護理臨床教師自評教學能力之研究

A Study of Teaching Competencies of Self-Assessment Among Clinical Preceptors

大部分的護理臨床教師有豐富的臨床經驗和學識，但普遍自覺缺乏教學技巧及信心，對於指導護生備感壓力與焦慮，同時也深感在職教育課程中缺乏教與學相關概念，以及培育其成為護理臨床教師之教育訓練不普及，使得護理人員在轉換教師角色時有所困難。本研究旨在探討不同護理臨床教師背景資料自評教學能力之差異性，以及護理臨床教師自評教學能力之預測因子。本研究採橫斷性問卷調查法，採方便取樣，以北部地區某一醫學中心及區域級醫院中同意參與本研究之護理臨床教師為研究對象，發出154份問卷，有效問卷147份，回收率達95.4%。研究結果顯示，護理臨床教師自評教學能力之單題平均得分為4.06 (SD = 0.39)，得分最高的前5項依序為能要求學生回覆示教、提供安全實習環境、能和病人建立良好的關係、在照顧病人方面展現熱忱，及對於學生好的工作表現給予正向回饋；得分最低的前5項依序為教學時能引發學生的興趣、花足夠的時間在學生身上、協助學生尋找相關資料或網站、和學生討論實習的優缺點和限制，以及能要求學生評值護理臨床教師的教學品質。再者，護理臨床教師之年齡、婚姻狀況、教育程度、進階層級、薪資、服務醫院等級、護理工作總年資及護理行政主管支持度的不同，對護理臨床教師自評教學能力有顯著差異；而年齡及護理行政主管支持度是多元線性迴歸模式的顯著預測因子，可解釋26.3% (adjusted R2 = 21.4%)護理臨床教師自評教學能力之變異量。本研究結果可作為護理臨床教師自評教學能力之參考，進而重新檢視護理臨床教師之課程設計和教學內容，規劃出具整體性及系統性的課程，促使護理臨床教師在臨床教學時更能得心應手，增加教學信心和教學品質以提升教學能力。

Most clinical preceptors, despite having extensive clinical experience and knowledge, often see themselves as not sufficiently confident and competent to teach nursing skills to students, and as a result tend to suffer a high level of stress and anxiety at work. Many of them have commented that their in-service training failed to adequately prepare them for their role as clinical preceptors, and that clinical preceptor training opportunities have been too scarce. These factors, according to them, have compromised their transition from their old role as nurses to their new role as clinical nursing preceptors. The purpose of this study is to investigate differences in self-rating teaching competence scores among a sample of clinical nursing preceptors of different backgrounds, and identify predictors of the sample’s self-rating teaching competence scores. This cross-sectional survey study included a convenience sample of 154 clinical nursing preceptors from a regional hospital and a medical center in northern Taiwan, who gave written consent to participate in the study. 147 valid questionnaires were returned at a valid return rate of 95.4%. The results showed that the mean single-item self-rating score for the sample was 4.06 points (SD = 0.39). The five highest scoring items were related to the sample’s abilities to ask students to respond to demo teaching, provide a safe clinical training environment, encourage students to associate positively with patients, motivate students to be enthusiastic about taking care of patients, and give positive feedback to outperforming students. The five lowest scoring items were related to the sample’s abilities to inspire learning interest in students, remain sufficiently attentive and accessible to students, assist students in locating learning resources (including online learning resources), discuss advantage, weakness and limitation of practice with students, and ask students evaluate the teaching quality of clinical nursing preceptors . In addition, the factors of the subjects’ age, marital status, education, nursing clinical ladder status, salary, type of current hospital, total years of service as professional nurses, and the amount of support from supervisors were found to have caused significant differences in the subjects’ self-rating scores. Multiple linear regression analysis was performed to identify significant predictors, namely the subjects’ age and amount of support from supervisors, that accounted for 26.3% of variance in the subjects’ self-rating scores (adjusted R2 = 21.4%). The questionnaire survey used in this study is a useful tool for clinical nursing preceptors to rate their own teaching competence. Furthermore, an across-the-board review of existing clinical nursing preceptor training programs may be conducted, and a more integral and systematic training program devised to enhance overall teaching performance of clinical nursing preceptors by boosting their competence and confidence in teaching is needed.