臺灣博碩士論文加值系統

為提升護理人員Port-A導管照護之學習動機及熟練技能，藉由虛擬實境教學系統，使護理人員能在安全的環境下不斷練習直到精熟。本研究旨在探討植入式Port-A導管照護虛擬實境教學系統介入後，護理人員於植入式Port-A導管知識測驗、照護技能、學習態度及學習滿意度之學習成效探討。本研究採單組前測、後測及延宕測之類實驗研究設計(quasi-experimental design)，研究對象採方便取樣自北部某區域教學醫院，須執行Port-A照護單位且到職工作2年內之護理人員，共收案43人，所有受試者於課程介入前後均接受前測、後測及延宕測，前測的內容包括知識測驗與DOPS評量；後測內容包括知識測驗、DOPS評量、虛擬實境學習系統之學習態度、虛擬實境學習系統滿意度；介入結束後一週後進行10位參與者的一對一訪談，延宕測內容為知識測驗與DOPS評量。資料分析應用SPSS 21.0 版進行描述性統計分析及Repeated measures ANOVA進行分析。研究結果顯示：（一）植入式Port-A導管知識測驗於學習系統介入平均得分後測及延宕測均顯著高於前測。（二）植入式Port-A導管注射技能DOPS直接觀察技能評量，平均得分後測及延宕測均顯著高於前測。（三）虛擬實境學習系統學習態度總平均為4.29 ( SD = 0.46)。（四）虛擬實境學習系統滿意度總平均為4.31 ( SD = 0.58)，整體滿意度為90.7%。（五）植入式Port-A 導管照護之虛擬實境學習系統質性分析與整體感受，包含：虛擬實境擬真畫面令人印象深刻、虛擬實境的練習有幫助性、未來願意學習虛擬實境、虛擬實境系統的限制、可作為未來課程規劃之方向。本研究結果建議：持續推動虛擬實境學習系統於護理教育應用、廣泛應用情境案例於教學系統課程、推動護理臨床教師對虛擬實境學習系統充分了解，以及增加虛擬實境教學主題課程設計，運用於醫院新進護理到職訓練或學校臨床實習課程之參考。

In order to improve the motivation and skill of nursing staffs port-A catheter implantation, the virtual reality-based instructional simulation system enabled the nursing staff to practice in a safe environment until they were proficient. This study aimed to investigate the effect of a virtual reality-based educational intervention on a group of nurses’ knowledge and skills about port-A-catheter implantation, as well as their learning attitude and overall satisfaction with the educational intervention. A one-group pretest-posttest quasi-experimental design was used. A convenience sample of nurses (43) was limited to registered nurses employed for at least two years at the staff level at a university hospital in Taipei, with clinical experience in port-A-catheter implantation. Three measurements were taken at pretest (knowledge and Direct Observation of Procedural Skills (DOPS)), posttest (knowledge, DOPS, learning attitude, satisfaction with the learning experience in general, and one-on-one interview with ten of the participants one week after the intervention), and delayed posttest (knowledge and DOPS). Data analysis was performed using SPSS 21.0 for descriptive statistics and repeated measures ANOVA. Findings are as follows: (1) The sample demonstrated significantly higher port-a-catheter implantation knowledge levels at posttest and delayed posttest than at pretest. (2) The sample demonstrated significantly higher port-a-catheter implantation skill levels at posttest and delayed posttest than at pretest, as suggested by DOPS results. (3) The sample’s mean of learning attitude toward the educational intervention was 4.29 points (SD = 0.46). (4) The sample’s mean of satisfaction toward the educational intervention was 4.31 points (SD = 0.58). Overall satisfaction level was 90.7%. (5) Qualitative data analysis yielded the following findings: The sample was impressed with the real-life likeness of the virtual reality-based educational intervention, found the practice drills included in the educational intervention very helpful, would like to learn more about virtual reality in the future, was aware of the limitations of virtual reality, and was aware of the applicability of virtual reality in educational training. Based on the findings of this study, the following recommendations were made: The use of virtual reality in nursing education should be encouraged. A virtual reality-based educational intervention should include enough clinical scenarios to be a practical learning aid. Clinical nursing preceptors should have a proper understanding of virtual reality-based educational intervention. In addition, virtual reality-based educational interventions should be more widely used to facilitate in-service training for novice nurses and clinical nursing training for nursing students.

