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研究生:張文蕙
研究生(外文):Wen-Hui Chang
論文名稱:客觀結構式臨床測驗評量於護理人員溝通能力教育訓練之研究
論文名稱(外文):A Study on the Use of Objective Structured Clinical Examination for Communication Competency Assessment for Nurses
指導教授:許麗齡許麗齡引用關係
指導教授(外文):Li-Ling Hsu
口試委員:謝素英
口試委員(外文):Suh-Ing Hsieh
口試日期:2013-06-24
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:醫護教育研究所
學門:教育學門
學類:專業科目教育學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:中文
論文頁數:126
中文關鍵詞:情境模擬溝通教學出院準備服務溝通能力溝通自我效能客觀結構式臨床測驗評量學習滿意度
外文關鍵詞:simulation-based communication training sessiondischarge planningcommunication skillscommunication self-efficacyObjective Structured Clinical Examinationlearning satisfaction
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本研究旨在探討出院準備情境模擬溝通教學介入後,護理人員之溝通能力、溝通自我效能、客觀結構式臨床測驗評量與學習滿意度之成效探討。採實驗性研究設計(experimental design),以台北市某醫學中心N0~N2護理人員為研究對象,共78人;實驗組40人接受情境模擬溝通教學課程,控制組38人採傳統課室案例討論教學;研究工具包括:溝通能力查檢表、溝通自我效能評量表、學習滿意度問卷及客觀結構式臨床測驗評量(出院護理指導查核表及標準化病人回饋表)。在教學課程介入前後,兩組皆接受前後測,介入後4週進行客觀結構式臨床測驗評量。以SPSS17.0電腦統計套裝軟體進行資料分析,包括描述性統計分析(次數分配、百分比、平均數與標準差)及t-tests、ANCOVA、Mann-Whitney test等統計方法。研究結果顯示:(一)溝通教學介入後,控制組與實驗組於溝通能力查檢表及溝通自我效能評量表前後測得分有顯著差異。(二)溝通教學介入後,控制組與實驗組於溝通能力查檢表及溝通自我效能評量表得分有顯著差異,且實驗組高於控制組。(三)溝通教學介入後,控制組與實驗組於學習滿意度得分有顯著差異,且實驗組高於控制組。(四)溝通教學介入後,控制組與實驗組於客觀結構式臨床測驗評量之考官評量得分有顯著差異,且實驗組高於控制組;但標準化病人評量得分無顯著差異。未來研究建議可將客觀結構式臨床測驗評量擴大至其他依實務設計不同情境教案之護理能力評量,並可進行長期追蹤及質性研究。
This study evaluated the effectiveness of a simulation-based intervention on enhancing nurse communication performance and communication self-efficacy in discharge planning process. The effects of the intervention on the results of an Objective Structured Clinical Examination (OSCE) assessment and a learning satisfaction survey administered to nurses were also evaluated. In this experimental design study, a total of 78 nurses within the nursing ladder N0-N2 were recruited from a major hospital in Taipei City. The experimental group (40 nurses) was given the simulation-based intervention. 38 nurses in the control group attended traditional lectures on communication. The Communication Skills Checklist, Communication Self-Efficacy Scale, Learning Satisfaction Survey, and OSCE (Discharge Checklist for Nurses and Standardized Patient Survey) were used as assessment tools for communication performance and learning satisfaction evaluation. Both groups were measured before and after the intervention. The OSCE was administered to both groups in the fourth week of intervention. Data were analyzed using SPSS 17.0, descriptive statistics (frequency distribution, percentage, mean, and standard deviation), t-tests, ANCOVA, and Mann-Whitney test. Results revealed (1) the mean scores for communication skills and communication self-efficacy for both groups showed statistically significant differences before and after intervention. (2) Significantly higher mean scores for communication skills and communication self-efficacy were seen in the experimental group compared with the control group. (3) Significant differences were found in the mean learning satisfaction scores for both groups before and after intervention, with the experimental group having higher scores. (4) Significant differences were found in mean OSCE scores for both groups before and after intervention, with the experimental group having higher scores. However, no significant differences were found in mean assessments scores from standardized patients. Further long-term follow-up or qualitative research may be conducted to investigate the use of OSCE for other types of nursing competency assessment.
第一章 緒論 1
第一節 研究動機及背景 1
第二節 研究目的 4
第三節 研究問題 5
第四節 研究假設 5
第五節 名詞解釋 6
第二章 文獻查證 8
第一節 護理人員之溝通能力 8
第二節 情境模擬教學於溝通之應用 11
第三節 客觀結構式臨床測驗 13
第四節 相關研究 15
第三章 研究方法 26
第一節 研究設計 26
第二節 研究架構 27
第三節 研究對象及場所 28
第四節 研究介入 30
第五節 研究工具 34
第六節 研究流程 42
第七節 資料分析 43
第八節 倫理考量 45
第四章 研究結果 48
第一節 研究對象之基本屬性分析 48
第二節 溝通能力查檢表及溝通自我效能評量表得分比較 51
第三節 學習滿意度問卷得分比較 55
第四節 客觀結構式測驗評量得分比較 55
第五節 比較各項評量工具間之相關性 60
第五章 討論 61
第一節 護理人員對溝通能力之評核 61
第二節 護理人員對溝通自我效能之評核 63
第三節 課程學習滿意度評量得分 65
第四節 客觀結構式臨床測驗評量得分 67
第六章 結論與建議 70
第一節 結論 70
第二節 研究限制 71
第三節 建議 72
參考文獻 75
中文文獻 75
英文文獻 77
附錄一 樣本數估計 85
附錄二 溝通情境教案 86
附錄三 情境模擬溝通教學計畫-「出院準備護病溝通」 91
附錄四 實際教學介入時間及內容 96
附錄五 研究工具-問卷內容 100
附錄六 客觀結構式臨床測驗(OSCE)教案及評量表 104
附錄七 專家效度委員一覽表 112
附錄八 專家意見修改一覽表 113
附錄九 人體試驗審查委員會同意書 123
附錄十 受試者同意書 124


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