2
60
”ANA code 2015”
65 8
/ / /
/
1 2
105
57
2
74
(2) ���������� ������� ��������"�
1
KiSS-18102 KiSS-18
0.23 0.76 KiSS-18
r=0.76
0.7 106 1
0.7
2 P-MEX107
P-MEX 0.31 0.70
0.59
2
0.71 0.93 2
(3) ���������� �����!���#
2
1
1 2
75
×
N
76
i X
IPE
IPE N
× N
×
IPE
2 4
2004
o × GP 4
IPE 108,109
2008 N ―
2012 3 N
× 2011 4 ×
3-5 1 30
× 2014
2 60 2016 110
21 17 2
2 131 N 27
× A-3-(1) A-3-
(2) × A-3-(2) A-4-(1) A-
4-(2) B-(2)
N 2014
o × early exposure
77
97,110,111
0.5 24
1 30
/
27. 2013 2016 ( / )
1
2013 10/18 9/9 2/3 3/3 7/- 31/33
20142 36/110 7/8 0/5 5/5 9/- 57/128
2015 30/110 13/28 7/8 6/7 4/- 60/153
2016 51/110 15/17 2/2 2/2 2/- 72/121 1 2 2013 2 2014
/�0 �+���� �����(%� -����$* IPE ��
���1,
(1) '#�.!"�$* IPE����+������2���)&
IPE
2014 2 60
2014
2013 1.
2.
78
3.
8
2013 :
2016 2
7
39
28 2016 2014
2017
(2) �������� IPE�� �������������
2014
Team-Based Learning112
120-150 2
113
28 5 7
ceěņĜ ģġĢĦceƻņĭĢĤĦĜ ģġĢħceěņĭĢĢĪĜ ģġĢĦceěņĭĢĤĤĜ ģġĢħceěņĭĢģĤĜ ģġĢĦceěņĭĢĤġĜ ģġĢħceěņĭĢģģĜ ģġĢĦce ģġĢħceěņĭĢģġĜ
ð�® Ĥğģħ ĤğĤĤ ĤğĤġ Ĥğħġ Ĥğģħ Ĥğģĥ Y�Ūũ ĤğĤĨ
IJƻß¹eƼ
ŇĝĚ1�ĉ
ceěņĜ ģġĢĦceěņĭĢġĢĜ ģġĢħceěņĭĪĨĜ ģġĢĦceěņĭĢġģĜ ģġĢħceěņĭĢģġĜ ģġĢĦce ģġĢħceěņĭĢĢĩĜ ģġĢĦceěņĭĢĤġĜ ģġĢħceěņĭħĩĜ
ð�® ĤğģĨ ĤğĦģ ĤğĤġ ĤğĤĢ Y�Ūũ ĤğĥĪ ĤğĢĪ ĤğħĤ
ĿŁĝĚň
ŇĝĚ1�ĉ
ƻŮůšƼ
ŇĬġğġġĢĝĚʼnģĭġğĢġ ŇĭġğĩġĝĚʼn
ģĬġğġġĢ Ğ ŇĬġğġġĢĝĚʼn
ģĭġğģġ
ŃĚôÖƸ×ŵ(ZŶģġĢħceŵ(Z
�ĚûEē½ŶŗôÖĠ×ŴđŦŰŲƁÐżŤŲşűŠŬŘŕŗôÖĠ×ŴàCž�ŦťƅvŧŬŘŕŗôÖĠ×űWŷşřŭŬŘŵĤē½űŕFÌĆ}ÜŶŗĢğĚ&šūśoƄųŚŘŕŗģğĚřźƁūśoƄųŚŘŕŗĤğĚźř
ūśośŘŕŗĥğĚŞųƁūśośŘŵĥ¢ĐŖĤē½ŵFÌŵbK�ƅð�®ŲŦŬŖģġĢceŲģġĢħceŵð�®ŵ£þŴŶ� �ň�Xěļŀńľł§Ĝƅ¸ŚŬ
�ĚģġĢĦceŲģġĢħckŵð�®ŵ£þŶ�áÓLƭƞƳŴſŭŰäŚŕp,ŕY×ŵ90Ġ�90ŵ,ŕWćŵæGƻ1�ŵŻƼƅA�Ŵ|%ŦŰ)�ŦŬ
�ĚģġĢĦceŲģġĢħckŵð�®ŵ£þŶ�áÓLƭƞƳŴſŭŰäŚŕp,ŕY×ŵ90Ġ�90ŵ,ŵæGƻ1�ŵŻƼƅA�Ŵ|%ŦŰ)�ŦŬ
�ĚģġĢĦceŲģġĢħckŵð�®ŵ£þŶ�áÓLƭƞƳŴſŭŰäŚŕp,ŕWćŵæGƻ1�ŵŻƼƅA�Ŵ|%ŦŰ)�ŦŬ
�ĚģġĢĦceŲģġĢħckŵð�®ŵ£þŶ�áÓLƭƞƳŴſŭŰäŚŕp,ŵæGƻ1�ŵŻƼƅA�Ŵ|%ŦŰ)�ŦŬ
ģġĢħceŵR�®
ƸĥƒƩŞƀĤƒƩŴ.«
ƸY���ƅđťŪũŴ)�
ƸŲšŴųŦ
Ğ
ƸSV��ŵY×Ŵ90ŨƂW·ŴĎ
XŦŰôÖƸ×ƅY�
W·ð��
IJěĢĝĚĢĪĥƼĭģġğĥ�
IJěĢĝĚģĢĨƼĭġğġħ� Ğ IJěĢĝĚĢĪĥƼĭĥĩğĥ
�
[÷Ù 6WÈŵŻ &=ô· &=ôÙ JM6ºNÂY×Ŵ90ŨƂW·
(ZƸzĔ�
ǀôÖǁ
ƸĚ5©ăŵ?JMŵJM6ºƅ~ŭŰŚ
Ƃ6`ŴſƂôÖ
ƸJM6ºŵYw
ƸƵƹƳƭƞƳŵ�Ãŕ6`ŲŦŰŵƎƮƲ
Ƈ�Ý
ǀôÖǁ
ƸƩƉƏƵƍƊƷƗƲƷƐŕ¯ÀŵƇƨƵƹ
ƛŕơƱƝƈƧƸƗƱƥƹŴŮŚŰ
ǀ×ƿƒƪƯƢƑƹƓưƷŵYüǁ
ƸŞŞƄƁä2ŵ×ƻfƂ�ÕŕU3ŕ
èÓŕƌƊƫÿŦŕêŚ�ŜŕU3<ĒƼ
Ƹß)>ƅ�ŠŕƐƳƹƨŵƬƷƣƹŲ'
�ŨƂ
ǀôÖǁ
ƸĚƨƵƦƋƜƓươƲƖƫ�nŵ�yæÎ
ƸÞd µŕÅ�»ƔƴƷƩŴŮŚŰ
ǀ×ƿƓơƲƌƅ¸ŚŬuo¥Xǁ
ěĢĜâãş·ŧƂ±¦ƅìXŦŕßýşŲƂ
ä2Ƹ+�ŴŮŚŰØŜƂ
Ŕ��ƽƿ~hŦŰŚŬsÙťƆşŕď(
űŗŝÄŘƅ¬ūśŲŦŰŠŬ
Ŕ��ƾƿrÖŵřƂ¾zŴŕqŦţų!
gĘDŵùQƅz�śſśĖźƃŬ
ěģĜ��ĥźűŕßýŵ+�Ƹä2ƅ¥X
Ŧŕūŵµ¹ƅØŜŕƐƳƹƨű'�ŨƂ
ǀôÖǁ
Ƹ?JMŵY×�]Ùƻ¿ö`Ƹ�!`Ƽ
ŞƀŵôÖ
ǀ×ƿ5©ăŵ?JMŵ�!6ºÇÆ
ŵ´±žJM�¤ŵ·¨ƅµéŨƂǁ
ěĢĜ?Y×JŵJMŵ�¦ž�!6ºÇ
ÆŴŮŚŰ�/W×ŨƂŖ
ěģĜ�/W×ŦŬ(ZŴŮŚŰƨƴƘƷ
ƝƹƓưƷŨƂ
ěĤĜJMű·¨ŨƂsÙťƆŵ��ŴŮŚ
Ű�ëŦŕY×�]ÙŲŵ;�B»ųž
ƁŲƁƅĀŧŰW×ƅªŽƂ
ƨƵƦƋƜƓươƲƖƫ�
nŲŵ[m
ƸƒƪƯƢƝƈŕ\ċÛđHŕÅ�Źŵø²
Ƹ6º\ċÛŵN¼ŲųƂ��iyŲÅ
�»ƕƎƳ
Ƹ6º\ċÛŵN¼ŲųƂ��iyŲÅ
�»ƕƎƳ
ƸƨƵƦƋƜƓươƲƖƫ&á
Ƹ§ž µÒĕƅµéŦŕÅ�»ú�ƅ
&śŨƂ
ƸƒƪƯƢƝƈŕ\ċÛđHŕÅ�Źŵø²
ƸsÙlŵƑƇ��
�§ ôÖ ôÖƸ× ôÖƸ× ôÖƸ×
ôÖƸ×F ŎĦ�ĚƸőħ�ƸƺĚĢĢ� ŏĚĦ� ŐĚħ� ŒĚħ�ĞœĚĨ�
ƝƹƩ 5©ăŵJM6ºƅWŸěĢĜĞěģĜĝěĨĜ �ÙŲčƄƂ{§ŴŮŚŰWŸ ƨƵƦƋƜƓươƲƖƫŕÛ� µ JMŵ6ºƸ_¤·¨ƅÀƂ
ģġĢħceŵR�®
ƸôÖŵ)ĉƅ«ƀŦŕƐƳƹƨƶƹƏŵ
�ČƅP0
ƸĮijĹĸŵ��ƤƞƌŴ��òíƅ�0
ƸôÖ(Zƅ�µŕƕƲƫ4
ƸŲšŴųŦ
Ğ
W·ð��
IJěĢĝĚģĥĪƼĭĞĢğĤĥ�
IJěĢĝĚģĦĢƼĭĞĤĢğģĤ�
IJěĢĝĚģĥĨƼĭĞġğġĨ� Ğ
ŇĭġğģĦĝĚʼnģĭġğġġĦ ŇĬġğġġĢĝĚʼn
ģĭġğĢĢ ŇĭġğĨĪĝĚʼn
ģĬġğġġĢ Ğ
[÷Ù &=ôÙ &=ôÙ &=ôÙ &=ôÙ
(ZƸzĔ�
ǀôÖǁ
Ƹ-Ą½ ŕƓƱƣƕŵó�
ƸƐƳƹƨW×ŕƇƉƕƧƴƉƏŵuÖŴ
ŮŚŰ
