護理人員高級心臟救命術訓練成效自我評估之探討

A Self-Assessment Tool to Determine the Effectiveness of an Advanced Cardiovascular Life Support (ACLS) Training Program

目的：探討護理人員在高級心臟救命術訓練後自我評估學習之成效。方法：本研究為橫斷性調查研究；以Kirkpatrick四層次評估模式為研究之理論基礎，自編結構性問卷作為研究工具，內容包含個人背景資料及「課程滿意度」、「個人專業能力增進」及「實際工作應用成效」三面向之成效評估，以北部某醫學中心的護理人員為對象，回收有效問卷333份。結果：（1）訓練成效得分高至低依序為「個人專業能力增進」平均分數為4.07、「課程滿意度」平均分數為4.01、「實際工作應用成效」平均分數為3.95。（2）工作科別為「加護單位」的護理人員在實際工作應用成效優於在「洗腎單位」的護理人員（F值3.77、p＜0.01）。主管職位在個人專業能力增進優於一般護理人員（t值1.97、p＜0.05）。（3）整體而言，「課程滿意度」、「個人專業能力增進」與「實際工作應用成效」兩兩間呈現顯著正相關。結論：建議依護理人員需求安排訓練及鼓勵政策，導入醫療團隊資源管理訓練於高級心臟救命術訓練中，以高擬真模擬輔助訓練，定期舉辦跨領域團隊合作照護教育訓練及定期不預警的進行急救綜合演練測驗，此研究結果可提供未來高級心臟救命術訓練與臨床緊急應變能力增進之課程規劃作為參考。

Purposes: The aim of this study was to evaluate the effect of an ACLS training course on clinical learning efficacy by the use of a self-assessment tool. Methods: This cross-section study based on Kirkpatrick four-level assessment model and recruited 333 nursing staff in a medical center. All subjects were asked to complete a questionnaire which consisted of three domains: course satisfaction, professional capabilities, self-assessment of competency. Results: (1) For each parameter of training efficacy, scores by priority ranking were as follows: enhancement of individual professional ability, class satisfaction, and impact on practical work efficiency. (2) Scores for the self assessment of ACLS competency and practical work efficiency of emergency/intensive care nurses were higher than those of hemodialysis unit staff. Scores for the enhancement of individual professional ability of head nurses were higher than those of general nursing staff. (3) There were significant intergroup differences for class satisfaction, enhancement of individual professional ability, and practical work efficiency. Conclusions: We recommended that successful implementation of a training program should meet the demands of trainees. Such interventions may include incorporation of the Team Resource Management model, utilization of high fidelity medical simulations, scheduled integrated team-based drills, and unscheduled hands-on practice and tests. The results of this study could serve as a reference for the improvement of future ACLS training courses.