不同學制護生最後一哩課程壓力與學習成效探討

The Stress and Learning Effects of Last-Mile Curriculum among Nursing Students from Three Types of Nursing Programs

本研究旨在探討不同學制護生，「最後一哩」課程介入之壓力感受，以及護理專業能力、專業承諾、專業社會化之學習成效。採橫斷式調查研究設計，選取北部某科技大學護理系學生共478人為研究對象，運用「壓力量表」、「護理專業能力量表」、「護理專業承諾量表」及「護理專業社會化量表」進行資料收集。研究發現：（1）護生在最後一哩課程面臨高壓力狀態，且壓力程度影響護生學習成效；四技護生相較於五專及二技，在課程前出現較高預期性壓力，雖最後一哩課程能有效降低壓力，但在生活與朋友及醫療環境構面之壓力仍偏高，需較多壓力因應之協助。（2）最後一哩課程介入，對不同學制護生之護理專業能力及專業承諾均具成效，但學院部護生進步空間較小；護生對護理興趣及環境特性中的場所支持度與教學策略，對護生學習成效均具影響力，值得教育機構檢視不同學制個別化之最後一哩課程目標，並強化環境特性之正面力量。本研究結果可提供護理教育規劃最後一哩課程之有效參酌。

The purpose of this study was to investigate the stress and the learning effects of the Last-Mile Curriculum on the professional competence, professional commitment, and professional socialization of nursing students from three types of nursing programs. This research was based on a cross-sectional study. The purposive sampling consisted of 478 nursing students from a university of science and technology in Northern Taiwan. Four quantitative instruments were used, including self-administered questionnaires of the stress scale, nursing professional competence scale, the nursing professional commitment scale, and the nursing professional socialization scale for data collection before and after the whole Last-Mile clinical practice curriculum. The results showed: (1) The degree of stress of nursing students was the highest compared to other clinical practices, and affects the learning outcomes of nursing students. The graduates from four-year colleges had the highest expected stress before the Last-Mile Curriculum. The results showed positive effects on the implementation of the Last-Mile Curriculum on the expected stress of the graduates from four-year colleges, and need the more help to reduce the stress. (2) The professional competence and commitment have positive effects on the implementation of the Last-Mile Curriculum in nursing students among three types of nursing programs. There are still a lot of improvements to be achieved in the learning effects. Therefore, the results of this study are offered as reference for future Last-Mile Curriculum planning of nursing education.