ƸƐƳƹƨŲƛƹƫŵąŚŴŮŚŰ
ǀ×ƿiy�ŵƛƹƫƅ�ęŨƂǁ
ěĢĜƐƳƹƨƬƷƣƹŵ'Ā®Ų¾ą®ƅ
çŮŢƂ
ǀôÖǁ
ƸĚÍIǂǃDžDŽŵĻŀĽŅĺĻıķķĺŵƒƇŲų
ƂĥŮŵƒƷƥƝƷƓƹƻƲƹƚƹƓƜƨŕ
±¦ƭƢƙƲƷƐŕ¾ ��ŕƒƪƯƢƑƹ
ƓưƷƼËƅÏ�
ǀ×ƿƛƹƫƶƹƏŵĈæpƅƐƳƹƨ
��ƅĀŧŰƅ�ęŨƂǁ
ƸĻŀĽŅĺĻıķķĺŵĥŮŵƒƇƸƒƷƥƝƷ
ƓƹËƅ¸ŚŰŕ1�»dž1³»»ų'
A��ŴŮŚŰ�ƁÿƂ
ǀôÖǁ
ƸĚƨƵƦƋƜƓươƲƖƫ�nƻ6`xÊž
įĽņĶıİĺŵƦƴƹƫƶƹƏËƼŵÏ�Ųŕ
ūŵĈæpŴŮŚŰ
ǀ×ƿĢckŵƨƵƦƋƜƓươƲƖƫŵ
-Ą½ ƅØŜŕß^ð�ŨƂǁ
ěĢĜ7��ŵ-Ą½ ģģē½ƅW·Ŵ�
ÃŨƂ
ěģĜĢckŵ-Ą½ ƅØŜƂ
ěĤĜƐƳƹƨű8õŦŕĢckŵ-Ą½
ģģē½ƅ�yŨƂ
ěĥĜƐƳƹƨŵuo¥XƨƵƗƕƅ�Ɓÿ
Ƃ
ěĦĜģģē½ŴFÌŦŕð�Ñ�ƅĢĂČk
ŴƦƈƹƠƣƜƏŨƂ
ǀôÖǁ
Ƹ6ºÙĞsÙč�ŵėL
Ƹ6ºƒƪƯƢƑĞƓưƷŴčŨƂYïÁÉ
ŵÏ�
ƸƒƪƯƢƑƹƓưƷƕƎƳŴŮŚŰ
ƸĺķĴĵıĺƻtŚÀƀŪƅ�ŜƂƼŕĺijĮĹı
ƨƵƟƒƳƻşƆ6ºŴčŨƂƒƪƯƢƑƹ
ƓưƷƼŵÏ�
ǀ×ƿƓơƲƌƅ¸ŚŬƵƹƳƨƴƉǁ
ěĢĜƓơƲƌĢīîŵ°®şXźƀũñş
ĊŚsÙŲÚŠjŵ6`ƅŧƂ
ěģĜƓơƲƌģƿć¨2ŴŝŚŰŕƎƮƨƝƷ
şA$ŴtŚÀƀŪƅ�ŜƂ
ěĤĜƵƹƳƨƴƉŵ�ƁŞŜƁƅŨƂ
ƨƵƦƋƜƓươƲƖƫ�
nŲŵ[m
Ƹ\ċÛŲŵā�Ƹ8#
Ƹ6º\ċÛŵN¼ŲųƂ��iyŲÅ
�»ƕƎƳ
Ƹ\ċÛŲŵā�Ƹ8#
ƸÐÔ¶Oŵ�"
Ƹ6º\ċÛŵN¼ŲųƂ��iyŲÅ
�»ƕƎƳ
ƸƨƵƦƋƜƓươƲƖƫ&á
Ƹ\ċÛŲŵā�Ƹ8#
Ƹ6º\ċÛŵN¼ŲųƂ��iyŲÅ
�»ƕƎƳ
ƸsÙlŵƑƇ��
�§ ôÖƸ× ôÖƸ×
åģĩğŔ�a6ÈTW*c¡ĴķıȽŗJM6º@AƗƪơƹĢŘŵôÖƸ×ŵ(Z:ŷW·ŴſƂð�ƿģġĢĦce:ŷģġĢħceŵ£þ
ôÖƸ×F ŊĚĥ� ŋĚĥ� ŌĚĦ� ōĚĦ�
ƝƹƩ ƐƳƹƨW×ŵN� ƛƹƫƶƹƏƸƲƹƚƹƓƜƨ ƨƵƦƋƜƓươƲƖƫŕÛ� µ 6ºƒƪƯƢƑƹƓưƷŵNÂ
ôÖƸ× ôÖƸ×
TU×ðØ ßÝÞâTU×ðæÞßäØ ßÝÞãTU×ðæÞÞßØ ßÝÞâTU×ðæäàØ ßÝÞãTU×ðæâáØ ßÝÞâTU ßÝÞãTU×ðæÞÞáØ ßÝÞâTU×ðæÞàâØ ßÝÞãTU×ðæÞßÝØ
·�� àÛàÝ àÛáà àÛâà àÛâá MsĊĉ àÛáá àÛàá àÛáá
íîÙÖò
ñÙÖ.{Ç
ïÖ»©Ŏ�ªĖ$NėßÝÞãTUĖ$N
�Ö¿<Ñ�ė÷»©Ü�ªĕÍ�ĆđēĤ¤ğĄēÿĒĀČøõ÷»©Ü�ªĕ°:ġ�ĆąĨcćČøõ÷»©Ü�ªĒKĘÿùĎČøĖàÑ�Ēõ= Åg®ė÷ÞÛÖ"āċû]ħĔúøõ÷ßÛÖùĝĤċû]ħĔúøõ÷àÛÖĝù
ċû]ûøõ÷áÛÖþĔĤċû]ûøĖá�ËöàÑ�Ė= ĖSD�Ĩ·��ēĆČö
�ÖßÝÞâTUēßÝÞãTXĖ·��Ė�Áė�±§EņĺŊĕĢĎđ²úõ_(õMªĖ3-Ü3-Ė(Ė´>ř�.{ĖĞŚĨ8tĕf!Ćđ&zĆČ
�ÖßÝÞâTUēßÝÞãTXĖ·��Ė�Áė�±§EņĺŊĕĢĎđ²úõ_(õKÆĖ´>ř�.{ĖĞŚĨ8tĕf!Ćđ&zĆČ
K�·��
è×ÞÙÖßàáŚæßÛáÞ�
è×ÞÙÖÞßáŚæÝÛÞå� Ú è×ÞÙÖßâÝŚæÝÛââ
�
ñæÝÛÞßÙÖóßæÝÛÝÞ ñæÝÛãäÙÖó
ßæÝÛÝÝÞ Ú ñæÝÛáãÙÖó
ßæÝÛÝÝß
�ÖßÝÞâTUēßÝÞãTXĖ·��Ė�Áė�±§EņĺŊĕĢĎđ²úõ_(õMªĖ3-Ü3-Ė(õKÆĖ´>ř�.{ĖĞŚĨ8tĕf!Ćđ&zĆČ
�ÖßÝÞâTUēßÝÞãTXĖ·��Ė�Áė�±§EņĺŊĕĢĎđ²úõ_(Ė´>ř�.{ĖĞŚĨ8tĕf!Ćđ&zĆČ
$NŎeÒ�
Ş»©ş
Ŏ0�ÄĖo^1��)ÜIJĴĹŅĕďú
đ
Ş�ªŝ��1�AĖo^1��)ÜIJ
ĴĹŅĖMaē<ÓĨ�µĈĥş
×ÞØ6įŊŏŁĕ0�Ä$Ė��1�A
Ĩ,ĤVđĥ
×ßØ,ĤVđģĦČ��1�AĖ��o
^õ��o^õ��o^Ėo^1��)
ĨºĜđj%Ĉĥ
×àØ0�ÄĖo^1�ĕďúđδē�
¦Ė�Ïþģ<Óēµ�¡Ĩ~¶Ĉĥ
Ş�ªŝ0�ÄĖ1�<ÓĨµ�Ĉĥ�
bŁŌijĬĮĻĨ�čăĥş
×ÞØĹŏŃĖiLŝÞØ0�ÄĖ1�PÈ
ĖCF�BĨµ�ĈĥŁŌijĬĮĻõßØ0
�ÄĖo^1�Ė MŠ.�/Ĩ@ĥŁ
ŌijĬĮĻõàØÖ1KÆãTÉĖKĘĨ M
ąĊĥJKnÐŁŌijĬĮĻ
×ßØįŊŏŁĒĹŏŃĨÅgĆõŁŌijĬĮ
Ļ¸}ĨĝēĠj%Ĉĥ
×àØp;ÿ�*ĆČ$NĕGĐĀõŁŌ
ijĬĮĻ}Ĩ¨Ĥ�Ĉ
×áØ«}ĆČŁŌijĬĮĻĕďúđŁŋķō
ĹŏIJňōĨ²û
×âØàãÝU·�Ĩ²û
Ş»©ş
ŎCFĒĖI�ÃlĖMÀĕďúđ¢
�
Ş�ªŝ��~¶ş
×ÞØCFĒI�ĒĖÊħĤÿZ´Ĕ��
Ĩj�
×ßØO½¬ĕOĈĥmkĨ6¯Ē~¶Ĉĥ
×àØëê�Ĩ�ĎđõZ´ĔmkĨįŊŏŁ
ĒĝēĠõ~¶Ĉĥ
Ş»©ş
ŎśTÉĖęĤÂĤ
ŎʼnŀŋĮIJňōõ¥ÔKªõ��Kªĕď
úđ
Ş�ªŝKªr�Ė~¶ş
×śØ¯&ĖKªr�ĖłīōĻŎ<Ó�Ĩ
q�Ĉĥ
×ŜØQįŊŏŁĒ6¯ĖKªr�Ėłīō
ĻŎ<Ó�ĕďúđ¹Ćõ�úĕĩļĿīĴ
Ĉĥ
×àØQįŊŏŁĒ¹Ć7ĎČĄēĨįŊŏ
ŁĒ#wĈĥ
ßÝÞãTUĖHu�
Ŏ+x£ tĖ�ÉŋłŏĻř¯��Ė�
�ē1�j��)ĨºĜĥŚĕýúđõ,
ĤVđģĦČ¯��Ĩ9ğ��1�AĨ
�ªĒhVĈĥ
ŎēāĕĔĆ
Ú
ŎēāĕĔĆ
r� »©Ŏ�ª �ª »©Ŏ�ª »©Ŏ�ª
O½¬ "5»� Mª3-Ė1K�K� "5»� "5»�
ĹŏŃ 0�ÄĖo^1�ĕďúđKĚ CF1�Ė MĨ«üĥįŊŏŁ�ªCFĕýĂĥ��1���ĖÃlĖM
ÌĕďúđʼnŀŋĮIJňōŎ��Kª
ŁŌŀĬĸIJňĽʼnĵŅ�
\ēĖO[
ŎıńŇľĹĪõPÈÍ?õ��ěĖ¾�
ŎÕúĴĭŊē�¼ĕGĐāPÈ�MÀ
ŎPÈēĖÃlŎ2�
ŎıńŇľĹĪõPÈÍ?õ��ěĖ¾�
ŎÕúĴĭŊē�¼ĕGĐāPÈ�MÀ
Ŏ1�PÈĖG�ēĔĥ�|Wdē�
��ĴĭŊ
ŎıńŇľĹĪõPÈÍ?õ��ěĖ¾�
ŎÕúĴĭŊē�¼ĕGĐāPÈ�MÀ
ŎPÈēĖÃlŎ2�
Ŏ`¬�YĖİĩj�
Ŏ1�PÈĖG�ēĔĥ�|Wdē�
��ĴĭŊ
³ßåÛôyR1�JK'T�éìç��÷CF1�78ĶńĽŏÞøĖ»©Ŏ�ªĖ$N4ĘK�ĕĢĥ·�ŝßÝÞâTU4ĘßÝÞãTUĖ�ÁřďĐĀŚ
»©Ŏ�ª= ŐÚőÖÞÝv ŒÚœÙŔÚŕôÞÝÚÞßv ŖÚŗôÞv ŘôÞv
81
112
2016 3 2
2013
1
/ /
114
(a) (b)
(c)
(d)
2016 2
9
5
115 5
3 1 /
2 / 2
82
1. /
2. / 3. / 3
1. 2. 3. 4.
