案例教學法在四技兒科護理學的發展與應用

Development and Application of a Case-Based Pedagogy in Pediatric Nursing at a 4-Year University of Technology

本研究以案例教學法實施於某科技大學護理系兒科護理學課程。利用嚴謹發展的案例，經同儕間的討論、教師的引導、諮詢、傾聽等互動過程，展現解決案例健康問題的能力。本研究採質量混合型研究，執行期間於2019年9月至2020年1月，研究對象為修習「兒科護理學」課程的大三學生2班共109位，實驗組57位；控制組52位。實驗組參加由研究者發展的三個案例，分別在第5、10、15週進行討論及報告；控制組維持傳統課室教學。實驗組和控制組分別填寫「問題解決量表」前測及後測，實驗組另填寫「案例教學滿意度量表」並進行焦點訪談，兩位教師以「護理過程之rubric評分表」針對小組報告評分。資料以描述性統計、配對t檢定及內容分析法進行分析。研究結果顯示，經由案例教學方式，實驗組和控制組在問題解決量表前、後測得分無顯著差異；實驗組對案例教學的教學方式和案例教材均有高度滿意，質性分析顯示正向的學習經驗，但也呈現案例教學法的限制。整體而言，一學期三次案例教學可提供學生好的學習經驗及高的學習滿意度，但在時間安排上需再做調整。

The present study implemented a case-based pedagogy in a pediatric nursing course held by the department of nursing in a university of technology. To encourage peer discussion, assist teachers in providing guidance and consultation, and encourage students to listen and interact with each other, the pedagogy provided rigorously-developed cases for students to demonstrate their abilities in solving health-related problems. This study adopted a mixed quantitative and qualitative research method. The study was conducted from September 2019 to January 2020. The participants comprised 109 junior students who took a pediatric nursing course and were from two classes. They were divided into the experimental group (57 students) and the control group (52 students). The experimental group participated in three cases developed by the researcher and discussed and presented a report at the 5th, 10th, and 15th week of the semester. The control group received conventional classroom teaching. Both the experimental and control groups filled in the scale of problem solving for the pretest and the posttest. The experimental group filled in an additional scale (i.e., the scale of satisfaction with case-based teaching) and participated in a focus-group interview. The group presentations were scored by two teachers using a rubric form for assessing nursing processes. The data were analyzed using descriptive statistics, a paired t-test, and content analysis method. The results revealed that with the case-based pedagogy, no significant differences were observed between the pretest and post-test scores of the experimental and control groups on the scale of problem solving. The experimental group was highly satisfied with the case-based pedagogy and the teaching materials. The qualitative analysis indicated positive learning experience as well as the limitations of the case-based pedagogy. Overall, three case-based teaching sessions in a semester can provide students with excellent learning experience and high satisfaction level. However, the course schedule should be adjusted.