護理學校客觀結構式臨床測驗資源分析

Analysis of OSCE Resources in Nursing Schools

背景：客觀結構式臨床測驗（Objective Structured Clinical Examination, OSCE）被認為是一項可以彌補紙筆測驗不足的測驗方式，護理界也因應OSCE是否納入護理師國考應考資格做過諸多討論。目的：本研究目的為探討台灣設有護理科系學校OSCE建置的軟硬體現況做為政策擬定之參考。方法：採橫斷式研究設計，在2018年9月至10月間，以台灣設有護理科系學校為研究對象，填答OSCE考場資源調查表；調查表內容包括測驗場地設施、模型道具、試務運作、行政資源、考官、標準化病人等六大項。所得資料以SPSS19.0建檔與統計分析。結果：共獲37份有效調查表（回覆率88.1％），89.2％（n＝33）護理學校設有OSCE考場，設置的OSCE考間以12間居多、32所學校曾執行過所有課程結束後的總結性評量或稱為高階OSCE的經驗，同步進行OSCE的考站以10站居多。從OSCE資源的調查結果可知「測驗場地設施」與「模型道具」等硬體環境得分較高，分別為84.5與86.3分；軟體環境得分依序為「試務運作」77.8分、「行政資源」71.8分、「考官」52.6分、「標準化病人」28.6分。一般大學、科技大學與專科學校之OSCE資源得分，除「測驗場地設施」外，其餘5項分項與總分均無統計顯著差異。結論／實務應用：多數學校設有OSCE考場，可加強「考官」與「標準化病人」等OSCE考場資源得分較低項目、建立護理OSCE考場認證標準與鼓勵OSCE長期性研究，得以提高OSCE執行效益，並作為未來規劃將OSCE納入護理師國家考試應考資格推動之參考。

Background: Objective Structured Clinical Examination (OSCE) is an evaluative tool that can compensate for the weaknesses of paper and pencil tests. In the nursing field in Taiwan, there has been considerable discussion regarding the possible use of OSCE in the National Registered Professional Nurses Examination. Purpose: The purpose of this study was to explore the current status of implementing of OSCE at nursing schools in Taiwan in order to establish for the further OSCE policy. Methods: A cross-sectional survey was conducted across nursing colleges in Taiwan from September to October in 2018. Participants completed a self-administered survey which consisted of six main parts, including facilities on site, model props, operation of the examinations, administrative resources, examiners, and standardized patients. Data were analyzed using SPSS 19.0 software. Results: A total of 37 administrators of the OSCE centers responded to the survey, which is a response rate of 88.1%. Around 89.2% (n = 33) of the schools have established OSCE centers, and the most common number of the examine rooms for OSCE is 12 rooms. Thirty-two schools have carried out the summative assessment, or high-stake OSCE, after the completion of all courses. The number of simultaneous examined stations for OSCE is mostly 10 stations. In terms of OSCE resources, the results showed that the facilities on site and the model props were given scores of 84.5 and 86.3 respectively. Other scores were as follows: 77.8 points for the successful operation of the examinations, 71.8 points for the school’s administrative resources, 52.6 points for the preparedness of the examiner, and 28.6 points for the preparedness of the standardized patients. There was no statistically significant difference in each dimension of OSCE resources among general universities, universities of science and technology, and technical colleges, except facilities on site. Conclusions / Implications for Practice: The majority of the nursing schools had an OSCE center. Strengthening the lower-scoring categories, such as ''examiner'' and ''standardized patient,'' will improve the effectiveness of OSCE. Establishing standards for a certified OSCE center, conducting long-term research on utilization to improve the effectiveness of OSCE implementation so the results can further facilitate the role of OSCE in the National Registered Professional Nurses Examination.