中文摘要 i
英文摘要 ii
目 次 iv
表 次 vi
圖 次 vii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 5
第三節 研究問題 5
第四節 研究假設 6
第五節　名詞解釋 6
第二章 文獻查證 7
第一節 植入式PORT-A導管照護概念 7
第二節 植入式PORT-A導管教育訓練 18
第三節 情境學習理論 20
第四節 虛擬實境之概念 22
第五節 虛擬實境之相關研究 25
第三章 研究方法 30
第一節 研究設計 30
第二節 研究架構 32
第三節 研究對象及場所 33
第四節 研究介入 34
第五節 研究工具 40
第六節 研究步驟 45
第七節 資料處理與分析 47
第八節 研究倫理 49
第四章 研究結果 50
第一節 研究對象之基本資料 50
第二節 植入式PORT-A 導管照護虛擬實境教學介入之學習系統使用狀況 53
第三節 植入式PORT-A 導管照護虛擬實境教學介入的知識與PORT-A導管注射技能之組內效應 56
第四節 植入式PORT-A 導管照護虛擬實境教學介入之學習態度分布 58
第五節 植入式PORT-A 導管照護虛擬實境教學介入之學習系統滿意度分布 60
第六節 植入式PORT-A 導管照護之虛擬實境教學介入之學習系統使用經驗 63
第五章 討論 68
第一節 虛擬實境教學之學習理論 68
第二節 植入式PORT-A導管知識測驗成效 69
第三節 植入式PORT-A直接觀察技能(DOPS)評量成效 71
第四節 學習態度之評量 73
第五節 學習系統滿意度 75
第六節 虛擬實境教材之學習經驗 76
第六章 結論與建議 80
第一節 結論 80
第二節 研究限制 83
第三節 研究應用 84
參考文獻 86
中文部分 86
英文部分 91
附 錄 99
附錄一 以G-POWER估算樣本結果圖 99
附錄二 人體試驗審查委員會計畫執行許可書 100
附錄三 植入式Port-A導管照護虛擬實境學習訪談指引 101

表 次
表2-1 國內各家醫院及機構新人訓練之植入式Port-A導管課程方式 19
表2-2 虛擬實境(VR)應用於醫護理教育之相關研究 27
表3-1 研究設計及測量 31
表3-2 教學設計及測量 37
表3-3 介入方案 39
表3-4 Port-A知識測驗雙項細目表 43
表3-5 資料分析方法 47
表4-1 護理人員基本屬性分佈 51
表4-2 植入式Port-A導管照護之虛擬實境教材13次的練習人次、訓練總平均時間、關卡提示總平均
次數及錯誤總平均次數 53
表4-3 護理人員接受植入式Port-A導管照護虛擬實境教學介入成效的組內差異 57
表4-4 植入式Port-A 導管照護虛擬實境教學介入之學習態度分佈 59
表4-5 植入式Port-A 導管照護虛擬實境教學介入之學習系統滿意度分佈 62
表4-6 受訪者基本資料 63

圖 次
圖2-1 植入式Port-A導管置入部位 7
圖2-2 植入式Port-A導管之結構 8
圖2-3 植入式Port-A導管之彎針 9
圖2-4 植入式Port-A導管之注射部位 10
圖2-5 無菌彎盆內之用物 11
圖2-6 Port-A置入透氣膠膜覆蓋 11
圖2-7 Port-A置入程序流程圖 Port-A置入程序流程圖 12
圖2-8 虛擬實境之三大特性 23
圖3-1 研究架構 32
圖3-2 虛擬實境教學系統教材內容編制流程步驟 35
圖3-3 虛擬實境學習系統操作情境 36
圖3-4 研究步驟 46
圖4-1 植入式Port-A導管照護之虛擬實境教材13次之練習人數 54
圖4-2 植入式Port-A導管照護之虛擬實境教材13次訓練之總平均時間 54
圖4-3 植入式Port-A導管照護之虛擬實境教材13次之關卡提示總平均次數及錯誤總平均次數 55

中文部分
王文靜(2003)．基於虛擬情境的教學模式研究．課程與教學，6(2)，69-78。
三軍總醫院(2016)．三軍總醫院臨床醫事人員培訓計畫護理部二年期護理師（士）訓練課程計畫．取自http://wwwu.tsgh.ndmctsgh.edu.tw/nur1/category_ content_data/96/20160401185534721.pdf。
王炫智(2010)．虛擬實境在體育教學中之應用．學校體育， (116)，81-86。
王昱豐、林志文、許裕燦、邱建勳(2005)．Diagnosis of port-a catheter-induced thrombosis by upper extremities radionuclide venography．核子醫學雜誌，18(1)，63-66。
王新芳、黃秀英、祝孔聖、王傳育、馬君、王良順、彭汪嘉康(2013)．利用根本原因分析（root cause analysis，RCA）改善化療藥物外滲事件．醫療品質，5(1)，50-64。
