混合學習在急診護理師護理專業進階推動中之成效

Effectiveness of Blended Learning in Promoting Clinical Ladder Advancement among Emergency Department Nurses

台北某醫學中心的急診室護理師，經常面對高壓與高風險情境，且對專業能力要求甚高，但2019至2023上半年，護理專業進階完成率僅3.8%。調查顯示護理專業進階不足之主因包括：護理專業進階動機不足、寫作報告困難、臨床教育電子護照（E-portfolio）介面不熟悉，以及課程與排班時間衝突。為改善現況，成立專案小組，導入混合學習模式，並採多項措施，如設計護理專業進階獎勵卡、一對一報告書寫輔導、培訓E-portfolio種子教師、建置線上讀書會與數位學習資源，以提升學習彈性與可近性。專案推動後，護理專業進階完成率大幅提升至25.8%，顯示學習動機、自主性與制度參與度均獲明顯改善。結果指出，混合學習模式結合持續性輔導與多元支持機制，能有效促進急診護理師能力成長，與推動護理專業進階制度，對提升臨床照護品質具重要價值。

Emergency department (ED) nurses at a medical center in Taipei frequently work in high-pressure, high-risk settings where professional competence is strongly demanded. However, the completion rate of the nursing professional advancement program remained low at only 3.8% from 2019 to the first half of 2023. A needs assessment identified the main barriers to advancement as insufficient motivation, difficulties in writing required reports, unfamiliarity with the clinical education e-portfolio interface, and scheduling conflicts between program courses and shift work. To address these issues, a project task force was established to implement a blended learning model supported by multiple strategies, including the development of an advancement incentive card, one-on-one coaching for report writing, training e-portfolio seed instructors, and building online study groups and digital learning resources to improve flexibility and accessibility. Following implementation, the completion rate increased markedly to 25.8%, indicating substantial improvements in learning motivation, learner autonomy, and participation in the advancement system. These findings suggest that a blended learning approach, combined with ongoing coaching and multifaceted support mechanisms, can effectively facilitate competency development among ED nurses and promote successful implementation of professional advancement programs, thereby contributing to improved quality of clinical care.