應用客觀結構式測驗課程提升護理臨床教師教學評量之一致性

Elevating Clinical Nursing Preceptors' Teaching Ability by Applying an OSCE Course

本研究目的為訓練護理臨床教師指導新進護理人員轉送危急病人教學之一致性。本研究採單組前後測設計，研究對象以中部某醫學中心擔任護理臨床教師共25人，研究期間一致性評量工具為客觀結構式臨床測驗課程於危急病人轉送，結果顯示護理臨床教師在「轉送隨行設備之準備」及「有效與相關轉送人員溝通」二項，達統計上顯著差異（p＜.001），顯示訓練課程有助於護理臨床教師在危急病人轉送ㄧ致性的調整；其中在「轉送前病人之評估」構面中之生命徵象及昏迷指數、完成重症病人轉送評估單及「轉送隨行設備之準備」構面中之AmbuMask、運送前管路檢查、與「有效與相關轉送人員溝通」構面中之電話交班、聯絡人員共同轉送項目，前、後一致性均達統計上顯著差異（p＜.05）；參與之護理臨床教師對於此項教學課程，整體滿意度達98％。本研究建議作為護理教學建置護理臨床教師危急病人轉送教學課程及提升教學能力參考。

This study involved the training of clinical nursing preceptors by improving the consistency of teaching regarding newly employed nursing staff and training nursing preceptors in how to direct newly-employed nursing staff in transferring critical-condition patients. A one-group pretestposttest study design was applied, and 25 clinical nursing preceptors were enrolled at a medical center in Central Taiwan. The objective structured clinical examination (OSCE) was employed as the assessment tool for analyzing consistency in transferring critical-condition patients. The results of the study indicated that two items 'assessment for preparation of pretransferring' and 'effective communication with relevant staff' exhibited signifi cant statistical values (p<.001). This suggested that the training course facilitates consistency. The consistency of nursing preceptors during the assessment process, regarding the categories' patient pretransfer assessment,'' preparation and functional assessment of transfer equipment,'' effective communication with associated crews,' and 'coordinated transfer' exhibited significant differences. The satisfaction of OSCE during the training course was significantly higher than in the pretest (p<.05). The overall satisfaction of nursing preceptors in this instructional course reached 98%. The findings indicate that the consistency of clinical nursing preceptors' teaching was improved by an effective instructional training course, based on the OSCE. To establish a standard in transferring critical patients and guiding new staff, adopting the proposed training for clinical nursing preceptors is recommended.