王維那、郭嘉琪(2014)．96小時與72小時更換周邊靜脈留置針的效應探討－隨機控制試驗．護理暨健康照護研究，10(3)，190-198。doi:10.6225/jnhr.10.3.190
中華民國兒童癌正基金會(2007)．如何照顧你的靜脈導管．取自http://www. ccfroc.org.tw/child/child_affection_read.php?a_id=26
台灣腫瘤護理學會(2017)．基礎腫瘤護理訓練課程．取自http://www.onst.org.tw/active/side_info.asp?id=214
台灣護理學會(2013)．護理臨床教師教學教案設計指引．取自https://www.twna. org.tw/frontend/un16_commission/webPages_6/file/1021211.pdf
江錦玲、謝美玲、王琬詳(2011)．中心靜脈導管照護及其相關感染之探討．長庚護理，22(2)，184-190。
邱梨淑、李仙惠、張慧貞(2014)．以多媒體教學介入透析病人血管通路穿剌異常之改善專案．臺灣腎臟護理學會雜誌，13(1)，16-29。
李石增(2013)．臨床能力評量指引（二版）．台北：台灣愛思唯爾。
李怡頡、林欣樺、莊依如、官惠貞、紀嘉君、林宜君…吳淑貞(2016)．某區域教學醫院腫療科病房降低中心導管相關血流感染之經驗．感染控制雜誌，26(1)，1-12。
李金泉、葉品逸(2004)．員工安全態度量表之發展．工業安全衛生月刊，179，34-45。
余鑑、陳麗玉、黃建國(2010)．模擬訓練應用於實習醫學生之成效評估．創新與經營管理學刊，1(1)，51-65。
長庚醫院(2015)．內植式輸液塞之注射及輸液護理（Injection and Primary Care of Port-A）標準作業規範．台北市：長庚醫院。
林子超、陳五洲(2006)．虛擬實境應用於體育教學之探討．大專體育，(83)，36-42。doi:10.6162/srr.2006.83.07
林金燕(2016)．降低新進人員執行內植式輸液塞Port-A穿刺異常率．2016年腫瘤護理人員研究論文發表會．台北市：台灣腫瘤護理學會。
林進材(1999)．遺忘理論及其在教學上的應用．師友月刊，(384), 34-36.
林滿、王復德(2006)．靜脈內植式輸液塞合併症之初探．榮總護理，23(1)，17-23。doi:10.6142/vghn.23.1.17。
林嘉玲、林君萍、蘇美禎、張媚(2014)．情境模擬教學在護理教育．臺灣醫學，18(2)，238-243。
和信醫院(2010)．認識植入式中心靜脈注射座(PORT)．取自http://www.kfsyscc. org/cancer/cancer-treatment/care/treatment/ren-shi-zhi-ru-shi-zhong-xin-jing-mai-zhu-she-zuo-PORT
和信醫院(2012a)．起皰性化學藥物外滲處理標準技術．台北市：和信醫院。
和信醫院(2012b)．起皰性化學藥物外滲追蹤辦法．台北市：和信醫院。
和信醫院(2012c)．中心靜脈導管完全阻塞沖洗技術．台北市：和信醫院。
和信醫院(2013)．皮下靜脈置入器注射、沖洗及抽血技術．台北市：和信醫院。
和信醫院(2014a)．皮下靜脈置入器PORT-A功能異常處理作業．台北市：和信醫院。
和信醫院(2014b)．靜脈輸液通則及照護．台北市：和信醫院。
和信醫院(2016a)．化學治療安全防護作業標準．台北市：和信醫院。
和信醫院(2016b)．中心靜脈裝置護理照護作業標準．台北市：和信醫院。
和信醫院(2016c)．二年期護理職類臨床醫事人員培訓計畫．取自http://www.kfsyscc.org/upload/userfiles/files/%E4%BA%8C%E5%B9%B4%E6%9C%9F%E8%AD%B7%E7%90%86%E8%81%B7%E9%A1%9E%E8%87%A8%E5%BA%8A%E9%86%AB%E4%BA%8B%E4%BA%BA%E5%93%A1%E5%9F%B9%E8%A8%93%E8%A8%88%E7%95%AB_%E7%AC%AC%E4%B8%89%E7%89%8820160301(3).pdf
門諾醫院(2014)．門諾醫院二年期護理師、護士訓練計劃．取自https://www. mch.org.tw/UserFiles/20151022042/20151022140706.pdf
洪培元(2006)．由不安全行為談職業災害之防止．工業安全衛生月刊，210，54-62。
施寧怡、鄭惠方、余秀玲、蔡芸芳(2006)．提升護理人員靜脈內植式輸液塞換藥護理技術完整率．腫瘤護理雜誌，6(2)，43-52。