4 4. /
5.
/
"�# �� ������������ ������ IPE ��
���$�
(1) !�
IPE
2015
2016 2017
(2) ��
2014
2015 2016
83
N 1 / 2
/ 2
N 1. / N 2. / N
3. / 3 N 1. 2.
3. 4. 4 N
3
N ( )
N
N N 2015 2016
N 2
N 2
N 0.01( ) 0.06( ) 0.14( ) 116
IBM SPSS Statistics 22.0 N p<0.05 N
(3)
― N
― N
o ― N (1)
N (2) N ―
(3) (4) (5)―
(6)―
N ― 27-2-58
N
(4)
P
2015 144 140 91.5 2016 129
123 95.3 29 N
2015 39 2016
17 2015
49.3 2016
N 2015 N
84
(68 )
M X
N 3
N 28 N 3 4
3.26 3.63 2015 3.3
2016 2015 N 9
3
2016 - /
2015 2015
3.19 2016 3.63 2=0.20 (1)
(2)
(3) 2
N (4)
(5) N
2015 N 2016
$/6,9���&#=����
� @BAC 8( )( 8( )(
�! ��'��! .-. 4/,. .-3 53,/
�����' 06 /4,6 .4 .0,5
99�%�!D��E */1+ *.4,.+ *.0+ *.-,3+
99�����!D��E *5+ *2,4+ */+ *.,3+
99�����!D��E *4+ *2,-+ */+ *.,3+
�� �� 4. 2-,4 41 3-,/
�� 36 16,0 16 06,5
�<; 55 3/,6 35 22,0
�:? 2/ 04,. 22 11,4
���� �"
>=�
/-.3��
*87./0+
/-.2��
*87.1-+
85
o N
N N
2015 3.43
3.00 Welch t t=5.11, df=109.0,
p<0.001 2016 o N
- , -
2015 5 2016 8
N
2016 ×
2015 2 2015
3.30 2016 3.60 2=0.11 AHRQ gency for Healthcare
Research and Quality TeamSTEPPSvi Team Strategies and Tools to Enhance
Performance and Patient Safety 4
117 N
× 2016 AHRQ
× N
× N N
2015 2016 ,
2015 2016
2015 3.53 2016 3.54 2=0.001
N
N
− (1)
(2)
vi AHRQ N
o N TeamSTEPPS
AHRQ N ×
×
86
N (3)
(4)
N N
(5)1 10 7 3
360°
, , (1)-(2),(7) 2015
3 2015 3.27 2016
3.52 2=0.10 o
2015
4 3 N
2016 3 N
N
(5)
× N IPE
× × N × 2013
× 2016
38
×
×
IPE
× N 6
IPE IPE
― ×
IPE N
× N 2015 2016
87
2016
2017 2016
2015 2016
118
88
i
N × 1
3
IPE × 3
IPE
(1) SM
2016
3 N N
Rotation-based
clerkship (RBC) Longitudinal integrated clerkship (LIC)
20 119
CBME Community-based medical education N
120 LIC CBME
×
3 LIC CBME
o
×
5 19 4 6
3
×
2 N
N 4
89
4 N 5
× 1 ×
×
(2)
1)
― ―
2 2016 9
2)
102 117
×
3 ×
15 N ―
2
3)
2 N
× 1 30 14
× N
N 2
N 4
N (5 )
(4 ) (3 ) (2 ) (1
) 5 N
4)
× 7
30 N
5 × 7
N t Welch
90
Welch 7
t (d) d
116 t 7 t
8 d 0.20( )0.50( )0.80( )
( )
( ) ( ) 2
1 2 2
0.01( )
0.06( )0.14( ) 99
1 0
IBM SPSS Statistics 22.0 p<0.05
5) �����
2
(5) 2
� ��� �� ����� � ��� ���
d
� ��� �� ����������� � ��� ���
91
(3) #�
1) ��!�������
97 ( 95.1%) 75.3% 30
(40.2%) (45.7%) 9
�� OQPRS @ ,
�� !� 73 75/3
�� 24 24/7
�&� ;� 25 25/8
<� 19 19/6
=� 14 14/4
>� 16 16/5
?� 23 23/7
�&KJ���� %�#DFC 37 40/2
-(�*�. MM%�#DFC 42 45/7
HENGLABIA 12 13/0
MM��#DFC 1 1/1
��#DFC 0 0/0
)30V���+'J��#��-@:97.T���$
�W� �����"�&J*�U
2) �"�������� $���(��� 1)�� ��
( 1) 7 30
t
31 7 30
t 0.01
(dDiff) 30
dDiff=1.06 dDiff=1.05
dDiff=0.80 dDiff=0.65
dDiff=0.64
32
92
30
�& �8 �8" Z Y UTWVV
5���x�AB\(7
DPC0E��� ��� FNGI RHGHHI HGNM
5���x<-/�8DMC
0E���� ���� FOGM RHGHHI HGPH
5���x`lnge^j
qb]\B$DLC0E���� ���� FQGN RHGHHI IGHM
5���x1�/�@DMC
0E��� ���� FNGH RHGHHI HGNL
5���x2>[%:DJC
0E�� ��� FKGO RHGHHI HGKQ
5���x�+/y3�/
?�DKC0E���� ��� FIGO RHGHHI HGIP
5���x9�6+DKC
0E���� ���� FLGK RHGHHI HGLN
�<#*tKHC0u ����� ����� FQGQ RHGHHI IGHN
;KIv�.ish_daofpcm=�!DrkqIE\#*��DXSPPE
t'��4��w ,��)�����.�8\=u
( )
( ) ( )
( )
( 1) 7 30
( )
33 6.3
5.8 0.12
( )
34
(p<0.001)
p=0.006 (p=0.03)
(p<0.001) (p<0.001) 30 (p<0.001)
+<
z+<
z+<
z+<
z+<
z+<
z+<
z+<
z
-�d
?-]yoil^
elal
dhaj
deah
dlae
iac
deaf
dcaf
dchal
�-]yoef^
elad
dgak
ddal
dlag
hag
dfad
dcaf
dcgac
"M��e
p��]yoef^
fcae
diad
dfak
dlai
iag
deah
dcac
dckai
q��]yodk^
fdag
diad
ddaj
ecac
iad
dead
ddae
dckaj
r��]yodg^
elad
dfah
ddac
dkai
hag
dead
laj
llag
s��]yodi^
elak
dhai
deaf
dlai
haj
dfah
dcai
dcjad
t��]yoed^
ekac
dhah
dead
dkag
hah
deah
dcac
dceac
"M����.*d
]O'S^
_\zncach`\__\zncacd`\___zncaccd
y{
y{
y{
y{
y{
y{
y{
y{
__
y{
___
y{
y{
y{
y{
y{
y{
y{
lgaf
hai
ddac
lak
deah
y{
I���¦
�YZ�7K
]k[C^
�1
����¡
Qfe¤�4$UN��2B&-��A� ���������S%*�+<m"M�]yolj^¢3(�G� ¥)>��;�����A"M�S£
__
y{
_y{
dlai
hal
deak
dcag
dcjac
dcak
djah
d\�82|5!]qvxuw9£
e\��XL�0�4]qvxuw9£ ��:6B���b
:6B���]yode^
H6B���b��
H6B���b���
��}~�}]yojh^
fcac
dhaj
eiaf
dfae
I���¦
O'J=
]f[C^
�R+<
¢fc[C£
I���¦
R@B M
]h[C^
I���¦
��������
���Z,]g[
C^
I���¦
D#B"W
]h[C^
I���¦
ET�/P
]e[C^
I ��¦
�=B§F�B
V�
]f[C^
("�. J� %/� F8' b d eX
��� WY^UW W XYUX `VUVVW VUXW
� Y]U] W WUX VUX^ VUVW
����� ^UY W WUZ VUXZ VUVX
��� WYWUW W ZWU] `VUVVW VUYY
� W_U] W VU_ VUYZ VUVW
����� VUW W VUV VU^] `VUVVW
��� Y]WU_ W ]ZUW `VUVVW VUZ\
� XU^ W VUX VU\Y VUVVY
����� WUV W VUX VU\] VUVVX
��� \WUW W XZUY `VUVVW VUXX
� VUVVW W VUVVW VU__ `VUVVW
����� VU_ W VUZ VU[V `VUVVW
��� WZU] W WVUY `VUVVW VUWW
� WWUV W XU[ VUWX VUVY
����� VUVVW W VUVVW VU_^ `VUVVW
��� WU] W WUW VUX_ VUVW
� _U_ W WU] VUXV VUVX
����� WUW W VU] VUZV VUVW
��� W^U\ W WVU] VUVV VUWW
� XU\ W VUY VU\V `VUVVW
����� XUY W WUY VUX[ VUVX
��� Y[\^UZ W \_UX `VUVVW VUZ[
� W_^UX W VU\ VUZ\ VUVW
����� YYUW W VU\ VUZX VUVW
("�. J� %/� F8' b d eX
��� XWVUX W Y[UW `VUVVW VUYV
