臺灣博碩士論文加值系統

護理課程強調知識和技能相結合與應用。然而，傳統學徒制的護理課程由於受限於教師人力，在教導護理標準作業流程時經常採用一對多的授課方式，學生練習和獲得回饋的機會往往不足。尤其在身體評估的課程中，護理人員必須學習面對面病患，在緊急狀況時更需要進行基本病理的研判與處理；因此，如何提供一對一且立即回饋的學習環境，以增加學生練習機會，並改善護理技能的熟練度與正確性，是極待面對的重要議題。本研究嘗試結合行動與感應科技，建置行動化輔助技能訓練身體評估系統，來訓練護理科系的學生對於呼吸系統疾病進行整體的身體評估；同時，運用精熟學習的模式，加強學生對於護理標準流程概念和技巧的瞭解與熟練度。經由實際的實驗與分析結果顯示，使用行動化護理技能訓練系統的學生，在學習成就與技能表現方面都顯著優於接受傳統教學的學生。由此可知，本研究提出的學習模式，除了讓學生有正確的身體評估概念外，更能夠強化學生完成身體評估標準作業流程的精熟程度。

In nursing education, instructors emphasize the application of combined knowledge with clinical skills. In a traditional education, the course structure of classroom learning and clinical training result in separating knowledge and skills when students are applying the standard operating processes in nursing. This teaching pattern makes educating students difficult. Therefore, it is important to utilize an integrated curriculum when teaching standard operating process in Health Assessment & Physical. This study attempts to design a mobile support system with ubiquitous learning for nurse training. This system not only trains students to make a full assessment of respiratory diseases with standard operating process, but also helps students to completely and rightly establish concepts and skills of the assessment model through the addition of a mastery game model during the training of standard operating process. A Mastery mechanism enhances the students’ ability to complete the training in a limited time and helps reach the goal of enabling students to evaluate respiratory diseases rapidly and correctly. A preliminary experiment shows that the learning outcome of students is notable increased by utilizing a mobile support system in nursing training.

目錄
論文摘要 I
ABSTRACT II
誌謝 III
目錄 IV
圖目錄 VI
表目錄 VII
一、緒論 1
1.1研究背景 1
1.2研究動機及目的 2
1.3論文架構 2
2.1護理教育的相關研究 4
2.1.1護理教育的目標及特性 5
2.1.2護理教育的相關理論 (認知學徒制&精熟學習) 6
2.2行動與無所不在技術的發展 9
2.3情境感知無所不在的學習的相關研究 10
三、行動化護理技能訓練系統 11
3.1系統架構與功能 11
3.2系統運作流程與介面設計 13
3.3結合認知師徒制概念的行動化護理技能訓練系統 36
四、實驗設計 39
4.1實驗對象 39
4.2研究工具 39
4.3實驗流程 40
4.4實驗環境與學習情境 42
五、實驗分析與討論 44
5.1學習成效 44
5.2學習態度 45
5.3認知負荷 46
5.4行動載具易用性和有用性 46
六、結論與未來展望 49
參考文獻 50
附錄A 56
附錄B 58


圖目錄
圖3-1、系統架構圖 12
圖3-2、護理用假人和標籤 12
圖3-3、系統流程圖 14
圖3-4、登入介面　　　　圖3-5、呼吸系統的評估步驟 16
圖3-6、分配的床位 17
圖3-7、閱讀病歷 18
圖3-8、評估生命徵象和蒐集資料的介面 19
圖3-9、蒐集體溫的資訊 20
圖3-10、蒐集血壓的資訊 21
圖3-11、蒐集呼吸和心跳次數的資訊 22
圖3-12、修改蒐集資訊的操作介面 23
圖3-13、在視診蒐集資料的例子 24
圖3-14、前胸觸診中淺層觸診的例子 25
圖3-15、前胸叩診的例子 26
圖3-16、前胸聽診的例子 27
圖3-17、觸覺性震顫的十個檢查點 28
圖3-18、肺部叩診；圖3-19、橫膈離軌度之測量 29
圖3-20、後胸聽診的例子 30
圖3-21、血液檢查報告 31
圖3-22、評估疾病 32
圖3-23、病人目前有哪些健康問題 33
圖3-24、護理的立即性處置 34
圖3-25、學生對於案例的精熟程度 35
圖3-26、系統的錯誤回饋和修正功能 37
圖3-27、精熟的機制讓學生能自動地撒除鷹架 38
圖4-1、實驗流程圖 41
圖4-2、實驗的環境(護理教室) 42
圖4-3、RFID感應示意圖 43
圖4-4、學生以PDA和RFID進行情境感知無所不在學習 43


表目錄
表3-1、呼吸系統的標準評估流程表 15
表4-1、實驗對象分組表 39
表5-1、控制組和實驗組的前測獨立樣本t檢定 44
表5-2、後測成績的ANCOVA檢定結果 44
表5-3、技能考試成績的t檢定結果 45
表5-4、學習態度問卷的t檢定結果 45
表5-5、認知負荷分的t檢定結果 46
表5-6、行動學習系統接受度問卷 47

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