可信賴專業活動在護理學生的學習與能力培育的應用

The Application of Entrustable Professional Activities in Developing Nursing Students’Learning and Clinical Competence

隨著全球醫療環境變遷與病人需求日益多元，護理教育正由傳統學科導向轉型為強調能力導向教育。本文探討「可信賴專業活動（entrustable professional activities, EPAs）」於護理教育的應用意涵，並提出其在學生臨床能力養成與課程評量設計上的實務策略。EPAs以具體任務為核心，整合知識、技能與態度，強調學習者能勝任並獨立執行專業角色的能力。以內外科護理課程為例，說明如何依據學生學習階段設定能力里程碑，結合高擬真模擬教學與多元評量工具，進行任務導向學習與評核。透過課程模組設計回饋機制，強化學生臨床判斷、溝通協作與專業責任感。然目前EPAs在教學現場的導入仍面臨挑戰，包括課程結構尚未完整建置、教師對理念與操作方式的共識不足，以及學生對能力整合與主動學習模式的適應性與學習動機尚待培養。EPAs提供明確的教學與評量架構，有助於護生在學期間逐步建構臨床實務能力與角色認同，成為能被信賴的護理專業人才。

The evolving global healthcare environment and increasing diversity in patient needs have necessitated a shift in nursing education from a traditional subject-based approach to a competency-based approach. The implications of applying entrustable professional activities (EPAs) in nursing education are explored in this study and practical strategies are proposed for cultivating clinical competencies and designing curriculum assessments. EPAs emphasize task-based learning, integrating knowledge, skills, and attitudes to prepare learners to perform professional roles independently and reliably. In this study, an actual medical-surgical nursing course is used to illustrate how to establish developmental milestones based on student learning stages and how to implement task-oriented learning and assessments using high-fidelity simulation and evaluation tools. Leveraging modular curriculum design and formative feedback mechanisms, EPAs strengthen students’clinical reasoning, communication and collaboration skills, and sense of professional responsibility. However, implementing EPAs in current teaching practice faces challenges, including incomplete curriculum frameworks, lack of consensus among faculty regarding related concepts and methodologies, and limited readiness among students to engage with the integrated and self-directed learning models. EPAs offer a clear structure for teaching and assessment, helping nursing students gradually develop clinical competence and professional identity and ultimately prepare them to become trustworthy nursing professionals.