���� W]YU] Z WUZ VUXZ VUV\
�������� XXUZ Z VU_ VUZ[ VUVZ
��� W\]UX W [YU^ `VUVVW VUY_
���� WZ_UZ Z WU^ VUWZ VUV^
�������� WXUY Z WUV VUZX VUV[
��� Z\]U^ W _[U\ `VUVVW VU[Z
���� ]YUV Z WU\ VUW^ VUV]
�������� X\U[ Z WUZ VUX\ VUV\
��� ^VU] W YXU\ `VUVVW VUX^
���� [^UV Z WU[ VUXW VUV]
�������� WWUW Z WUW VUY[ VUV[
��� XVUX W WZU\ `VUVVW VUW[
���� WWUY Z VU\ VU\\ VUVY
�������� ^UW Z WU[ VUXX VUV]
��� XU_ W WU_ `VUVVW VUVX
���� X_UV Z WUX VUYW VUV\
�������� ZU] Z WUX VU[Z VUVZ
��� YXU^ W W^UW `VUVVW VUW^
���� [[UW Z WU[ VUXX VUV]
�������� WUZ Z VUX VU_Z VUVW
��� Z^_[UX W _]U] `VUVVW VU[Z
���� W_\YUX Z WUZ VUXY VUV\
�������� YV[U[ Z ]\UZ VUXV VUV]
A�����6;�?�;N�
SYR<T
A����F#B6
SYR<T
�K)5�YVR<�
IYYUf�:y�xnsp�v�r}L!'S�{�WTi)5��g,�iQ��GD�~u�S�*3�T
hkl 1Sca^^T�0$�@���&7��4�����:�EiL�
IYZ��:y�xnsp�v�r}L!'S�{�WTi)5��g�E��iQ��GD�~u�S�*
3�Thkl 1Sca^^Tf�0$�@���&7��4�����:�EiL�
A�����PQi2C
S^R<T
A����K9;�E
S[R<T
A����o|�wtmz�qjiQ
+
SZR<T
A����= ;�O
S[R<T
A����>Mg-H
SXR<T
A�����6;�?�;N�
SYR<T
A����F#B6
SYR<T
�K)5�YVR<�
A�����PQi2C
S^R<T
A����K9;�E
S[R<T
A����o|�wtmz�qjiQ
+
SZR<T
A����= ;�O
S[R<T
A����>Mg-H
SXR<T
'!�- I� $.� E7& a c dW
���� Y^TU V ]TX UTUUZ UTU^
��� YY\TX V V[TY _UTUUV UTV[
�������� V]T^ V XTW UTU] UTUY
���� [WT^ V WVTX _UTUUV UTWU
��� VZ]T\ V \T] UTUU[ UTU]
�������� VTW V UTY UTZW UTUUZ
���� WV\TW V YXT] _UTUUV UTXY
��� ZXTY V YT\ UTUX UTUZ
�������� UTW V UTU UT]Z _UTUUV
���� WUTX V ]TW UTUV UTU^
��� VZUT[ V V^TV _UTUUV UTV]
�������� [T] V WT] UTVU UTUX
���� VT] V VTX UTWZ UTUW
��� VXTW V WT^ UTU^ UTUX
�������� YTY V XTX UTU\ UTUY
���� UTV V UTV UT]W UTUUV
��� VUXTW V WXTU _UTUUV UTWV
�������� XTW V WTX UTVY UTUX
���� VVT\ V [T[ UTUV UTU\
��� VUTU V VTV UTXV UTUV
�������� UT[ V UTX UTZ\ UTUUY
���� VZX\TZ V XUT] _UTUUV UTW\
��� Y^YVTU V V[T[ _UTUUV UTV[
�������� VZVTW V XTU UTU^ UTUX
�J(4�XUQ;�
@����n{~vsly�pihP
*
RYQ;S
@����<�:�N
RZQ;S
@����=Lf,G
RWQ;S
@�����5:�>�:M�
RXQ;S
@����E"A5
RXQ;S
@�����OPh1B
R]Q;S
@����J8:�D
RZQ;S
HXZ��9x�wmro�u�q|K &R�z�VSh(4��f�D+&hP��FC�}t�R�)
2�Sgjk 0Rb`]]Se�/#�?���%6��3�����9�DhK�
96
B2<
hfqgo
cdic
nel42<
C�����RSk3E ���� ���� _XWXXY
C����L:<�G ��� ���� XWXX\
C����u��}zs��wmkS* ���� ���� XWXZ
C����>�<�Q ���� �� _XWXXY
C����?Og,J ��� ��� XWX^
C�����8�@�<P� ���� ��� _XWXXY
C����H"D8 ��� ���� XWZY
�L(7UZXT=V ���� ��� _XWXXY
�G+&UH"MV
'!�. bUKZ[ -�
KZ\W�;��~tyv�|�x�M &U���YVk(7g�G+&k
SUN/$�V��IF��{�U�)5�Vjpr�1Ua`]]V�0#�A�
��%9��6�����;�GkM�
35 36
30
0.1 9 12
30
��� ���� ������������ IPE ���
(1) ����
Interprofessional Education (IPE) 1960
97
RONOK
RQNTK
QUNR
QUNX
QS
QU
QW
RO
RQ
RS
RU
RW
�@ �@#
�X}�5qypjmkuovlsE��"LxrwPM
=���\�HIe.>]e$2(;
L�@&"�M
�A?�tnwL�%0�Mdgi�+LZYWWM
{* �:���!3��1�����5�@|
���4�,L[YONOW~CRT)|
�@&"L<-6M
�@&"{b`haf^_c^z/-6|
PXNU
QPNQ
PVNT
PVNX
PU
PW
QO
QS
QU
�@ �@#
�PO}�5qypjmkuovlsE��"LxrwPM
=���\8�6�G]e$2(;L�@&"�M
�A?�tnwL�%0�Mdgi�+LZYWWM
{* �:���!3��1�����5�@|
���4�,L[YONPO~CRT)|
�@&"L<-6M
�@&"{b`haf^_c^z/-6|
(q )
(q )
98
TNXQ
UNUW
TNTW
TNSQ
S
SNT
T
TNT
U
UNT
V
VNT
W
�@ �@#
�PP}�5qypjmkuovlsE��"LxrwPM
=���\9Fa'B]e$2(;L�@&"�M
�A?�tnwL�%0�Mdgi�+LZYWWM
{* �:���!3��1�����5�@|
���4�,L[YONOV~CRT)|
�@&"L<-6M
�@&"{b`haf^_c^z/-6|
POVNOK
PPWNOK
XSNR
POONQ
WO
XO
POO
PPO
PQO
PRO
PSO
�@ �@#
�PQ}�5qypjmkuovlsE��"LxrwPM
ROJ7�D$2e$2(;L�@&"�M
�A?�tnwL�%0�Mdgi�+LZYWWM
{* �:���!3��1�����5�@|
���4�,L[YONOX~CRT)|
�@&"L<-6M
�@&"{b`haf^_c^z/-6|
(q )
.
(q )
99
× Tribalism
16 N
IPE 2000 IPE
N 6 2001 N IPE
121 N N
IPE Randomized
Control Trial(RCT) ― N IPE
― 2
N IPE ― 2001
2010 N ×
122,123 3 124 1 125 N
126 Web N 127 IPE ×
o ― IPE
N N ―
IPE ―
o
2004
IPE N
108
N
1
× ―
128 2012
RIPLS129 KiSS-18102 N 99 N
N RIPLS
130 2013 99
o N N
100
N N N
N ×
2
(2)
1)
― ―
(10 ) (1 ) 2
2016 10 2017 1
2)
109
19
3)
2 N
N × 1 30
× N
N
N
4)
× ( ) 7
30 N
× 7
N t Welch 7
t N (d)
N d 116 t
6 t ( 7) N
d N 0.20( ) 0.50( ) 0.80( )
( )
101
( ) ( ) 2
1 2 2
0.01( )
0.06( )0.14( ) 99
IBM SPSS Statistics 22.0 p<0.05
5) �$&)�
(3) '!
1) ��#���� �� 128 ( 100.0%) (61.7%)
8 (85.2%)( 37)
15 70
(54.7%) 19
� JLKMO B 2
�� "� >@ =85>
�� ;@ :?5:
�1N�& ��1��& 87@ ?<59
��#�(HG� DI >7 <;5>
FE <? ;<5:
,:>5���/)G��$��3BA89?4
CCCP���&��8�!�*'0��+G-�Q
���#�1P%.�&6
�#��&6��#��
&Q8@ 8;5?
2) �%�������� (���(��� 1)��"�� ( 1) 7 30
102
t
( 38)7 30 2016 10 (
) 2017 1 ( )
2 3 19.3 19.9
10.9 10.5
0.3
�& )H�'
LRPQV�QP(M
);�'
LRPQW�Q(Ma ` \ [^]]
8���
L�IJ�c+:}���� ��� NQOVW POQP POQT
8���
LB/1�<M���� ���� NPOUR POVQ POPV
8���
LgsunleqxidcJ"M���� ���� NPOUT POUY POPT
8���
L3�1�FM���� ���� NROVX POPPX PORW
8���
L4Db#@M��� ��� NPOPU POYV POPQ
8 ��
L�-{51E�M���� ���� NPOWX POTT POPW
8���
L?�9-M���� ���� ROQR POPT PORS
�B!,LSPK2M ��� ���� NQOPV PORY POQQ
ASX~�0pzofkhvmwjtC��LyrxQMc!,��L_ZQRPM|*��6��Q�.
