運用多元教學策略提升NPGY 學員意識及肌力評估之正確性

Improving the Accuracy of Consciousness and Muscle Strength Assessment of NPGY Students by Using Multiple Teaching Strategies

意識及肌力評估是神經系統監測病況變化的重要指標，單位發生兩件畢業後兩年期護理師（nurse of post-graduated year；以下簡稱NPGY學員）未發現病人意識改變，產生病人照護安全疑慮。本專案小組對此進行原因分析，發現意識及肌力評估多以傳統口述方式進行授課，且教材多以文字敘述，進入臨床前無情境演練之機會，經專案小組介入多元教學策略，包括1.製作意識及肌力評估數來寶口訣以加深學員的記憶，2.舉辦情境模擬教學課程以增強學員的認知及評估技巧，3.製作意識及肌力評估教學影片提供學員反覆練習，4.建立教與學雙向回饋機制做學習成效即時性矯正。專案執行後，NPGY學員意識及肌力評估認知結果由79.0%提升至100.0%，意識及肌力評估正確性DOPS評量由42.0%提升至96.0%，達成本專案目的，可有效提升NPGY學員意識及肌力評估正確性。

Both consciousness and muscle strength assessments are important monitoring indicators in neurological diseases. In our unit, two NPGY trainees neglected the change of patient consciousness, causing patient care safety concern. The clinical team conducted a cause analysis and found that both consciousness and the muscle strength assessments were taught verbally in a traditional way. The textbooks were mostly written by textual description in pre-clinical situation, without sufficient scenario exercise. The team created a multi-level teaching strategy, including 1. making awareness and muscle strength assessments into rap songs to strengthen the memory of trainees, 2. organizing scenario simulation teaching courses to enhance the recognition and evaluation skill of trainees, 3. providing teaching videos to trainees, and 4. establishing two-way feedback mechanism of teaching and learning. After the implementing this project, the recognition of awareness and muscle strength assessment of NPGY trainees increased from 79.0% to 100.0%, and the accuracy of DOPS assessment of NPGY trainees increased from 42.0% to 96.0%. This project promotes the accuracy of awareness and muscle strength assessment in NPGY trainees effectively.