臨床輔導員自覺教學困難的探究

論文名稱(中/英文)	研究生	指導教授
臨床輔導員自覺教學困難的探究 An Investigation Difficulties of Clinical Preceptors	江怡慧	鍾聿琳博士
[ 摘要 ]
本研究目的是探討臨床輔導員自覺的教學困難，並探討不同背景變項會影響臨床輔導員的教學困難的情形，本研究為量性研究，以問卷調查為方法，以台北縣市二家區域教學醫院及三家醫學中心，近半年內臨床工作期間擔任一位以上專科層級護生實習之臨床輔導員的護理人員為研究對象進行方便取樣，根據自擬臨床輔導員自覺教學困難問卷為研究工具，發出樣本為130份，實際回收樣本為123份，有效問卷回收率為93.08%。問卷編製過程經專家內容效度、問卷預試、項目分析，信度分析考驗，正式施測問卷Cronbach’s α值為0.898，並以因素分析，t檢定、F檢定及Pearson’s積差、描述性統計及單因子變異數分析進行考驗，以Bonferroni 法或Tukey進行事後檢定。研究結果發現，臨床輔導員自覺的教學困難共有十八個項目，可分為「教學知能不足」、「工作過重造成與教學的衝突」、「無法提升專業知能以配合教學」、「缺乏個別化的教學策略」及「護生學習態度不佳」五個範疇，可解釋臨床輔導員對自覺教學困難各題項間的反應總變異量為64.717%。整體來說，「年齡」、「學歷」、「護理工作總年資」、「進階層級」、「科別」及「是否為自願性角色」六個背景變項會影響臨床輔導員自覺教學困難之認同度，「輔導員工作年資」及「是否上過教育訓練課程」不影響臨床輔導員自覺教學困難的認同程度。本研究建議，應對現行的臨床輔導員教學課程做通盤的檢視，將「不知如何評估護生的基本能力」、「無法引發護生學習的動機」、「不知如何設計教學活動」、「不知如何評量學生」及「不喜歡教學」五項教學能力作為臨床教育之參考，除此之外，建議臨床輔導員進行臨床教學之前需進行教學訓練，主動提供臨床輔導員臨床教學相關技能；本研究結果亦發現，年齡較高、進階層級較高、護理工作總年資較低及自願擔任臨床輔導員的護理人員的自覺教學困難較低，故建議未來在遴選臨床輔導員過程中可以列入以上的條件，可減少臨床輔導員自覺的教學困難。
[ Abstract ]
The purpose of this study is to explore the subjective difficulty of clinical preceptors in student teaching and the variants of different backgrounds that might influence the subjective difficulty of clinical preceptor in student teaching. This study is a quantification study carried out by questionnaires. Research subjects of this study are care workers in two regional teaching hospitals and three medical centers in Taipei who acted as clinical preceptor responsible for at least one student nurse (from nursing college) within recent six months. The effective response rate of questionnaire was 93.08% (out of 130 questionnaires in total). The questionnaires were tested by content validity, questionnaire pretest, item analysis, and reliability analysis. The Cronbach’s α of formal questionnaires was 0.898. The results were analyzed by factor analysis, t test, F test, Pearson’s correction, descriptive statistics, and one-way ANOVA. Then, a posterior comparison was proceeded by Bonferroni method or honestly significant difference. The result revealed that there were 18 factors which were expected as a difficulty in teaching by clinical preceptor. These 18 factors could be categorized into 5 aspects, including insufficient teaching ability, conflict between overloading clinical activity and teaching activity, the lack of special knowledge for teaching, absence of individualized teaching strategy, and poor learning attitude of student nurses. The total variance explained was 64.717% in this study. Overall, there were six variants that influence the self-identity the subjective difficulty in teaching of preceptor, including age, antecedent, total years of care worker, seniority, different specialist, and volunteer for preceptor. But two variants, which were total years of preceptor and teaching training protocol, would not influence the self-identity of subjective difficulty in teaching of preceptor. This study suggested an overall survey for current teaching protocol of preceptor. Evaluation of basic ability of student nurse, motivation of learning of student nurse, design of teaching activity, evaluation of student nurse, and interest of teaching should be used as references to the teaching ability of a preceptor. Besides, this study suggests special training for teaching ability for preceptors before clinical teaching. This study also revealed that care workers with older age, higher seniority, or fewer total years of experiences, and volunteers for preceptor had lower subjective difficulty in teaching. The information may imply that the above factors should be considered as selection criteria for preceptor in the future to avoid subjective difficulty in teaching.