以實證應用為核心的外科專科護理師培育經驗：從學校課程到臨床實務的無縫銜接

Evidence-Based Practice–Centered Education for Surgical Nurse Practitioners: A Seamless Transition from Curriculum to Clinical Practice

外科專科護理師（Surgical Nurse Practitioner, SNP）學生從學校課室的靜態學習到臨床實習須面對圍手術期（Perioperative period）病人狀況快速變化及講求決策效率的高壓環境，如何有效應用實證資訊進行臨床問題推理與專業判斷，對學生、學校教師及臨床指導老師都是極大挑戰。本文以SNP課室教學與臨床實習課程為例，強調「以實證應用為核心」之無縫銜接特色。課程規劃結合鷹架式（Scaffolding Style）三階段模式、Miller金字塔（Miller’s Pyramid）能力層級及實證實務（evidence-based practice, EBP）流程，於校園端系統化培養臨床問題形成、文獻檢索、批判性評讀與證據轉譯能力，並以情境模擬與形成性回饋提升專業能力。臨床端則提供可即用資源，「找證據—用證據」，將實證建議轉化為可執行、可追蹤且可持續改進的照護。面對SNP學生的角色轉換過渡期，臨床指導老師是建立學生心理韌性及落實實證應用的重要引導人。期望藉由SNP培育經驗分享，提供課程與臨床訓練規劃之實務參考，促進學校教育與臨床照護實務之無縫連結，縮短學用落差。

Surgical Nurse Practitioner (SNP) students transition from relatively structured classroom learning to clinical practica in a high-pressure perioperative setting characterized by rapidly evolving patient con¬ditions and time-sensitive decision-making. The effective application of evidence to clinical reasoning and professional judgment presents substantial challenges for students, academic faculty, and clinical preceptors. This article describes an SNP training model that emphasizes an evidence-based, applica¬tion-focused approach to achieving continuity between didactic instruction and clinical practice. The curriculum framework integrates a three-stage scaffolding model, Miller’s Pyramid of Clinical Com¬petence, and the evidence-based practice (EBP) process. In the academic setting, the program system¬atically develops competencies in clinical question formulation, literature search strategies, critical appraisal, and evidence translation. Scenario-based simulation and formative feedback are used to strengthen professional competence. In the clinical setting, readily accessible resources and structured guidance support the processes of“evidence identification and implementation,”enabling evidence-in¬formed recommendations to be translated into actionable, trackable, and continuously improvable care practices. During the role-transition period, clinical preceptors play a pivotal role in supporting learner adaptation, fostering psychological resilience, and reinforcing the integration of evidence into clinical decision-making. By sharing this SNP training experience this report provides practical guid¬ance for curriculum and clinical training design aimed at strengthening alignment between academic preparation and clinical practice and reducing the theory–practice gap.