實施「客觀結構式臨床技能測驗——整合型長站設計」於護理系臨床實作組之經驗

Implementation of Objective Structured Clinical Examination-integrated Long Station Design in the Clinical Practice Group of Nursing Program

學生進入「最後一哩」之臨床實習前，以模擬臨床實務情境的測驗評量其專業知識、態度與技能，有助於其自我檢視及統整學校教育與實務智能。整體而言，目前護理教育認為OSCE是一種有效評量學生臨床實務能力的方式，且是培訓學生批判性思考的有效策略之一。但是規劃、設計與進行OSCE測驗非常耗時與費心，因此，是一種花費高昂且需要大量人力、物力的評量模式。因此若能降低OSCE執行上的困難度，如簡化OSCE的流程、題項、站數等，除了能增加學生「最後一哩」臨床實習的熟悉度，相信更能幫助準護理畢業生順利銜接就業。本文針對某科技大學日間部二技臨床實作組之「臨床照護實作」課程實施「客觀結構式臨床技能測驗—整合型長站設計」，評量學生的臨床專業知識、態度與技能。實施結果發現：學生第一次經歷單一整合型長站的OSCE測驗，大部分學生持正向的態度，學生經由此次的測驗了解自己不足之處、了解自己的優點、了解臨床需要應用批判性思考及統合過去所學的專業知識，學生也認為此方式的考試與臨床貼近、有臨場感，大多數學生皆認同未來繼續執行類似的考試；由此可知，以「客觀結構式臨床技能測驗（OSCE）──整合型長站設計」可以真正評量學生之臨床技能之能力。 The assessment of professional knowledge, attitudes, and skills on a test that simulates a clinical practice situation helps to self-review and integrate school education and practical intelligence before students entering the ＂last-mile curriculum＂. The present nursing education regards the objective structured clinical examination (OSCE) as an effective means of evaluating the students' clinical practice ability and one of the effective strategies to train the students' critical thinking. However, planning, designing, and conducting OSCE are time-consuming and demanding, and thus, it is a highly-expensive and labor-intensive assessment model. Therefore, if we can reduce the difficulty of OSCE implementation, such as simplifying the OSCE process, as well as the problems and number of stations, in addition to increasing the students' familiarity of ＂last-mile curriculum＂ clinical practice, then we believe that OSCE can help prospective nursing graduates smoothly link employment. In this study, the ＂Clinical Nursing Care and Practice＂ curriculum is implemented for the Clinical practice group of a science and technology university. Objective structured clinical examination-integrated long station design was used to evaluate students' clinical professional knowledge, attitudes, and skills. Implementation results found that, for the first time that students experienced a single integrated long station OSCE, most of them took a positive attitude. Through the test, the students can understand their shortcomings and strengths, as well as the clinical needs of the application of critical thinking and integration of past knowledge, and students also think this way of examination and clinical close has a sense of spot. Most students agree that they will continue to perform similar exams in the future and that ＂OSCE-integrated long station design＂ can assess students' clinical skills.

The assessment of professional knowledge, attitudes, and skills on a test that simulates a clinical practice situation helps to self-review and integrate school education and practical intelligence before students entering the ＂last-mile curriculum＂. The present nursing education regards the objective structured clinical examination (OSCE) as an effective means of evaluating the students' clinical practice ability and one of the effective strategies to train the students' critical thinking. However, planning, designing, and conducting OSCE are time-consuming and demanding, and thus, it is a highly-expensive and labor-intensive assessment model. Therefore, if we can reduce the difficulty of OSCE implementation, such as simplifying the OSCE process, as well as the problems and number of stations, in addition to increasing the students' familiarity of ＂last-mile curriculum＂ clinical practice, then we believe that OSCE can help prospective nursing graduates smoothly link employment. In this study, the ＂Clinical Nursing Care and Practice＂ curriculum is implemented for the Clinical practice group of a science and technology university. Objective structured clinical examination-integrated long station design was used to evaluate students' clinical professional knowledge, attitudes, and skills. Implementation results found that, for the first time that students experienced a single integrated long station OSCE, most of them took a positive attitude. Through the test, the students can understand their shortcomings and strengths, as well as the clinical needs of the application of critical thinking and integration of past knowledge, and students also think this way of examination and clinical close has a sense of spot. Most students agree that they will continue to perform similar exams in the future and that ＂OSCE-integrated long station design＂ can assess students' clinical skills.