提升護理臨床教師直接觀察操作型技術評量法（DOPS）應用之教學研究

Application of DOPS to Clinical Nursing Practice

直接觀察操作型技術評量法(direct observation of procedural skills, DOPS)是臨床護理教學評量的實用工具之一，涵蓋廣泛的操作性技能、結合回饋與操作。然而，台灣許多醫院護理部門雖已引用DOPS作為護理人員臨床表現之評值工具，但卻缺乏對於評量者應用量表能力之評估。本研究旨在將DOPS應用導入護理臨床教師師資培訓課程，凝聚護理臨床教師DOPS評量的共識，並探討DOPS應用課程對提升護理臨床教師DOPS應用能力之成效。研究對象為北區某區域醫院42位護理臨床教師，研究工具為個案醫院「DOPS量表」、「DOPS訓練課程成效滿意度問卷」、「抽痰技術操作影片」，介入方案為「DOPS應用訓練課程」。研究結果顯示，護理臨床教師在接受課程，護理臨床教師應用DOPS量表的組間變異降低，在「知情同意」、「止痛與鎮定」、「無菌技術」、「技術能力」、「相關處置」等項次評量一致性的提升皆達顯著差異，顯示DOPS應用訓練課程可以凝聚護理臨床教師的共識，有效提升護理臨床教師應用DOPS量表的一致性。此外，課程滿意度調查結果顯示護理臨床教師對課程反應良好，而經由課堂討論後的共識統整與文字化具體結論，可以做為護理臨床教師應用DOPS進行學員評量時的依循參考，建構更客觀的評量準則。建議以DOPS量表作為人員護理能力評量的醫院，可以將此課程規劃為新進護理臨床教師在實務擔任教學工作前的師資培訓課程之一，以提升新進護理臨床教師之教學評量能力，並可經由課堂討論的經驗交流，讓護理臨床教師分享彼此的教學經驗進而凝聚共識，不僅可以減少教學挫折與提升教學信心，更能與進促進教師教學效能與學員學習成效。

Direct observation of procedural skills (DOPS) is a practical instrument for evaluation of clinical nursing education for its combination of operation skills and feedback. Although many hospitals in Taiwan have adopted DOPS to evaluate nurses' clinical performance, there is no method to assess evaluators' ability in using this instrument. The purpose of this study is to add DOPS to the clinical nursing educator training course, establish consensus on the use of DOPS, and determine the effects of training with DOPS in promoting clinical nursing educators' ability. The study subjects were 42 clinical nurse educators from a regional hospital in northern Taiwan. The study instrument were the DOPS scale, DOPS training satisfaction questionnaire, and video for sputum suctioning operation. The project was named ＂Application of DOP Training Course＂. The study results showed that the training programs could improve the application of DOPS and reduce disparities between clinical nursing educators (p＜.05). There was a significant difference in consensus of information, narcotics and sedatives, sterile techniques, and relevant management. Furthermore, the educators were highly satisfied with the DOPS curriculum In addition, the consensus could be integrated and substantiated as objective evaluation standards and could be used as a reference for educators in the future. The recommendation was made to those hospitals using DOPS as an evaluation tool to add this course as part of the new clinical nursing educator orientation training. Implementation of DOPS helps foster experience exchanges in class, share mutual experiences and establish consensus, minimize frustration, promote confidence in teaching competency and improve the quality of nursing clinical learning efficacy.