護理臨床教師指導護生實習的情況越來越普遍，經由研究者與多位護理臨床教師
的訪談結果發現，多數的護理臨床教師都是在醫院的指派下擔任護理臨床教師的角
色，大部分的護理臨床教師有豐富的臨床經驗和學識，普遍自覺缺乏教學技巧及信
心，對於指導護生備感壓力與焦慮，同時也深感護理在職教育課程中缺乏敎與學相關
概念，以及臨床指導員教育訓練的不普及，使得從護理人員在轉換成教師的角色有所
困難。
本研究旨在瞭解護理臨床教師自評教學能力情形與影響因素。本研究為描述性及
相關性研究設計(descriptive and correlational study design)，採橫斷式調查方法
(cross-sectional survey)，自擬「護理臨床教師教學能力自評表」，其內在一致性
Cronbach’s α為0.99，進行專家內容效度檢定，題項內容效度(Item-Content validity
index, CVI)為0.95與量表內容效度(Scale-CVI, S-CVI)為0.75；調查北部地區某家醫學
中心及區域級醫院各科別之護理人員，總共發出154份問卷，回收147份問卷(有效
回收率95.4％)。將回收的資料以SPSS 17.0進行資料分析，採用次數分配、百分比、
平均數、標準差、單因子變異數分析(One-Way ANOVA)、無母數分析(Mann-Whitney
test或Kruskal-Wallis test )、線性複迴歸(multiple linear regression)等方法進行推論性統
計。研究結果發現: (一) 護理臨床教師自評教學能力平均單題得分範圍介於4.45分到
3.67分（最高為5分），依平均數得分排序最高的前3個變項依序為「能要求學生回
覆示教」、「提供安全實習環境」、「能和病人建立良好的關係」。(二) 護理臨床教師自
評教學能力分數，會因個人背景因素之不同而有所差異；年齡越大、護理工作總年資
越資深、進階層級為N3層級或N4層級、區域醫院的護理臨床教師、認為高薪資影
響擔任護理臨床教師者、高度行政主管支持度者，其自評教學能力分數較高。(三) 經
由複迴歸分析發現，在控制婚姻、教育程度、醫院等級及進階層級下，只有年齡及護
理行政主管支持度是護理臨床教師教學能力之顯著獨立預測因子；換言之，年齡組別
中41-58歲相較於21-30歲的護理臨床教師，其教學能力提高14.81分；護理行政主
管支持度為高支持度者，其教學能力較普通支持度者高12.80分，此模式可解釋21.4%
護理臨床教師教學能力之變異量。本研究結果期望能提升護理臨床教師教學能力及發
展完整、客觀臨床教學能力之評值工具，可作為護理臨床教師自評教學能力之參考。

An increasing number of veteran nurses are trusted with the task of training student nurses. Interviews between the author of this study and many clinical nurse trainers revealed the fact that the majority of clinical nurse trainers were given the role of nurse trainer by the hospital at which they work. The vast majority of clinical nurse trainers are well-versed and well-experienced in clinical practice, but many perceive themselves as lacking the skills and the confidence to pass their knowledge to student nurses, and feel anxious and stressed about their role as nurse trainer. Many of them believe that existing in-service nursing education does not provide enough guidelines for the transfer of knowledge between nurse trainer and nurse, and educational training opportunities for clinical nurse trainers have been scarce. Consequently, many nurse trainers have difficulty switching to the role of teacher.
The purpose to this study was to investigate the teaching competencies of self-assessment and the related influencing factors among clinical preceptors. This is a descriptive and correlational study design using cross-sectional survey. There were 154 structural questionnaires sent out in a medical center and a regional educational hospital and 147 questionnaires were returned completed for data analysis. The return rate was 95.4%. The research instrument used in the study was the, questionnaire on teaching competencies of self-assessment among clinical preceptors with the Cronbach's α 0.994, Item-Content validity index (I-CVI) 0.95 and Scale-CVI(S-CVI) 0.75 valued by experts. Data was analyzed by using SPSS 17.0 with descriptive, one-way ANOVA, Mann-Whitney test and multiple linear regression analysis. The results disclosed: (1) The mean teaching competencies of self-assessment scores among the subjects was range from 4.45 to 3.67 (5-point Likert Scale); Order of the first three items of highest mean score was as the following: "Asking students to demonstrate preceptor teaching, "Providing a safe practice environment", and "Having good relationship with patients". (2) The teaching competencies of self-assessment among clinical preceptors appeared to be related to personal background. The following ones had higher scores: the older, the more years of nursing experience, the N3 and N4, working in regional hospital, the benefits or rewards-oriented, the higher supportive level of nursing administrators. (3) Multiple regression analysis showed that the influencing factors including age, marital status, education, class of working, clinical nursing ladder, and supportive level of nursing administrators explained 21.4% of total variance. (4) In controlling for the variances of age, marital status, education, class of working, clinical nursing ladder, and supportive level of nursing administrators, only the variances of age and supportive level of nursing administrators were as significant independent predictors. Compared with the groups of 21-30 years-old, when the groups of 41-58 years-old older each additional year-old, the mean score increased by 14.81 points. The mean score among the higher supportive level of nursing administrators was 12.80 points less than that of common ones. We hope this study to be able to benefit the teaching competencies of clinical preceptors, and to be an intact and objective instrument for clinical practices.

