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研究生:林慧珍
研究生(外文):Hui-Chen Lin
論文名稱:結合雙向同儕互評的翻轉學習模式對護理 人員健康評估學習成就、自我效能、反思 與批判思維之影響
論文名稱(外文):Effects of bi-directional peer assessment-based flipped learning approach on nursing staffs’ learning performance and higher order thinking tendency in a health assessment course
指導教授:黃國禎黃國禎引用關係
指導教授(外文):Gwo-Jen Hwang
口試委員:劉子鍵王淑玲楊接期楊凱翔孫之元
口試委員(外文):Tzu-Chien LiuShu-Ling WangJie-Chi YangKai-Hsiang YangChih-Yuan Sun
口試日期:2020-01-15
學位類別:博士
校院名稱:國立臺灣科技大學
系所名稱:應用科技研究所
學門:自然科學學門
學類:其他自然科學學類
論文種類:學術論文
論文出版年:2020
畢業學年度:108
語文別:中文
論文頁數:115
中文關鍵詞:翻轉學習同儕互評專科護理師內容分析
外文關鍵詞:flip learningpeer assessmentnurse practitionercontent analysis
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健康評估課程是專科護理師臨床訓練的重要課題之一,因應醫療環境改變,專科護理師擔任醫院第一線評估與照護病人的工作。護理師必須接受訓練使其具備健康評估能力以提升病人照護品質,然而,護理學員表示在健康評估課程需要有更多指導,練習不足與學習不夠深入等因素,導致學習成效不佳,護理師在接受健康評估技能測驗時倍感壓力。
同儕互評是讓一群能力與知識背景相似的學習者,對彼此的作業給予評分與評論,學習者同時扮演評估者及被評估者的角色,可以藉由觀模與學習來促進認知成長。然而,在傳統同儕互評的模式中,評估者及被評者的互動關係是單向的,亦即評估者無法獲得來自被評者的回饋,因而沒有對評估內容進行反思的機會。雙向同儕互評模式目的是在於讓被評者有機會表達意見,讓評估者瞭解所提供的評分與評論是否正確或是對於被評者有所幫助;在雙向互動的過程,評估者及被評者都有機會進行反思,因而促進評分及評論的品質,並提昇學習成效及批判思維表現。
本研究開發了一個線上雙向同儕互評系統,應用在專科護理師護理健康評估翻轉教學課程中,透過同儕的力量來協助護理師學員達成學習目標。同時,設計實驗來瞭解不同模式線上同儕互評對於護理師學員在學習成就與高層次思維的影響,並記錄學員同儕評論內容,分析其對於同儕評論品質的影響。為了瞭解不同線上同儕互評模式對護理師學員的助益,本研究以健康評估課程進行設計實驗,參與對象為參加研習課程的74名護理師;其中一個梯次為實驗組、另一個梯次為控制組。實驗組使用雙向線上同儕互評模式,控制組使用傳統線上同儕互評模式。實驗的結果顯示,運用翻轉學習導入雙向線上同儕互評模式除了可以增強專科護理師知識、臨床技能之外,此方法還顯著提高了專科護理師學員反思。此外,由評論內容分析的結果發現,使用雙向線上同儕互評模式的學生,比使用一般同儕互評模式的學生明顯地提出更多可協助同儕改善健康評估表現的具體建議。
The health assessment course is one of the important topics of clinical training for nurse practitioners. In response to changes in the medical environment, nurse practitioners serve as the first-line assessment and care of patients in hospitals. Nursing staff must be trained to have a health assessment ability to improve the quality of patient care. However, nursing trainees said that more guidance is needed in health assessment courses, insufficient practice and in-depth learning and other factors have led to poor learning outcomes. Feeling stressed while taking the Health Assessment Skills Test.
Peer assessment is a group of learners with similar abilities and knowledge backgrounds to give each other's work scoring and comments. Students can play the role of assessor and assessee at the same time. They can promote cognitive growth through observation and learning. Through good peer review quality, students can observe and think carefully to come up with their own ideas and come up with solutions, which can promote learning effectiveness, critical thinking and reflection. However, in the conventional peer-assessment approach, the interactive relationship between the assessers and assessees is one-directional, that is, the assessers cannot get feedback from the assessees, so they have no opportunity to reflect on the assessment content their provided. The purpose of the bi-directional peer-assessment approach is to give the assessees the opportunity to express their opinions and let the assessers know whether the ratings and comments they provided are correct or helpful to the assessees. In the process of bi-directional interactions, both the assessers and the assessees have the opportunities to reflect, thereby promoting the quality of peer-rating and commenting, and enhancing their learning achievements and critical thinking performance.