�=7G$%>cC}
39
30
30
->
~->
~->
~->
~->
~->
~->
~->
~
/�
B/e}wrnf
nkim
lqin
lnio
ltim
pip
lmin
lkis
lkrit
�/e}wotf
nkiq
lqiq
lpil
ltiq
pir
lmim
llim
lllik
!_¡!K
�!_�!Ke}wlknf
nkim
lqim
lnir
ltin
piq
lmin
lkit
lksil
gd~vkikphdggd~vkiklhdggg~vkikkl
9"��<6�9"exz|y{=¤�A��
���D#P����
�W->
£nkcF¤
nlim
lriq
lqin
mkil
pip
lmip
llin
lloip
ggg
lpik
ltit
ggg
lsis
gllin
llmir
���D!_HZ!Kj
?!D=!Kj:D=
!Ke}wltf
M�� ¦
WCE!P
epcFf
M�� ¦
���������
��b.
eocFf
M�� ¦
G$E#]
epcFf
M�� ¦
IY�0U
emcFf
M�� ¦
?E§J�E
\�
encFf
M�� ¦
T(N?
encFf
}�
lkiq
}�
lkois
����e}wqrf
nlin
lril
�������e}wppf
mtim
gg
lpiq
glmit
}�
}�
}�
gggg
}�
}�
}�
}�
gg
pip
}�
lmim
pir
lmio
Vnt¥�8%[Q��6E'/��D� ���������X&+�->u,5`�4e}wlmsf£7)�K�!l*@�RL^12S�X¤
�3
����¢
M�� ¦
�ab��;O
escFf
}�
}�
ggg
}�
}�
}�
104
3
( 1) 7 30 3
( ) ( ) 3 ( )
N
(p=0.003) N (13.5) (14.9)
40 41 3 ( )N
N
3 ( ) ( ) 3 (
) N
(p<0.001) 30 (p=0.04) 42
N N 13.7
16.1 43 30
N 108.3 113.9
3 ( )N
N
3 ( ) ( )
3 ( )
N (p<0.001)
(p<0.001) (p<0.001)
(p<0.001) 30 (p<0.001) 44
N
45 2 N 0.17
3
( )N N
30 N
30
46
105
& �. L� #/� H7% e g h[
A�����STk2C ���� Z[X[ Z [Xb^ YXYb YXY[
�� [^XY Z ZXYY YX\[ YXYZ
������� YXb Z [Xb^ YX_^ YXYY[
A����M8:�E ���� ZX\ Z YX\Z YX^a YXYY\
�� Z]XY Z YXa^ YX\_ YXYZ
������� YX\ Z YXYb YX`` YXYYZ
���� YXZ Z YXY^ YXa[ cYXYYZ
�� ZZ_Xa Z bX[Y YXYY\ YXY`
������� aXZ Z \XYY YXYb YXY[
A����<�:�Q ���� Z`X_ Z _X^[ YXYZ YXY^
�� aXa Z ZXY] YX\Z YXYZ
������� YX] Z YXZ] YX`Y YXYYZ
A����=Oi+J ���� YXZ Z YXY\ YXa_ cYXYYZ
�� YX[ Z YX_^ YXaY YXYYZ
������� YXa Z YX]a YX]b YXYY]
A�����5�>�:P� ���� ZXY Z YXa[ YX\` YXYZ
�� YX[ Z YXY^ YXa\ cYXYYZ
������� YXa Z YX_^ YX][ YXYZ
A����H!B5 ���� bX^ Z ]X^a YXY\ YXY]
�� ZYXZ Z ZX\a YX[] YXYZ
������� YX[ Z YXZZ YX`] YXYYZ
�M'4V\YU;W ���� ]_X] Z YXb] YX\\ YXYZ
�� `Y`X` Z \XYZ YXYb YXY\
������� _XZ Z YXZ[ YX`\ YXYYZ
K]YX�9{�zpur�x�t�N�%V�}�ZWk'4��i*�kT
��ID��w�V�(3�Wjmn 1VfdZ[YW�0"�?��Z$6�F@R,-GkN�
A����q~�yvo|�
slkT)
106
:, �,
D�����VWk5F ���� ��� \[ba
D����O;=�H ���� ��� \[_b
D����q~�yvo|�slkW+ ���� ���� \[\\_
D����? =�T ���� ��� \[_]
D����@Ri-M ��� ��� \[c\�
D ����8�A�=S� ���� ���� \[c_
D����K#E8 ���� ���� \[^`
�O)7Y_\X>Z ��� ����� \[\d
N`]��<{�zpur�x�t�P!'Y�}�]Zk,�)7YQ2%��Z
hhhhh��LG��w�Y�*6�Zjmn�4Yfe]^\Z
hhhhh�3$�B��]&9�ICU/0JkP�
("�1,�
gYN`\�.�
%��- K� X ".� G6$ f h i\
@�����STm1B ���� \Y_ [ ZY`[ ZY^^ ZYZ[
�� \_YZ [ \^Yc_ ZYcc ZYZ[
������� [Ya [ ZY^Z ZY_] ZYZZ]
@����L79�D ���� ZYZ [ ZYZ[ ZYc\ ZYZZ[
�� _]Yc [ ]Y]\ ZYZa ZYZ]
������� ZY` [ ZY[` ZY`c ZYZZ[
���� ZY_ [ ZY[b ZY`b ZYZZ[
�� [b^Y] [ [_Y\Z dZYZZ[ ZY[[
������� ]Yc [ [Y^] ZY\] ZYZ[
@����;�9�P ���� _Ya [ \Y[[ ZY[_ ZYZ\
�� [_Yc [ [Ybc ZY[a ZYZ\
������� [Y^ [ ZY_] ZY^a ZYZZ^
@����<Nk*I ���� ZYZZ[ [ ZYZZ ZYcb dZYZZ[
�� ZY\ [ ZYZa ZYac ZYZZ[
������� ZYZZ[ [ ZYZZ[ ZYcb dZYZZ[
@�����4�=�9O� ���� ZY[ [ ZY[[ ZYa^ ZYZZ[
�� ZY[ [ ZYZ[ ZYc[ dZYZZ[
������� \YZ [ [Ya_ ZY[c ZYZ[
@����G A4 ���� bY^ [ ^YZ[ ZYZ_ ZYZ]
�� \Y^ [ ZY]\ ZY_a ZYZZ]
������� [YZ [ ZY^` ZY_Z dZYZZ[
�L&3V]ZU:W ���� ZYZ] [ ZYZZ[ ZYcb dZYZZ[
�� ca`Y^ [ ^Y[c ZYZ^ ZYZ]
������� _bY\ [ [Y[c ZY\b ZYZ[
��������������
J^\��8}�|rwt�z�v�M�$V���[Wm&3��k)��RmT
jjjj��HC��y�V�'2�Wlop 0Vge[\ZWj�/!�>��[#5�E?
jjjjQ+,FmM�
@����s��{xq~�
unmT(
107
��U ���;�U
C�����VWk5E ���� ���� \[_^
C����N:<�G ���� ��� \[\b\
C����q~�yvo|�slkW, ��� ���� d\[\\]
C����>!< S ���� ���� \[]b
C����?Qi-L ��� ��� \[bc�
C���� 8�@�<R� ���� ���� \[c]
C����J$D8 ��� ���� \[ab
�N*7Y_\X=Z ���� ����� \[\`
M`_��;{�zpur�x�t�O"(Y�}�]Zk�U�*7YP2&��Z
hhhhh��KF��w�Y�+6�Zjmn�4Yfe]^\Z
hhhhh�3%�A��]'9�HBT/0IkO�
)#�1�U
gYM`^�.�
)#�0 N� &1� J9( h j k^
C�����UVo4E �� ]^[b ] _[\a \[\d \[\_
������ ^b_[a ] ]][`\ f\[\\] \[\e
��������� ^[a ] \[b^ \[`_ \[\]
C����O:<�G �� ][\ ] \[^` \[b_ \[\\^
������ ]d^[a ] ]^[\\ f\[\\] \[\e
��������� \[^ ] \[\` \[d` f\[\\]
�� ][] ] \[_d \[a` \[\\_
������ ^c_[_ ] ^`[]\ f\[\\] \[]c
��������� ][_ ] \[`c \[`e \[\\`
C����>!< S �� ]e[_ ] c[]\ \[\\e \[\b
������ eb[\ ] ]^[_e f\[\\] \[]\
��������� \[] ] \[\^ \[dd f\[\\]
C����?Qm-L �� \[\ ] \[\\^ \[ec f\[\\]
������ \[d ] \[^` \[b^ \[\\^
��������� \[e ] \[b\ \[`` \[\]
C�����7�@�<R� �� \[c ] \[b\ \[`` \[\]
������ _[b ] \[cd \[_d \[\]
��������� \[\\^ ] \[\\] \[ec f\[\\]
C����J$D7 �� d[] ] _[e_ \[\a \[\_
������ ^_[d ] _[_\ \[\c \[\_
��������� ][e ] \[e^ \[_` \[\]
�O*6Y_\W=Z �� b^[b ] ][^c \[^b \[\]
������ XXXXX ] ]e[c\ f\[\\] \[]`
��������� ^_[c ] \[`d \[`e \[\\`
C����u��}zs��
wpoV,
M``��;��~tyv�|�x�P"(Y���]Zo*6��m���; G
llllpo��moV��KF��{�Y�+5�Znqr 3Yig]^\Z
llll�2%�A��]'8�HBT./IoP�
108
��oq
nsn��op
G�����YZu8I ���� ���� `_dc
G����R>@ K ���� ��� i`_``a
G����{����y��}vuZ. ���� ���� i`_``a
G����B#@"W ��� ���� i`_``a
G����CUr/P ��� ��� `_fb
G ����<�D�@V� ���� ���� `_ch
G����N&H< ���� ���� `_`g
�R,:]c`[A^ ����� ����� i`_``a
+%�3
���?"Kvu��
l]Qdd�0�
Qde��?���z�|���~�S$*]���a^u���?"Kvu��u
mmmm\5;�,:]T4(��^��OJ����]�-9!^twx�7]kjab`^
mmmmm�6'�E� a)=�LFX12MuS�
���$ 8� �% 5+� N P QD
��� BAD C BABI BAIK BABBC
�� CKAD C CAIH BACK BABC
�� FCAH C EAJE BABG BABE
���� CDGAC C CCAGB LBABBC BABK
�9�)?EB>-@ ��� BAJ C BABD BAKB LBABBC
�� GCAF C BADG BAHD BABBD
���� ECGEAC C CGACB LBABBC BACD
7FHA,fqe[`]mcn_j:���?phoC@V�)��T!�S�<S
RRR�2WV�TV=�u�61�kbo?��(�@UXY�'?OMCDB@
RRRs&�.��C�*�3/;"#4V:�t
0���u\ildaZrgo^
WV=
109
(4) ��
1) � �����������������������
1
8 (30 )
1.06
131
132
dDiff=1.05
133
dDiff=0.80
134,135
0.1
d=0.18
110
136
137
2) �������������� IPE ���
3
39
138
3
44 4 30
10
1
IPE
111
N
132 N 139
Generic Skills N
N
Specific 3 N
3) P S X 5
N
IPE N
N
N N
N vii
140 N
IPE 3
N
Hidden Curriculum o 141
vii
N
112
|N{ fwz*_h&��
N
N
Profession N
5
N
N 1990
N 3
N
α
N
1990
4
3 11 2
90 21 7 3
N N
N o
113
1990
20
N
N
N
o
3 N 3
N (1)
(2) N
(3)
N
259 2
1 N 2
2 N
1 N 30 7
114
2 N 31 8
N
1 N
N
IPE
2016 N
2015 2016
2016 2017 2016
N
N 1
1 IPE
3 -
IPE N
8
(30 )
IPE N N
N
N
N
PDCA N
PDCA
115
a� � n�
1. CAIPE. 2002; http://www.caipe.org.uk/resources/. Accessed 3/4, 2014.
2. Reeves S. Interprofessional education: effects on professional practice
and healthcare outcomes (update). Cochrane Database of Systematic
Reviews. 2013(3).
