虛擬互動實境輔助專科護理師批判性思考訓練之應用

Applying Virtual Reality Assisted Critical Thinking Training Programs Among Nurse Practitioners

虛擬實境（virtual reality）是利用電腦產生一個三度空間的虛擬世界，提供使用者視覺、聽覺、觸覺等不同感官的感受，使用者感覺彷彿身歷其境，沒有時間及空間限制，可觀察及體驗所設計的三度空間情境。虛擬病人（virtual patient）是虛擬實境的延伸發展，近年來已被廣為使用多年在各種醫護教育訓練，透過虛擬實境練習，以提升專業能力。有些機構專科護理師的臨床業務與醫師範疇完全一致，是在醫師監督下執行輔助醫療業務，其中包含身體評估、病史收集及問診、探測病人異常表現、判斷檢驗結果、鑑別診斷及病人健康問題之決策等，因此專科護理師訓練與醫學教育所需要培養臨床思辨目標一致。虛擬實境已用於醫學教育來訓練醫學系學生，因此很適合使用虛擬實境的教育方式來做專科護理師批判性思考的訓練，以提升思辨及推理鑑別診斷之能力，但因目前台灣較少有針對專科護理師虛擬實境病人訓練使用及成效探討，故未來值得深入研究及推展。

The three-dimensional virtual world generated in virtual reality (VR) environments involves vision, hearing, touch, and potentially other user senses. VR environments are designed to closely simulate real situations/scenarios, allowing users to observe and engage in experiences free of time and space restrictions. Virtual patients are an extension of virtual reality. In recent years, virtual reality exercises have been widely used in various medical education and training programs to promote professional competence. The clinical practice of nurse practitioners is similar to physicians in some institutions. Nurse practitioners perform supplementary medical services such as physical assessment, medical history collection and consultation, problem detection, test result assessment, differential diagnosis, and patient health problem decision-making under the supervision of physicians. The critical thinking component in nurse practitioner education is largely similar to that taught in medical education. VR is often used in medical education to train medical students. Also, VR may be applied in critical thinking training for nurse practitioners to promote competence in reasoning and differential diagnosis. However, few studies in the literature have evaluated the effectiveness of VR-based training for nurse practitioners in Taiwan. In the future, this issue needs to be studied further.