胡綾真、羅靜婷、楊文琪(2010)．身體評估課程提升護理臨床評估能力之行動研究(研究計畫編號FYU2400-98-003)．高雄市：輔英科技大學。
耕莘醫院(2013)．進醫事人員教學訓練計畫．取自http://www.cth.org.tw/public/ dept_aboutus/75/045698a3000258545d67b03c1366d763.pdf
疾病管制局全球資訊網(2015)．2015傳染病統計暨監視年報．取自http://61.57. 41.133/uploads/files/201603/ec5e323b-fd81-40d5-91d3-b0f9b527c46d.pdf
振興醫院(2016)．振興醫療財團法人振興醫院 105 年度護理部新進人員到職訓練課程表．取自file:///C:/Users/%E6%B7%91%E9%B3%B3/Downloads/ 105%E5%B9%B4%E5%BA%A61%E6%9C%88%E4%BB%BD%E8%AD%B7%E7%90%86%E9%83%A8%E6%96%B0%E9%80%B2%E4%BA%BA%E5%93%A1%E5%88%B0%E8%81%B7%E8%A8%93%E7%B7%B4%E8%AA%B2%E7%A8%8B%E8%A1%A81050124.pdf
陳美玉(2000)。教師專業-教學法的省思與突破。高雄：麗文文化。
陳美珠、王復德、黃萬翠、陳瑛瑛(2015)．Port-a導管敷料更換頻率對注射部位及血流感染之影響．感染控制雜誌，25(5)，205-213。doi:10.6526/icj.2015.501
陳俊宏、李政章、周娟羽、陳淑華(2009)．提升手術室護理人員操作單門式高壓蒸氣滅菌鍋正確率之專案．護理雜誌，56(4)，53-61。doi:10.6224/ jn.56.4.53
陳郁文、陳志榮(2014)．Chlorhexidine在預防醫療照護相關感染的應用及分析．感染控制雜誌，24(2)，85-91。
陳詩捷、陳建雄(2015)．2D楔形設計輔助虛擬環境中之尋路體驗．設計學報，20(2)，63-77。
陳詩佩、梁炘燐、林珮瑩、羅樺鈴(2014)．提昇靜脈內植式輸液塞組合式照護技術正確率(摘要)．「第 26 次護理專案發表會海報發表」，台南市。
梁朝雲、李恩東(1998)．虛擬實境的發展與種類．視聽教育雙月刊，40(3)，18-26。
莊瑜珊、李細祥、高雅玲、黃協賢、李嘉玲、高玉瑾…陳亞璇(2015)．運用醫療品質突破方法降低 port-a 導管相關血流感染．感染控制雜誌，25(2)，53-61。
張金堅(2013)．談百年來人類癌症治療發展史．台灣醫界，56(2)，39–44。
張黎露、張瀞文、周文珊、林思岑(2011)．癌症病人常用中心靜脈導管臨床照護指引．腫瘤護理雜誌，11，15-40。
張黎露、許麗珠、周文珊、張瀞文、張淑惠、李佩怡、林盈秀(2013)．抗癌化療藥品外滲照護指引．腫瘤護理雜誌，13，55-73。
曹博盛(2012)．Bloom 認知領域教育目標分類的修訂版應用於數學領域之命題實例．中等教育，63(4)，38-65
馮淑惠、張文惠、錢端蘭(2006)．降低化學治療外滲的發生率．榮總護理，23(4)，374-383。doi:10.6142/vghn.23.4.374
葉凌鴻、羅方妤、李文婕、郭亭伶、蔡佳玲(2015)．運用治療性遊戲協助一位學齡前期白血病兒童降低port-a人工血管扎針之恐懼．長庚護理，26(4)，526-538。doi:10.3966/102673012015122604014
楊琳琪、林秋菊(2010)．風險評估之概念分析．護理雜誌，57(1)，89-93。
慈濟醫院 (2015)．護理技術手冊．新北市：慈濟醫院。
鄭文婷(2012)．癌症病人常見血液管路之照護．取自http://goo.gl/JPBY6W
鄭文雪、孫吉珍、邱秀渝(2011)．癌症針劑細胞毒性化學藥物外滲的預防與監測．醫護科技期刊，13(4)，251-262。doi:10.6563/tjhs.2011.13(4).5
嘉義基督教醫院(2014)．新進護理人員到職訓練計畫書．取自http://www.cych. org.tw/ndsec/doc/%E6%95%99%E8%82%B2%E8%A8%93%E7%B7%B4/%E6%96%B0%E4%BA%BA%E8%81%B7%E8%A8%93%E8%A8%88%E5%8A%83%E6%9B%B8.pdf。
廖述盛、黃秀美、賴崇閔(2011)．虛擬實境結合問題導向學習應用於行動化醫學教育之研究．科學教育學刊，19(3)，237-256。
趙金婷、鄭晉昌(1999)．虛擬實境學習環境的設計與評量．教學科技與媒體， 47，2-11
蔡秉燁、王培卉(2004)．動作技能領域網路教學模式之探討．淡江大學教育科技研究所．取自http://www. etc. edu. cn/articledigest15/dongzuo. htm.