3. Szasz G. Interprofessional education in the health sciences. A project
conducted at the University of British Columbia. The Milbank
Memorial Fund quarterly. 1969;47(4):449-475.
4. , , . ,
N 21
Inter-professional N Rawson,D. . Quality
nursing : the Japanese journal of nursing education & nursing
research. 1998;4(12):1032-1040.
5. . N :
. : ; 2012.
6. ( ). IPW . :
; 2009.
7. Takahashi HE, Sato S. Establishment of the Japan Association for
Interprofessional Education and perspectives. Journal of
Interprofessional Care. 2009;23(6):554-555.
8. Ito T. JIPWEN(
) (Interprofessional
Education through JIPWEN (Japan Interprofessional Working and
Education Network)). Niigata journal of health and welfare.
2010;10(1):73-78.
9. . 19
2007; http://www.mext.go.jp/component/a_menu/education
/detail/__icsFiles/afieldfile/2015/06/22/1257660_001.pdf. Accessed
116
1/31, 2017.
10. Buring S, Bhushan A, Broeseker A, et al. Interprofessional education:
definitions, student competencies, and guidelines for implementation.
American Journal of Pharmaceutical Education. 2009;73(4):59-59.
11. Kent F, Keating J. Interprofessional education in primary health care
for entry level students--A systematic literature review. Nurse
Education Today. 2015;35(12):1221-1231.
12. Sakai I, Yamamoto T, Takahashi Y, Maeda T, Kunii Y, Kurokochi K.
Development of a new measurement scale for interprofessional
collaborative competency: The Chiba Interprofessional Competency
Scale (CICS29). Journal of Interprofessional Care. 2017;31(1):59-65.
13. Parsell G, Bligh J. The development of a questionnaire to assess the
readiness of health care students for interprofessional learning
(RIPLS). Medical education. 1999;33(2):95-100.
14. Mahler C, Berger S, Reeves S. The Readiness for Interprofessional
Learning Scale (RIPLS): A problematic evaluative scale for the
interprofessional field. Journal of Interprofessional Care.
2015;29(4):289-291.
15. Yamamoto T, Sakai I, Takahashi Y, Maeda T, Kunii Y, Kurokochi K.
Development of a new measurement scale for interprofessional
collaborative competency: a pilot study in Japan. Journal of
interprofessional care. 2014;28(1):45-51.
16. Frenk J, Chen L, Bhutta Z, et al. Health professionals for a new
century: transforming education to strengthen health systems in an
interdependent world. Lancet. 2010;376(9756):1923-1958.
17. Holtman M, Frost J, Hammer D, McGuinn K, Nunez L.
Interprofessional professionalism: linking professionalism and
interprofessional care. Journal of Interprofessional Care.
2011;25(5):383-385.
18. Chandratilake M. From the professionalism of a profession to the
117
professionalism of a multiprofessional team. Medical Education.
2014;48(4):345-347.
19. .
(IPE)N .
. 2012;43(Suppl.):19.
20. Carr-Saunders AMS, Wilson PA. The professions. F. Cass; 1964.
21. . . , ( ),
: . :
; 2005:xi, 482p.
22. Lieberman M. Education as a profession. Prentice-Hall; 1956.
23. . . : ; 1996.
24. Hall RH. Professionalization and Bureaucratization. American
Sociological Review. 1968;33(1):92-104.
25. Barr H. Universities respond together to the interprofessional
challenge in Japan. Journal of interprofessional care. 2012;26(5):350-
352.
26. . = . Vol 1: ; 1986.
27. . : .
. 1972;22(3):30-49.
28. .
. . 2010;20(3):251-262.
29. Weiler PC. A Measure of malpractice : medical injury, malpractice
litigation, and patient compensation. Harvard University Press; 1993.
30. Arnold L. Assessing professional behavior: yesterday, today, and
tomorrow. Academic medicine. 2002;77(6):502-515.
31. Arnold L, Stern DT. What is medical professionalism? In: Stern DT,
ed. Measuring medical professionalism. New York: Oxford University
Press; 2006:15-37.
32. Hafferty FW. Professionalism and the socialization ofmedical students.
In: Cruess RL, Cruess R, Steinert Y, eds. Teaching medical
118
professionalism. New York: Cambridge University Press; 2009:53-70.
33. Smith LG. Medical professionalism and the generation gap. The
American Journal of Medicine. 2005;118(4):439-442.
34. . . In:
, , ( )―
( ). : ; 2009:19-30.
35. . . 1995.
36. , , , .
- .
. 2006;18(1):45-57.
37. Cruess R, McIlroy J, Cruess S, Ginsburg S, Steinert Y. The
Professionalism Mini-evaluation Exercise: a preliminary investigation.
Academic medicine. 2006;81(10 Suppl):S74-78.
38. Arnold EL, Blank LL, Race KE, Cipparrone N. Can professionalism be
measured? The development of a scale for use in the medical
environment. Academic medicine. 1998;73(10):1119-1121.
39. AmericanBoardofInternalMedicine. ABIM Project Professionalism.
1995.
40. Aramesh KK. Measuring professionalism in residency training
programs in Iran. Medical teacher. 2009;31(8):e356-361.
41. Ahadi T, Mianehsaz E, Raissi G, Moraveji S, Sharifi V. Professionalism
in residents of physical medicine and rehabilitation in Iran. Journal
of medical ethics and history of medicine. 2015;8:3-3.
42. DeLisa JA, Foye PM, Jain SS, Kirshblum S, Christodoulou C.
Measuring professionalism in a physiatry residency training program.
American journal of physical medicine & rehabilitation.
2001;80(3):225-229.
43. , .
. . 2009;98(12):3178-3182.
44. Tsugawa Y, Ohbu S, Cruess R, et al. Introducing the Professionalism
119
Mini-Evaluation Exercise (P-MEX) in Japan: results from a
multicenter, cross-sectional study. Academic medicine.
2011;86(8):1026-1031.
45. Tsugawa Y, Tokuda Y, Ohbu S, et al. Professionalism Mini-Evaluation
Exercise for medical residents in Japan: a pilot study. Medical
Education. 2009;43(10):968-978.
46. Morreale M, Balon R, Arfken C. Survey of the importance of
professional behaviors among medical students, residents, and
attending physicians. Academic Psychiatry. 2011;35(3):191-195.
47. Al Eraky M, Chandratilake M, Wajid G, Donkers J, van Merrienboer
J. Medical professionalism: development and validation of the Arabian
LAMPS. Medical Teacher. 2013;35 Suppl 1:S56-S62.
48. Gillespie CC. Residents' perceptions of their own professionalism and
the professionalism of their learning environment. Journal of
graduate medical education. 2009;1(2):208-215.
49. Klemenc Ketis Z, Vrecko H. Development and validation of a
professionalism assessment scale for medical students. International
Journal of Medical Education. 2014;5:205-211.
50. Jahan F, Siddiqui M, Al Zadjali N, Qasim R. Recognition of Core
Elements of Medical Professionalism among Medical Students and
Faculty Members. Oman Medical Journal. 2016;31(3):196-204.
51. ¡̗ʭ , ȕɆ�Ƃ , Ŧˠŷĉ . ɁŎɏșĸ0q�oLbY�g�\y0
ßǮ . ɁŎɏșɬŎ . 2014;29(4):599-604.
52. Tanaka M, Yonemitsu Y, Rieko K. Reliability and validity of the
Japanese version of the behavioral Inventory for professionalism in
nursing. J�_�gY�g� nursing care research. 2012;11(3):21-29.
53. Kelley KAKA. Cross-validation of an instrument for measuring
professionalism behaviors. American journal of pharmaceutical
education. 2011;75(9):179.
54. Cohen JJJJ. Professionalism in medical education, an American
120
perspective: from evidence to accountability. Medical education.
2006;40(7):607-617.
55. Blackall G, Melnick S, Shoop G, et al. Professionalism in medical
education: the development and validation of a survey instrument to
assess attitudes toward professionalism. Medical Teacher. 2007;29(2-
3):e58-e62.
56. Ɇ̄ǃʻ . HKePyıɓĭdžʣ0Ɂ˚+œˬ . ɿÿÞȸnjɦ ; 2013.
57. ABIM Foundation, American Board of Internal Medicine, ACP-ASIM
Foundation, American College of Physicians-American Society of
Internal Medicine, European Federation of Internal Medicine. Medical
professionalism in the new millennium: a physician charter. Annals of
Internal Medicine. 2002;136(3):243-246.
58. GeneralMedicalCouncil. Good medical practice 2015. 2015;
http://www.gmc-uk.org/guidance/good_medical_practice.asp. Accessed
5/1, 2015.
59. TheRoyalCollegeofPhysiciansandSurgeonsofCanada. CanMEDS 2015
Physician competency framework. 2015; http://www.royalcollege.ca
/portal/page/portal/rc/common/documents/canmeds/framework/canme
ds_full_framework_e.pdf. Accessed 12/9, 2015.
60. ǐ ǧ ö ŭ ¯ . ö ŭ 0 ʢ ǻ Æ Ɂ Ƶ ̐ ( ǂ ˆ ȸ ). 2008;
https://www.med.or.jp/doctor/member/000250.html. Accessed 5/13,
2015.