In this study, an online bi-directional peer-assessment system is developed. The system has been applied to a flipped classroom of nursing health assessment for nurse practitioners to facilitate peer feedback to achieve their learning goals. An experiment was designed to understand the impact of different peer-assessment modes on nurse practitioners' learning achievements and high-level thinking. Moreover, the comments provided by the students were analyzed to investigate the impacts of different peer-assessment modes on the quality of the students’ comments. The participants were two classes of 74 nurses who participated in a training program. One class was the experimental group, and the other is the control group. The experimental group used a two-way online peer-assessment approach, and the control group used the conventional online peer-assessment mode. The experimental results show that the the two-way online peer- assessment approach not only enhanced the learners’ achievements and clinical skills, but also significantly improved their reflective thinking. In addition, via analyzing the content of the comments provided by the students, it is found that the students learning with the two-way online peer-assessment provided more constructive comments to help peers improve their health assessment performances than those learning with the conventional approach.
摘要………………………………………………………………………......... I
ABSTRACT………………………………………………………………......... II
誌謝………………………………………………………………………......... IV
目錄………………………………………………………………………......... V
圖目錄……………………………………………………………………......... VII
表目錄…………………………………………………………………............. VIII
第一章 緒論…………………………………………………………….......…. - 1 -
1.1. 研究背景……………………………………………………….......…..…. - 1 -
1.2. 研究動機……………………………………………………….......…..….- 2 -
1.3. 研究目的與問題……………………………………………….......….. - 4 -
1.4. 名詞釋義……………………………………………………….......….…..- 5 -
第二章 文獻探討……………………………………………………….......….- 7 -
2.1. 護理健康評估………………………………………………….......…..…- 7 -
2.2. 翻轉學習……………………………………………………….......……...- 9 -
2.3. 同儕互評在護理教育的應用………………………………….....…..- 12 -
第三章 雙向同儕互評護理健康評估翻轉教學環境………………....- 17 -
3.1. 系統架構…………………………………………………….......…….…..- 17 -
3.2. 系統功能……………………………………………….......…………..….- 18 -
3.3. 翻轉學習說明與系統介紹………………………….......……………..- 20 -
3.4. 雙向同儕互評系統操作介面與功能介紹………….......…………- 23 -
第四章 實驗設計………………………………………….......………………..- 27 -
4.1. 研究架構………………………………………….......……………….. - 27 -
4.2. 實驗對象…………………………………………….......…………….. - 29 -
4.3. 教學課程…………………………………………….......…………….. - 29 -
4.4. 實驗流程…………………………………………….......…………….. - 30 -
4.5. 研究工具……………………………………………….......………….. - 32 -
4.6. 分析方法……………………………………………….......………….. - 37 -
第五章 研究結果與分析…………………………………….......……………- 39 -
5.1. 學習成就-知識測驗成績…………………………….......…………..- 39 -
5.2. 健康評估技能…………………………………….......……………….. - 42 -
5.3. 批判思維傾向……………………………………….......…………….. - 46-
5.4. 反思……………………………………………….......……………….. - 48 -
5.5. 自我效能…………………………………………….......…………….. - 51 -
5.6. 同儕評分與教師評分相關分析………...……….......……………- 53 -
5.7. 同儕評論內容品質分析……………………………….......…………..- 54 -
5.8. 訪談結果…………………………………………….......…………….. - 57 -
第六章 結論與建議…………………………………………….......…………- 61 -
6.1. 結論…………………………………………………….......…………..…. - 61 -
6.2. 學習知識與技能成效………………………………….......…………- 61 -
6.3. 高層次思維能力……………………………………….......………….. - 62 -
6.4. 同儕評論品質………………………………………….......………….. - 62 -
6.5. 限制與建議……………………………………………….......……….. - 62 -
參考文獻………………………………………………………….......……….. - 65 -
附錄……………………………………………………………….......……….. - 80 -
附錄1學習成就前測驗..……………………….…………….......……….. - 80 -
附錄2學習成就後測驗………………………….......……………………. - 82-
附錄3 OSCE前測教案...…….……………………………….......……….. - 85 -
附錄4 OSCE後測教案.………………………….......……………………. - 94 -
附錄5批判思維傾向問卷….......…………………………….......………..- 104 -
附錄6反思問卷………………………………….......……………………. - 105 -
附錄7自我效能問卷...……………………………………….......……….. - 106 -
附錄8學員訪談內容...……………………………………….......……….. - 107 -
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