衛生福利部(2016)．行政院衛生署104年死因統計表．取自http://www. mohw.gov.tw/CHT/DOS/Statistic.aspx?f_list_no=312&fod_list_no=6201
衛生福利部國民健康署(2016)．癌症登記線上互動查詢系統．取自https://cris. hpa.gov.tw/pagepub/Home.
賴志豐、張瓊穗(2005)．情境模擬策略融入師資培育線上課程之設計與發展：以“班級經營”為例．教育資料與圖書館學，42(3)，433-449。
賴崇閔、黃秀美、廖述盛、黃雯雯(2009)．3D虛擬實境應用於醫學教育接受度之研究．教育心理學報，40(3)，341-361。doi:10.6251/bep.20080422
謝明蓁(2011)．臨床情境模擬教學回顧檢討技巧．臺灣醫學，15(5)，543-550。
謝信正(2000)．網際網路建置虛擬環境之研究（未發表碩士論文）．國立中央大學，桃園市。
盧淑芬、陳季涵、尚婉明、周幸生(2012)．重症病人導管相關血流感染的預防與照護．護理雜誌，59(4)，5-11。
蕭雅莉、謝秀芳、林麗娟、張碧容(2010)．核心素養融滲護理能力教學-以鼻套管給氧技術為例．護理雜誌，57(5)，70-76。
醫院評鑑暨醫療品質策進會(2013)．教學醫院教學費用補助—訓練計畫作業說明．取自http://www.tjcha.org. tw/FrontStage/page.aspx?ID=750D48A4-DA9C-4038- BC82-D73187E7A7EC
蘇泰興(2006) ．醫學虛擬實境系統之開發與醫學臨床應用成效之探討（未發表碩士論文）．義守大學，高雄市。 

英文部分
Anderson, J. R. (1982). Acquisition of cognitive skill. Psychological Review, 89(4), 369.
Band, J. D., & Gaynes, R. (2012). Prevention of intravascular catheter-related infections. Retrieved from http://www.uptodate.com
Berardi, R., Rinaldi, S., Santini, D., Vincenzi, B., Giampieri, R., Maccaroni, E., ... & Pierantoni, C. (2015). Increased rates of local complication of central venous catheters in the targeted anticancer therapy era: a 2-year retrospective analysis. Supportive Care in Cancer, 23(5), 1295-1302.
Bird, S. (2007). Risk management: What is it? Australian Family Physician, 36(1-2), 67-68.
Bishop, L., Dougherty, L., Bodenham, A., Mansi, J., Crowe, P., Kibbler, C., & Treleaven, J. (2007). Guidelines on the insertion and management of central venous access devices in adults. International Journal of Laboratory Hematology, 29(4), 261-278.
Brenton, H., Hernandez, J., Bello, F., Strutton, P., Purkayastha, S., Firth, T., & Darzi, A. (2007). Using multimedia and Web3D to enhance anatomy teaching. Computers & Education, 49(1), 32-53.
Bricken, M., & Byrne, C. M. (1993). Summer students in virtual reality: A pilot study on educational applications of virtual reality technology. In A. Wexelblat(Ed.),. Cambridge, MA: Academic Press Professional.
Brown, J. S., Collins, A., & Duguid, P. (1989). Situated cognition and the culture of learning. Educational Researcher, 18(1), 32-42.
Burdea, G. (1993). Virtual Reality System and Application. Paper presented at Eletro’93 International Conference, NJ.
Burdea, G. C., & Coiffet P. (2003). Virtual reality technology. Hoboken, NJ: John Wiley & Sons.
Cameirao, M. S., Bermudez, I. B. S., Duarte Oller, E., & Verschure, P. F. (2009). The rehabilitation gaming system: A review. Studies in Health Technology and Informatics, 145(6), 65-83.
Charnley, E. (1999). Occupational stress in the newly qualified staff nurse. Nursing Standard, 13(29), 33.
Chaiyakunapruk, N., Veenstra, D. L., Lipsky, B. A., & Saint, S. (2002). Chlorhexidine compared with povidone iodine solution for vascular catheter site care: A meta-analysis. Annals of Internal Medicine, 136(11), 792-801.
Chou, C. C., Chang, C. P., Lee, T. T., Chou, H. F., & Mills, M. E. (2013). Technology acceptance and quality of life of the elderly in a telecare program. CIN: Computers, Informatics, Nursing, 31(7), 335-342.
Coulter, R., Saland, L., Caudell, T. P., Goldsmith, T. E., & Alverson, D. C., (2007). The effect of degree of immersion upon learning performance in virtual reality simulations for medical education. Medicine Meets Virtual Reality 15: in vivo, in vitro, in silico: Designing the Next in Medicine, 125, 155-160.
Di Giacomo, M. (2009). Comparison of three peripherally-inserted central catheters: Pilot study. British Journal of Nursing, 18(1), 8.