61. ǐǧöŎdžʣŎ¯q�oLbY�g�\ydžʣ0V�]�X[FƁƦ�
?� WS _[SoN�[ . q�oLbY�g�\y0ǟʉä˿ɔǿǷ .
2015;
https://docs.google.com/forms/d/1dxGjml_uJORyejdgdiQLSSAoXK3H_
Lj_qzlTUI1uITM/viewform?c=0&w=1. Accessed 5/18, 2015.
62. � Ɋ ö ŭ ¯ . ö 0 ĥ ̠ Æ Ɂ ʑ ̮ . 2006; http://dl.med.or.jp/dl-
med/wma/medical_ethics2006j.pdf. Accessed 2017, 2/1.
63. Miller BK. A model for professionalism in nursing. Today's OR nurse.
121
1988;10(9):18-23.
64. InternationalCouncilofNurses. The ICN code of ethics for nurses.
2012;
http://www.icn.ch/images/stories/documents/about/icncode_english.pd
f. Accessed 12/09, 2015.
65. AmericanNurseAssociation. Code of Ethics for Nurses. 2015.
66. ǐǧə˟ü¯ . ə˟ʡ0ÆɁʑ̮ . 2003; https://www.nurse.or.jp/
nursing/practice/rinri/rinri.html. Accessed 07/01, 2015.
67. AmericanPhysicalTherapyAssociation. Professionalism in Physical
Therapy: Core Values. 2012; http://www.apta.org/uploadedFiles
/APTAorg/About_Us/Policies/Judicial_Legal/ProfessionalismCoreValu
es.pdf. Accessed 10/01, 2015.
68. CharteredSocietyofPhysiotherapy. Code of Professional Values and
Behaviour. 2011; http://www.csp.org.uk/professional-union/
professionalism/csp-expectations-members/code-professional-values-
behaviour. Accessed 07/01, 2015.
69. AmericanSocietyofHealth-SystemPharmacists. ASHP Statement on
Professionalism. American journal of health-system pharmacy.
2008;65(2):172-174.
70. ǐ ǧ ʴ ç ŭ ¯ Ɂ � ¯ . ʴ ç ŭ Æ Ɂ ˁ ő . 1997; http://www.
nichiyaku.or.jp/contents/info_97/n971031.html. Accessed 2/1, 2017.
71. ŨĜɆ�̆ . ɐƝș . Vol 136, 210. ǫ£ : �ŁÖ˚ɦ ; 1967.
72. Guyatt G. Evidence-based medicine. American College of Physicians
Journal Club. 1991;114:A-16.
73. ȓɆ¿� . Ȇʁ.��B EBM 0Ţ̕ . ȟļɦ¯À̡ɢɲ . 2000;133:27-
37.
74. o��f^� . öɏ+Ś̔ŕǁ̉ . ǫ£ : ƙǔɦþɃ̘ ; 1992.
75. IPEC-Expert-Panel. Core Competencies for Interprofessional Collaborative
Practice. 2011.
76. �ǩɀƚ , ³ʵʜ¸ . DŽĕDŽƖ]�_�.��B^�Y|���P�Ś
122
3 .
. 2014;17(5):716-723.
77. Kohn LT, Corrigan J, Donaldson MS, Institute of Medicine .
Committee on Quality of Health Care in A. To err is human : building
a safer health system. National Academy Press; 2000.
78. .
. . 2014;73(4):310-314.
79. Densen P. Challenges and opportunities facing medical education.
Transactions of the American Clinical and Climatological Association.
2011;122:48-58.
80. . SEIQoL Response
Shift . . 2014;2(2):19-24.
81. , , , .
. .
2013;36(4):39-46.
82. , , , .
. . 2013(43):3-
6.
83. . o .
2014.
84. . .
. 2015;4(1):43-49.
85. .
. . 2016;17(3):150-153.
86. . : N . ;
1980.
87. AmericanInstituteofArchitects. 2017 Code of Ethics and Professional
Conduct. 2017. Accessed 3/20, 2017.
88. . . 2014;
https://www.nichibenren.or.jp/library/ja/jfba_info/rules/pdf/kaiki/kaik
123
i_no_70_160525.pdf. Accessed 3/30, 2017.
89. . . http://www.meti.go.jp/policy/kisoryoku/.
Accessed 3/20, 2017.
90. . o
. . 2015;19:1-13.
91. . :
. . 2012(18):75-114.
92. . o :
1 . :
. 2016(23):71-78.
93. PROG. o PROG. http://www.riasec.co.jp
/prog_hp/generic.html. Accessed 3/20, 2017.
94. .
. . 2013;23:95-99.
95. .
. . 2010;41(3):189-193.
96. , , , , , .
SD Student Doctor
. 21 . 2013;8:31-37.
97. , , .
. . 2016;6(1):49-62.
98. , , , .
o . . 2014;45(3):163-171.
99. , , , .
(IPE) - .
. 2013(19):37-45.
100. DeVellis RF. Scale development : theory and applications. 3rd ed.
Thousand Oaks, Calif.: Sage; 2012.
101. Kaiser HF. An index of factorial simplicity. Psychometrika.
124
1974;39(1):31-36.
102. . KiSS-18 . .
2004;6(2):41-51.
103. . G o .
. 2007;10(1):45-51.
104. .
o . journal of uoeh. 2005;27(3):263-272.
105. . :
. : ; 2011.
106. Nunnally JC. Psychometric theory. McGraw-Hill; 1978.
107. . .
. 2012;101(5):1440-1445.
108. , , , .
IPE .
. 2013;6(1-2):33-34.
109. Sohma H, Sawada I, Konno M, et al. Encouraging Appreciation of
Community Health Care by Consistent Medical Undergraduate
Education. In: Watanabe H, Koizumi M, eds. Advanced Initiatives in
Interprofessional Education in Japan: Japan interprofessional
working and education network. Tokyo: : Springer; 2010.
110. , , , , .
(early exposure)
. . 2014;63(4):263-267.
111. , . 1
. . 2011;42(1):1-7.
112. Michaelsen L. TBL- :
. 2009.
113. . . . 2012;126(4):181-
188.
114. ( )― :
125
. ; 2015.
115. Barkley EF, Cross KP, Major CH. : .
; 2009.
116. , .
. 2010
. 2011:47-73.
117. AgencyforHealthcareResearchandQuality. TeamSTEPPS. 2012;
https://www.ahrq.gov/teamstepps/instructor/index.html. Accessed 2/1,
2017.
118. , , , .
. . 2007;38(6):377-381.
119. McLaughlin K, Bates J, Konkin J, Woloschuk W, Suddards C, Regehr
G. A comparison of performance evaluations of students on
longitudinal integrated clerkships and rotation-based clerkships.
Academic medicine. 2011;86(10 Suppl):S25-S29.
120. . ( 1 )
CBME N? . 2013;36(3):242-245.
121. Cooper H, Carlisle C, Gibbs T, Watkins C. Developing an evidence base
for interdisciplinary learning: a systematic review. Journal of
advanced nursing. 2001;35(2):228-237.
122. Miller A, Morton S, Sloan P, Hashim Z. Can a single brief intervention
improve participants' readiness for interprofessional learning?
Journal of interprofessional care. 2013.
123. Wellmon R, Gilin B, Knauss L, Inman Linn M. Changes in student
attitudes toward interprofessional learning and collaboration arising
from a case-based educational experience. Journal of allied health.
2012;41(1):26-34.
124. . ( 1
) . . 2010;3(1):10-19.
125. Wakely L, Brown L, Burrows J. Evaluating interprofessional learning
126
modules: health students' attitudes to interprofessional practice.
Journal of interprofessional care. 2013;27(5):424-425.
126. .
. .
2010;2(1):2.
127. Boyle M, Williams B, Brown T, et al. Student attitudes toward a web-
based interprofessional education package. Journal of allied health.
2013;42(2):e33-36.
128. , , , .
o
. . 2009;4:51-57.
129. , , , , . IPE
IPW
. . 2012;4(2):84-95.
130. Mahler C, Berger S, Reeves S. The Readiness for Interprofessional
Learning Scale (RIPLS): A problematic evaluative scale for the
interprofessional field. Journal of interprofessional care.
2015;29(4):289-291.
131. , η , , , , .
. .
2015;64(1):25-34.
132. Kururi N, Makino T, Kazama H, et al. Repeated cross-sectional study
of the longitudinal changes in attitudes toward interprofessional
health care teams amongst undergraduate students. J Interprof Care.
2014;28(4):285-291.
133. Tani K. Community-based clinical education increases motivation of
medical students to medicine of remote area: comparison between
lecture and practice. The journal of medical investigation. 2014;61(1-
2):156-161.
134. . . .
127
1996;1:34-38.
135. . .
. 1998;29(6):385-391.
136. Kataoka HUHU. Measurement of empathy among Japanese medical
students: psychometrics and score differences by gender and level of
medical education. Academic medicine. 2009;84(9):1192-1197.
137. Stratton TDTD. Does gender moderate medical students' assessments
of unprofessional behavior? Journal of general internal medicine :
JGIM. 2012;27(12):1643-1648.
138. , , , .
1 2
. Dokkyo journal of medical sciences.
2013;40(3):175-184.
139. . . . 2012(12):211-
236.
140. Reddy S, Farnan J, Yoon J, et al. Third-year medical students'
participation in and perceptions of unprofessional behaviors.
Academic medicine. 2007;82(10 Suppl):S35-S39.
141. .
o
hidden curriculum. . 2012;101(1):201-205.
128
�� � b�
129
���$���������!%"������ #�����"� �����#
IJ À ¹¾º IJ À ¹¿º IJ À ¹Àº
IJ Á ¹¾º ¢¶[pħ�q�� IJ Á ¹¿º 8�ê0õ` Ç ¹¿º
8Ê�Ê�Ê=
¿¿ ïæðħYõ¨õ :�êYõ¨õħ�B � £�ħy�
¿½ ĞďûĀĤħĀĘý�� ĀĘýw�¼ģĕĨĆĤ y�
¿¾ ĞďûĀĤħĀĘý:� Co& 2üĚĦĐÍĞďûĀĤħĀĘýÎ:a :�
¾Ä ĞďûĀĤħĀĘý��¹¾º O5)³¼��f R¼:a���¡ y�
¾Å ĞďûĀĤħĀĘý��¹¿º ��ęĥĊĦĎĨćġĦ¼ĎĨěq9 y�
¾Æ ĞďûĀĤħĀĘýF5 F5S�¼;h_¼üĦċėĠĨ y�
ı Y¨õê`sĩ �Ī �B �ùëÞðY¨õê`sù8í £�ħy�
Å :�w�13�oêeôÝæ�H¢¶Ë$�ê|zéãÒäăĤĨ
ę�éi�£�ħy�
Æ»¾Ã 13$�4�:� "u«13ĩ��ñÝÙë�?ê�9Īå13x0:� :�
�.
