「紮根、困頓、成長」－－新手護生的臨床實習經驗

Roots of competency, setbacks and hardship, and growth opportunities - Clinical Nursing Practice of New Nursing Students

背景：護理系學生實際接觸臨床實務的基本護理學與實習課程是銜接各護理核心科目實習之重要基礎。目的：為能提升教學成效，期望透過學生學習之回饋中，明瞭學生實習之經驗，以做為教學精進之參考。方法：採質性研究焦點團體訪談法，以半結構式訪談指引進行深入訪談。研究對象以技職體系某大學護理系已完成基本護理學實習學生為對象，以隨機抽樣方式進行招募，共有40位學生參與訪談。結果：研究結果經分析後共歸納出三大主題，包括：一、能力的紮根，二、挫折困頓的經驗，三、成長的歷程等；其中涵蓋有十一個次主題。結論：從門外漢至新手護生的實習經驗中，真實反應學生的心境，其中包含正向與負向經驗。學生之專業能力紮根的過程中，經歷挫折、困頓，嘗試運用自我調整的模式，學習如何因應多變化的實習情境。針對學生正負向學習經驗的轉化，須仰賴實習教師們的敏感度及同理心，深入瞭解及評估學生在初次實習之壓力情境與感受，並能識別學生個別狀態，運用不同的教學策略，因材施教。實務應用：研究結果提供學生實際臨床實習經驗、對實務的看法以及教學輔導方式的體驗，可以作為未來護理教育中臨床教學方法改進之參考。

Background: Fundamental nursing and practicum courses that provide nursing students direct exposure to clinical practice are important foundations that facilitate core nursing internships. Purpose: In order to enhance learning outcomes, the study sought understand the internship experience of students via student feedback and use the feedback as a reference to improve teaching. Methods: For this qualitative research, the study interviewed subjects through a focus-group. The study used semi-structured interviews to gain deep comprehension of the students' experience. Study subjects were nursing interns who had completed fundamental nursing courses at the nursing department of a vocational university. The study recruited subjects through random sampling. A total of 40 students participated in the interviews. Results: After analyzing the research results, the study derived three main themes: 1) the establishment of competencies, 2) the experience of setbacks and fatigue, and 3) the process of growth; the study also included eleven sub-themes. Conclusions: The study accurately reflected the students' state of mind during their internship experience that transformed them into new nursing students. However, students reported both positive and negative experiences. While establishing professional competencies, students experienced setbacks and fatigue but made efforts toward self-regulation and learned how to react to the ever-changing situations of their internships. Varying with the students' positive and negative learning experiences, teachers of the interns should be sensitive and empathetic to fully understand and evaluate the students' individual circumstances and feelings under the stressful situation of their first internship. Teachers can then develop different teaching strategies and teach students according to their individual aptitudes. Applications: The results of this study reveal the actual experiences of students in clinical internships, their perspectives on the practicum and their insights as subjects of the teaching methodology, all of which can serve as references for improving clinical teaching in nursing education in the future.