護生對內外科臨床護理能力鑑定考試之評價

Taiwan Nursing Student Assessment of the Value of a Competence-Based Medical-Surgical Clinical Performance Examination Model

背景：傳統的實習評量方式無法全面了解學生的臨床護理能力，提升護理人員專業能力，由護理能力的鑑定之改革，是護理臨床教育的重大責任。
目的：本研究目的在了解內外科護理能力鑑定對提升台灣護生臨床能力之評價。
方法：以四項半結構式問題調查30位參與內外科能力鑑定考試四技或二技護生之學習過程相關經驗，以內容分析法（content analysis）分析學生之敘述性資料並計算編碼出現次數。
結果：內外科護理能力鑑定考試與傳統實習臨床評量最主要的差異包括學習情境、思考決策能力及評鑑方式的不同；實施內外科護理能力鑑定考試之優點包括能力的肯定、接近臨床情境、自我導向學習、修正自我學習及彈性學習；而缺點包括情境及結果不易控制，且耗時；主要的收穫包括可以認識、挑戰及培養自我能力（包括培養思考、決策及關懷能力）。
結論：本研究之發現對建構內外科護理實習課程之能力鑑定以提升學生之重要臨床能力具相當之參考價值。

Background: Assessment of nursing student abilities with regard to competent nursing practice has played an important role in the clinical nursing education revolution.
Purpose: This study was designed to evaluate the value to Taiwanese BSN graduates of a competence-based clinical performance examination model for medical-surgical nursing.
Methods: Four semi-structured questions were used to explore the learning experience of 30 nursing students through their performance on a medical-surgical nursing clinical performance examination (CPE). Qualitative content analysis was used to identify categories.
Results: Differences found between the CPE and traditional clinical practicum included learning situation, learning process decision making procedures, and result evaluation procedures. Advantages of the CPE included confidence in self-competence, enhanced stimulation in clinical settings, self-directed learning, revised learning, and flexible learning. Disadvantages included poorer control over the overall learning process and less control of outcomes. Benefits to subjects from participating in the CPE included increased awareness, acceptance, and cultivation of self competence. A number of students expressed they perceived no specific benefits attributable to the CPE.
Conclusion: Study findings are hoped to contribute to the development of the CPE in medical-surgical nursing in Taiwan.