Dinsmore, M., Langrana, N., Burdea, G., & Ladeji, J. (1997, March). Virtual reality training simulation for palpation of subsurface tumors. In Virtual Reality Annual International Symposium, 1997., IEEE 1997 (pp. 54-60).
Douglas, L., Aspin, A., Jimmeson, N., & Lawrance, V. (2009). Central venous access devices: Review of practice. Paediatric Nursing, 21(5), 19.
Fidalgo, J. P., Fabregat, L. G., Cervantes, A., Margulies, A., Vidall, C., Roila, F., & Group, E. G. W. (2012). Management of chemotherapy extravasation: Esmo–eons clinical practice guidelines. Annals of Oncology, 23 (7), vii167-vii173.
Ekstrand, C., Jamal, A., Nguyen, R., Kudryk, A., Mann, J., & Mendez, I. (2018). Immersive and interactive virtual reality to improve learning and retention of neuroanatomy in medical students: a randomized controlled study. Canadian Medical Association Journal Open, 6(1), E103.
Endacott, R., Scholes, J., Buykx, P., Cooper, S., Kinsman, L., & McConnell‐Henry, T. (2010). Final‐year nursing students’ ability to assess, detect and act on clinical cues of deterioration in a simulated environment. Journal of Advanced Nursing, 66(12), 2722-2731.
Gagne, R. M., & Glaser, R. (1987). Foundations in learning research. Instructional Technology: Foundations, 49-83.
Galloway, M. (2010). Insertion and placement of central catheters in the oncology patient. Seminars in Oncology Nursing, 26(2), 102-112. doi:10.1016/j.soncn.2010.02.004
Gantt, L. T. (2010). Using the Clark simulation evaluation rubric with associate degree and baccalaureate nursing students. Nursing Education Perspectives, 31(2), 101-105.
Gates, D. H., Darter, B. J., Dingwell, J. B., & Wilken, J. M. (2012). Comparison of walking overground and in a computer assisted rehabilitation environment (caren) in individuals with and without transtibial amputation. Journal of Neuroengineering and Rehabilitation, 9(1), 1-9.
Gorski, L. A., Czaplewski, L. M. (2004). Peripherally inserted central catheters and midline catheters for the homecare nurse. Journal of Infusion Nursing, 27(6), 399-409.
Granic, M., Zdravkovic, D., Krstajic, S., Kostic, S., Simic, A., Sarac, M., ... & Kovcin, V. (2014). Totally implantable central venous catheters of the port-a-cath type: complications due to its use in the treatment of cancer patients. The Official Journal of Balkan Union of Oncology, 19(3), 842-846.
Gurkan, S., Seber, S., Gur, O., Yetisyigit, T., Donbaloglu, M. O., & Gur, D. O. (2015). Retrospective evaluation of totally implantable venous access port devices: Early and late complications. The Official Journal of Balkan Union of Oncology, 20(1), 338-345.
Gutierrez, F., Pierce, J., Vergara, V. M., Coulter, R., Saland, L., Caudell, T. P., et al. (2007). The effect of degree of immersion upon learning performance in virtual reality simulations for medical education. Studies in Health Technology and Informatics, 125, 155-160.
Hadaway, L. C. (2003). Infusing without infecting. Nursing, 33 (10), 58-64.
Heinrichs, J., Fritze, Z., Vandermeer, B., Klassen, T., & Curtis, S. (2013). Ultrasonographically guided peripheral intravenous cannulation of children and adults: A systematic review and meta-analysis. Annals of Emergency Medicine, 61(4), 444-454. doi:10.1016/j.annemergmed.2012.11.014
Hockenhull, J. C., Dwan, K. M., Smith, G. W., Gamble, C. L., Boland, A., Walley, T. J., & Dickson, R. C. (2009). The clinical effectiveness of central venous catheters treated with anti-infective agents in preventing catheter-related bloodstream infections: A systematic review. Critical Care Medicine, 37(2), 702-712. doi:10.1097/ CCM.0b013e3181958915
Hsu, L. L., & Hsieh, S. I. (2006). An exploration of scenario discussion in a Web-based nursing course. The Journal of Nursing Research, 14(2), 155-165.
Huizenga, J., Admiraal, W., Akkerman, S., & Dam, G. T. (2009). Mobile game-based learning in secondary education: engagement, motivation and learning in a mobile city game. Journal of Computer Assisted Learning, 25(4), 332-344. doi:10.1111/j.1365-2729.2009.00316.x
Hulse, A. L. (2013). Clinical competency assessment in intravenous therapy and vascular access: Part 2. British Journal of Nursing, 22(17), 1008-1013. doi:10.12968/bjon.2013.22.17.1008
Iannarone, C., Sacco, F., Micozzi, M., Fegiz, A., Fiorelli, S., Vendittelli, V., & Pinto, G. (2012). Side effects and complication of Port-A-Cath. Annali Italiani di Chirurgia. pii:S2239253X12019263
Jeffrey, A.L., & Albert, B.J. (1991). Venous access preoperative, Operative, and PostoperativeDilemmas. Surgical Clinical of North American, 71(6), 1231-1246.