�.
ąĜĠēĄĨćġĦĭĖĨĐĒĨćčę ��æ±øöUséãÒä8í £�ħy�
Á "u«ê13$�éãÒä¹¾º "u«ê13$�ê|z梶 £�
 13$�ù8íéÑáâä 13$�ù8íéÑáâäêKlÔ £�
à "u«ê13$�éãÒ乿º $��æÝä13ù�ö�ùçÓ·ÓÖ £�
¿ ÿģþĦĎĨćġĦ¹¿ºĞďûĀĤħĀĘýêP�ħ�d¼��éãÒäËăĤĨę
�R£�ħy�
À
�.
�.
�.
�.
ÏZj��ê8�]��nÐ
ĮĬ¸13$�ù@¯ßöáðéL�æÜ÷ö4g�è�¤ù{Jßöáðé
È13åeôß�æËàê<bê~téãÒä}�åØöÌÉ13��æ�H걪ù}�åØöÌ
įĬĖĨĐĒĨćčęùIRßö4g�QGù§éãÚöáðé
ȸ�Bù}�ßöÛæË��ù}�ßöÛæé±KùXãÛæ×åØöÌɸ4g��µ±�ùl�åØöQGùæöÛæ×åØöÌ
İĬ��æê°å(`-ąĜĠēĄĨćġĦù:¦ßöáðé
È4g�èąĜĠēĄĨćġĦU�ù§éãÚöÌÉO5)³ħ\�ê7mèU�ê4gù§éãÚËzréMÞä¬�é�ÓÛæ×åØöÌ
ÏZjêk�Õóì8��ê!�Ð
Êg��ëË��$�8®æê*+ĀģĂĠĢĝåÑõËÁE°éøáõ©E寣Ü÷ö13$�*+ĉĜĒĨéÕÚöĮE~ù>¥æÝá��åÑöÌ13$�ù@¯ßö�
åL�æèö4g�è�¤æËĖĨĐĒĨćčęùIRßö4g�QGù{JÝË"u«×WÔö��$�ꢶîê}�ùvðöÌïáË$�4�:�æĞďûĀĤħĀĘý
:�ù©ÞäË(`-ąĜĠēĄĨćġĦù:¦�é8íÌ
ÊèÕÊÍĞďûĀĤħĀĘýÎ:�ëË¢6c°é86ê��a�ò13å�ÓÛæéèöêåË�9Ü÷ác°6êăĤĨę j×L�æèöÌ
Ê
Ê/^ 8Ê�Ê�ʶ 8�`s >¥�
¾ ÿģþĦĎĨćġĦ¹¾º ąĨĈ��ī13$�ê:²éãÒä £�
13$�
��
V¾ %
��ąĨďûĔĨċĨ ĩÊÊTÊÊAÊÊĪ
Í$8]�ğďĤħąúħĀģĂĠĢĝÎæ걪
āüđĢüĦê´�
ąĜĠēĄĨćġĦ N�æ$Dê±� ČĨĝ$�
�Ê�Ê, ��#� 8E'ì%^
13$�*+ĉĜĒĨĮ y� ¾ E ©E
�.
�.
�.
�.
�.
:�& 8~
:�& 8~
�.
�.
130
���$���������!%"������ #�����"� �����#
Ł ³ ®±¯ ćęĜĔĆĦĈĝĤ Ł ³ ®²¯ Ł ³ ®³¯
Ł ´ ®±¯ �«Rfĥ�g�� Ł ´ ®²¯ 1�ì,õX » ®²¯
J^y�
1¢ 1�
2�¨"�1t
2�¨"�1t
2�"�1t
2�"�1t
�*
�*
�*
2�"�1t
2�"�1t
2�"�1t
2�"�1t
2�"�1t
�*
�*
2�¨"�1t
2�¨"�1t
�*
�*
1¢ 1�
�*
�*
1¢ 1�
2�"�1t
2�"�1t
2�"�1t
ķ°ĸ ½¾¼ĽčĦĚ x�®²¯-.ëÚÞö�� x��ì�Tì
2§ëæØço�
Ĺ
Ĵ 2�0)�ìm�®±¯ 2�ìPõ�õĥ�<��®±¯ o�
ĵ 2�0)�ìm�®²¯ 2�ìPõ�õĥ�<��®²¯ o�
Ķ 2�0)� o�
��ĥo�ľ?¤ì1îùPõ�ö �¬1�éğėġĄĈĝĤëæØç1ï®±¯
į �k ì-. xù1ï®·¯ �ku��kw¦ì��Ûô ��
İ°ı �k ì-. xù1﮸¯ -. xì�2ù�ÙöąĠĦĘo�®³¯ o�
IJ°ij �k ì-. xù1﮹¯ -. xì�2ù�ÙöąĠĦĘo�®0)�¯ o�
Ī �k ì-. xù1ï®´¯ �k ìUF xëæØç1﮲¯ o�
ī°Ĭ �k ì-. xù1﮵¯ -. xì�2ù�ÙöąĠĦĘo�®±¯ ��
ĭ°Į �k ì-. xù1﮶¯ -. xì�2ù�ÙöąĠĦĘo�®²¯ ��
Î°Ï -. x/}2� -.ën,áçì2�®³°µZ¤¯ 2�
ħ ĀğÿĤďĦĈĝĤ ĀğÿĤďĦĈĝĤĥ�«S~ ��
Ĩ°ĩ �k ì-. xù1﮳¯ �k ìUF xëæØç1ï®±¯ o�
Ê -.ì xĥ=etjù|ö®´¯ �7;ìtjé�Aĥ xĥ��ëæØç1ï ��ĥo�
��ĥo�
Ë 2�ĀğÿĤďĦĈĝĤ 2�ĀğÿĤďĦĈĝĤ ��ĥo�
Ì°Í -.ì xĥ=etjù|ö®µ¯ -.eÑG�àúì��Ûô1ï
Ç -.ì xĥ=etjù|ö®±¯ -.eì[ôáé�A�«Ñ xìrpëæØç`� o�
È -.ì xĥ=etjù|ö®²¯ -.eì[ôáé�A�«Ñ xìrpëæØç`� o�
É -.ì xĥ=etjù|ö®³¯ v�-.ìtjé�Aĥ xĥ��ëæØç1ï ��ĥo�
Æ �k ì-. xù1﮲¯ =�_3w¦ì��Ûô ��
Å ĘĢėþĎĈĝēğĉĚÑ�a�s®²¯ ĘĢėþĎĈĝēğĉĚÑ�a�s ��ĥo�
ĘĢėþĎĈĝēğĉĚÑ�a�s ��ĥo�
Ä ćęĜĔĆĦĈĝĤĽĖĦđēĦĈĎĘ®²¯ ��é¥øöLhëæØç1ï ��ĥo�
à �k ì-. xù1ï®ľ¯ ]�u�]�w¦ì��Ûô ��
 ćęĜĔĆĦĈĝĤĽĖĦđēĦĈĎĘ®±¯ xćęĜĔĆĦĈĝĤì/} ��ĥo�
Á ĘĢėþĎĈĝēğĉĚÑ�a�s®±¯
À ½¾¼ĽčĦĚ x�®±¯ čĦĚģĦĄĥğĦČĦĈĎĘ ��ĥo�
6��
¿ ĀğÿĤďĦĈĝĤ �{��Ñ:��ìiHÑąĠĦĘ1�ì/\ ��ĥo� �*
�*
ÕQa�{ì1�V�{dÖ
ľļ-. xù8£ãöåòëE�éà÷ö/\zê|�ùqCãöåòëÑ¿-.è[ôã�éÑäì4YìtjëæØçs�èÝöÑÀ-.��é�Aì¥
�ùs�èÝöÒ
ĿļĖĦđēĦĈĎĘùBJãö/\zI@ù�ëæÞöåòëÑ¿�<ùs�ãößéÑ��ùs�ãößéë¥DùOæßéÜèÝöÑÀ/\z�ª¥ ùc
�èÝöI@ùéößéÜèÝöÒÕQaìb�Úóî1��ì��Ö
Ð\�{íÑ�� x1¢éì%&āğăĜĞĚè×õÑ´?¤ëøåõ�?è£�à÷ö-. x%&ĊęēĦëÚÞöľ?tù6�éáå�{è×öÒ-. x
ù8£ãö�èE�éêö/\zê|�éÑĖĦđēĦĈĎĘùBJãö/\zI@ùqCáÑ�k ÜNÙö�� xì�«ðìs�ùlòöÒñåÑ��Ño
�Ñ x/}2�ù�âçÑ$X(ćęĜĔĆĦĈĝĤù2�zë1ïÒ
+W 1Ð�Ð�Ы 1Ð�Ð�Ð5 1�Xh
Ó 1V�ěĐĠĥćûĥāğăĜĞĚÔéì¥�
ĂýĒĞýĤì©{
G�é >ì¥ G��DìčĦĚ x
-. x
º²
�º±!
�{ćĦĐüĕĦċĦ ĺÐÐKÐÐ9ÐÐĻ
ŀE�
�ŀ¡M
�Ð{Ð' �{�� 1?#î!W
-. x%&ĊęēĦľ o� ± ? �?
�
131
S S
----------------------------------------------------------------------------------------------------------
2016/4/19 ----------------------------------------------------------------------------------------------------------
/
1. 2. 3. 4. /
1. 2. 3. 4.
/ 1. 2. 3. 4.
/
1. 2. 3. 4.
1. 2. 3. 4.
/
/
132
(
2 4E 4 :M 1 8
53
5
6
5 5
6
K
5 E5
5 5
6 E5
5
6 E5
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17 N
18
133
- ) ) (
3 2 4 1 2
33
3 3
10 &�F+�E�@3A3L9CN";A3=0
20 &�F �I��N$ E(GA3=0
30 �%4JFUPVSTRQN#��E�GA3=0
40 �%4JFUPVSTRQN�68�MA3=0
50 �,D�.BH�-:N�?A3=0
60 �*E�!B2?=0
70 ��N5>OC�/B5LIK�B)';=0
80 �%I�F�GE�;1<7��B5L��B2?=0