目 錄
致謝………………………………………………………………………………………I
論文摘要………………………………………………………………………….…..ΙI
英文摘要………………………………………………………………………….……VΙ
目錄……………………………………………………………………………….……V
表次…………………………………………………………………….………………X
圖次…………………………………………………………………………….……..XI
第一章 緒論……………………………………………………………………….……1
第一節 研究背景及動機…………………………………………………………….1
第二節研究目的………………………………………………………………….…4
第三節研究問題………………………………………………………………….…4
第四節名詞界定……………………………………………………………….……4
第二章 文獻探討……………………………………………………………………….6
第一節　護理臨床教師………………………………………………………….……6
第二節 護理臨床教師教學能力內涵………………………………………….……9
第三節 影響教學能力相關因素……………………………………………………13
第四節 教學能力之國內外相關研究………………………………………………15
第三章 研究方法………………………………………………………………………20
第一節　研究設計……………………………………………………………………20
第二節　研究架構……………………………………………………………………21
第三節　研究對象與場所……………………………………………………………22
第四節　研究工具與研究流程………………………………………………………23
第五節 資料處理……………………………………………………………………29
第六節 研究倫理……………………………………………………………………31
第四章 研究結果………………………………………………………………………33
第一節　研究對象基本資料之描述性分析…………………………………………33
第二節　研究對象整體教學能力內容之描述分析…………………………………36
第三節　個人背景因素與教學能力之差異分析……………………………………40
第四節　影響護理臨床教師自評教學能力之預測因子……………………………43
第五章 討論……………………………………………………………………………46
第一節　研究對象基本資料分析…………………………………….…………..46
第二節　教學能力內容分佈情形……………………………………………………47
第三節　影響教學能力相關因素……………………………………………………49
第四節　影響教學能力預測因子之探討……………………………………………51
第六章 結論與建議……………………………………………………………………53
第一節　結論…………………………………….………………………………..….53
第二節 研究限制……………………………………………………………………55
第三節 建議…………………………………………………………………………55
參考資料…………………………………………………………………………………58
中文資料………………………………………………………………………………58
英文資料………………………………………………………………………………58
附件………………………………………………………………………………………62
附件一 Sonthisombat「護理臨床教師教學能力自評表」……………………62
附件二 參與者研究同意書…………………………………………………………65
附件三 訪談大綱……………………………………………………………………66
附件四 護理臨床教師自評教學能力量表初稿……………………………………67
附件五 量表項目資料來源…………………………………………………………71
附件六 訪談者資料列表……………………………………………………………73
附件七 訪談紀錄逐字稿……………………………………………………………74
附件八 護理臨床教師自評教學能力量表………………………..………..………80
附件九 專家效度委員一覽表………………………………………………….....84
附件十 臨床輔導員自評教學能力量表專家效度檢定………………………......85
附件十一臨床輔導員自評教學能力量表(專家效度評分表).................87
附件十二資料分析之統計假說摘要……………………………………………………97
附件十三 人體試驗委員會通過名證明函……………………………………………98
表次
表2-1-1 國內外學者針對護理臨床教師教學能力評值相關研究之彙整……………..18
表3-6-1 變項資料統計方法…………………………………………………………..…31
表4-1-1研究對象個人背景因素分佈情形……………………………………..…….…35
表4-2-1護理臨床教師自評教學能力每項狀況………………………………………...37
表4-3-1不同的個人背景護理臨床教師自評教學能力之差異……………………...…42
表4-4-1 雙變項和多變項線性迴歸分析護理臨床教師自評教學能力之預測因子…..45

圖次
圖3-1-1研究流程..................................................22
圖3-2-1研究架構..................................................28

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