Jordan, K., Behlendorf, T., Surov, A., Kegel, T., Maher, G., & Wolf, H. H. (2008). Venous access ports: Frequency and management of complications in oncology patients. Onkologie, 31(7), 404-410. doi:10.1159/000140451
Jung, E. Y., Park, D. K., Lee, Y. H., Jo, H. S., Lim, Y. S., & Park, R. W. (2012), Evaluation of practical exercises using an intravenous simulator incorporating virtual reality and haptics device technologies. Nurse Education Today, 32(4)，458-463。
Kneebone, R. L., Scott, W., Darzi, A., & Horrocks, M. (2004). Simulation and clinical practice: strengthening the relationship. Medical Education, 38(10), 1095-1102.
Kuter, D. J. (2004). Thrombotic complications of central venous catheters in cancer patients. The Oncologist, 9(2), 207-216.
Krupa, A. (2009). The competitive nature of declarative and nondeclarative memory systems: Converging evidence from animal and human brain studies. The UCLA Undergraduate Science Journal, 22, 39-46.
Kuo, M. C., & Chang, P. (2014). A total design and implementation of an intelligent mobile chemotherapy medication administration. Studies in Health Technology and Informatics, 201, 441-446. doi: 10.1007/978-3-642-00909-9_47 o & Chang.
Lave, J., & Wenger, E. (1991). Situated learning: Legitimate Peripheral Participation (Vol. 521423740). Cambridge: Cambridge university press.
Lee, P.-H., Liu, C.-L., Jeng, K.-S., & Yang, T.-L. (2003). Complications of totally implantable central venous access port. Formosan Journal of Surgery, 36(1), 18-24.
Lin, M.-C., Chang, T.-K., Fu, Y.-C., & Jan, S.-L. (2013). A magic port-a-cath. Journal of the American College of Cardiology: Cardiovascular Interventions, 6(3), e17-e18.
Liu, Y. T., Alsaawi, A., & Bjornsson, H. M. (2014). Ultrasound-guided peripheral venous access: A systematic review of randomized-controlled trials. European Journal of Emergency Medicine, 21(1), 18-23. doi:10.1097/MEJ.0b013e328363bebc.
Martin, F., & Ertzberger, J. (2013). Here and now mobile learning: An experimental study on the use of mobile technology. Computers & Education, 68, 76-85.
Maytin, M., Daily, T. P., & Carillo, R. G. (2015). Virtual reality lead extraction as a method for training new physicians: a pilot study. Pacing and Clinical Electrophysiology, 38(3), 319-325.
Miller, G. E. (1990). The assessment of clinical skills/ competence/performance. Academic Medicine, 65 (9 Suppl), S63-67.
Mitten, T. (2001). Subcutaneous drug infusions: a review of problems and solution. International Journal of Palliative Nursing, 7(2), 75-85.
Monahan, T., McArdle, G., & Bertolotto, M. (2008). Virtual reality for collaborative e-learning. Computers & Education, 50(4), 1339-1353.
Monteiro, M. (2013). Port-A-Cath central venous access device. Retrieved from http://goo.gl/jQmKu4
Nakazawa, N. (2010). Infectious and thrombotic complications of central venous catheters. Seminars in Oncology Nursing, 26(2), 121-31. doi:10.1016/j.soncn.2010.02.007.
Newell, A., & Simon, H. A. (1972). Human Problem Solving (Vol. 104, No. 9). Englewood Cliffs, NJ: Prentice-Hall.
Niederhuber, J., Ensminger, W., Gyves, J., Liepman, M., Doan, K., & Cozzi, E. (1982). Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery, 92(4), 706-712.
Norton, R. (1991). Scid Systematic Curriculum and Instructional Development之Workshop Manual. Center on Education and Training for Employment, Columbus: The Ohio State University.
Orto, V., & Greene, L. (2006). Beyond the ICU: Nursing’s rolein decreasing central venous CR-BSIs [Electronic version]. Nursing Management, 37(12), 28-30.
O’Grady, N. P., Alexander, M., Dellinger, E. P., Gerberding, J. L., Heard, S. O., Maki, D. G., et al. (2002). Guidelines forthe prevention of intravascular catheter-related infections. Morbidity and Mortality Weekly Report, 51(10), 1-29.
O'Grady, N. P., Alexander, M., Burns, L. A., Dellinger, E. P., Garland, J., Heard, S. O…Pearson, M. L. (2011). Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases, 52(9), e162-e193.
