護理學生性別能力建構──設計思考（Design Thinking）於性別課程之應用

Building Gender Competency for Nursing Students - Application of Design Thinking for a Course in Gender Issues

"醫療健康業服務對象是人，需要有敏感的性別意識以及良好完整的性別能力，才能讓照護對象獲得同等的醫療權益。「設計思考」為以人為本，因此是護理教育適用的思考模式。本文闡述應用「設計思考」五步驟進行性別課程創新設計，建構護理系學生性別能力的教學實務成果。本研究第一階段於107學年下學期於護理系「性別探索」課程，運用設計思考五步驟的前四步驟:同理心、定義問題、構思、製作原型，進行性別探索課程創新設計，應用「建設性爭論」、「新聞議題導入討論」以及「辯論式教學」等三項創新授課方式於日二技學生（實驗組），進修部二技學生為對照組，進行傳統授課。第二階段於108學年第一學期進行第五步驟：實際測試，以四技學生為對照組。性別能力的評量採用「健康照護學校性別能力指標」問卷。統計方法採用獨立樣本t檢定（Independent Sample t-test）、配對t檢定（Dependent Sample t-test），以及廣義估計方程式（Generalized estimating equation, GEE）等，另以質量性評量呈現教學成效。第一階段學習成效顯示，實驗組性別能力分數有顯著進步（p＜.001），實驗組總分進步幅度比對照組高出13.49分（p＜.01）。實驗組學生質性回饋重點有「課程改變了性別思維」、「學習到未曾思索的性別議題」、「認同創新教學方法及內容」，以及「課程收穫滿載」等四項，顯示學生對課程均為正面評價。第二階段的實際測試結果顯示，應用創新設計課程於實驗組後，性別能力總分顯著高於對照組（p＜.001），且進步幅度比對照組高出10.02分（p＜.05），顯示本研究所建構的創新課程設計可以有效建構護理學生性別能力。本研究將「教育」與「設計」二個領域合作創造出嶄新的護理教育思維，證實應用設計思考的課程創新設計於建構護理學生性別能力有實際成效。本研究結果提供護理教師新的思維，未來在護理教育中，可以考慮課程特性，應用設計思考進行課程規劃，提升老師「創造、設計」的自信。"

People are the target of healthcare services, and healthcare providers need to have sensitive gender awareness and complete gender competence in order to provide the best possible care for recipients. Design thinking is people-centered, thus it is an appropriate mode of thinking in nursing education. This article discusses the practical instructional accomplishments yielded by the application of the five steps of ''Design thinking'' in the innovative design of a course in gender issues to build gender competency in nursing students. During the 2018 course ''Exploration of Human Sexuality'' in the Nursing Department, we used the first four steps of the five (empathize, define, ideate and prototype) to develop an innovative gender exploration curriculum that applied constructive conflict, news discussion, and debate teaching in the curriculum for the daytime university students in the two-year program (experimental group). As a control group, night students in the two-year program received the traditional teaching curriculum. In the second stage, the fifth step (actual testing) was conducted during the first semester of the 2019 academic year, with students of a four-year college as the control group. Gender competency was assessed using the ''Health Care School Gender Competence Index'' questionnaire. The statistical methods applied included independent sample t-test, dependent sample t-test and posttest scores and a generalized estimating equation (GEE). In addition, qualitative assessment was used to demonstrate instructional efficacy. The learning efficacy in the first stage showed that the experimental group's gender competency scores improved significantly between the pretest and the posttest (p < .001), and that the overall improvement in scores of the experimental group outperformed that of the control group by 13.49 points (p < .01). Qualitative feedback by students in the experimental group included four key points: ''the course changed my gender thinking'', ''I learned about gender topics I had never thought about before'', ''I approve of the innovative instructional methods and content'', and ''I learned a lot in this course.'' This showed that the students viewed the course in a positive way. The actual testing results in the second stage showed that after applying the innovative design course to the experimental group, the overall gender competency scores were significantly higher than those of the control group (p < .001), with the level of improvement outperforming the control group by 10.02 points (p < .05). This showed that our innovative course design could effectively build gender competency in nursing students. The study combined the two fields of ''education'' and ''design'' to forge new thinking in nursing education, proving that the application of design thinking in innovative curricular design can yield practical benefits in building gender competency in nursing students. The results of this study provide a new way of thinking for nursing instructors. Future nursing education can take these curricular traits into consideration, and apply design thinking in curricular planning to elevate the self-confidence of teachers to create and design.