Paschold, M., Huber, T., Maedge, S., Zeissig, S. R., Lang, H., & Kneist, W. (2017). Laparoscopic assistance by operating room nurses: Results of a virtual-reality study. Nurse Education Today, 51, 68-72.
Perry, M. C. (2008). The chemotherapy source book：Lippincott Williams & Wilkins.
Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice. China: Lippincott Williams & Wilkins.
Prevention and Control of Healthcare Associated Infection (2012). Queensland Health : Insertion and Management of Percutaneous Central Venous Catheters (CVC) Guideline. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.348.6783&rep=rep1&type=pdf
Raaf, J., & Phil, D. (1991). Vascular access, catheter technology, and infusion pump. Comprehensive Textbook of Oncology. Willams & Wilkin, Baltimore, 247-275.
Reinhard Friedl, M. (2002)．Virtual Reality and 3d Visualizations in Heart Surgery Education. 論文發表於Forum Multimedia Publishing, LLC主辦之The Heart Surgery Forum.
Reznek, M. A., Rawn, C. L., & Krummel, T. M. (2002). Evaluation of the educational effectiveness of a virtual reality intravenous insertion simulator. Academic Emergency Medicine, 9 (11), 1319-132.
Schulmeister, L., & Camp-Sorrell, D. (2000). Chemotherapy extravasation from implanted ports. Oncology Nursing Forum, 27 (3), 531-538.
Schummer, W., Schummer, C., Bayer, O., Müller, A., Bredle, D., & Karzai, W. (2005). Extravasation injury in the perioperative setting. Anesthesia and Analgesia, 100(3), 722-727.
Seymour, N. E., Gallagher, A. G., Roman, S. A., O’Brien, M. K., Bansal, V. K., Andersen, D. K., & Satava, R. M. (2002). Virtual reality training improves operating room performance: Results of a randomized, double-blinded study. Annals of Surgery, 236(4), 458-464.
Shih, Y. S., Lee, T. T., Liu, C. Y., & Mills, M. E. (2013). Evaluation of an online orientation program for new healthcare employees. Computers, Informatics, Nursing, 31(7), 343-350.
Shumway-Cook, A., & Woollacott, M. H.(2001), Motor Control: Theory and Practical Applications, Lippincott Williams & Wilkins.
Skinner, E. A. (1996). A guide to constructs of control. Journal of Personality and Social Psychology, 71(3), 549.
Smith, S. J., Farra, S., Ulrich, D. L., Hodgson, E., Nicely, S., & Matcham, W. (2016). Learning and retention using virtual reality in a decontamination simulation. Nursing Education Perspectives, 37(4), 210-214
Stonelake, P., & Bodenham, A. (2006). The carina as a radiological landmark for central venous catheter tip position. British Journal of Anaesthesia, 96(3), 335-340.
Temkin, B., Acosta, E., Hatfield, P., Onal, E., & Tong, A. (2002). Web-based threedimensional virtual body structures: W3DVBS. Journal of the American Medical Informatics Association, 9(5), 425-436.
Tofani, B. F., Rineair, S. A., Gosdin, C. H., Pilcher, P. M., McGee, S., Varadarajan, K. R., & Schoettker, P. J. (2012). Quality improvement project to reduce infiltration and extravasation events in a pediatric hospital. Journal of Pediatric Nursing, 27(6), 682-689. doi:10.1016/j.pedn.2012.01.005
Tsai, S. L., Chai, S. K., Hsieh, L. F., Lin, S., Taur, F. M., Sung, W. H., & Doong, J. L. (2008). The use of virtual reality computer simulation in learning Port-A cath injection. Advances in Health Sciences Education, 13(1), 71-87.
Vince, J. (1995). Virtual Reality Systems. Essex, UK: Addison Wesley Longman.
Voida, S., Podlaseck, M., Kjeldsen, R., & Pinhanez, C. (2005). A study on the manipulation of 2D objects in a projector/camera-based augmented reality environment. In Proceedings of the SIGCHI conference on Human factors in computing systems, Portland, Oregon.
Whitney, S. L., Sparto, P. J., Hodges, L. F., Babu, S. V., Furman, J. M., & Redfern, M. S. (2006). Responses to a virtual reality grocery store in persons with and without vestibular dysfunction. Cyberpsychology & Behavior, 9(2), 152-156
Wickham, R. (1990). Advances in venous access devices and nursing management strategies. The Nursing Clinics of North America, 25(2), 345-364.
Winn, W. (1993). A conceptual basis for educational applications of virtual reality. Technical Publication R-93-9, Human Interface Technology Laboratory of the Washington Technology Center, Seattle: University of Washington.
Wragg, A., Wade, W., Fuller, G., Cowan, G., & Mills, P. (2003). Assessing the performance of specialist registrars. Clinical Medicine, 3(2), 131-134.
Zeltzer, D. (1992). Autonomy, interaction and presence. Presence, 1, 127-132.