交接班護理執業能力教學方案於內外科混合型病房護理臨床教學之行動研究
An Action Research of Shift to Shift Working Ability Project Among Bachelor Student Nurses During Their practicum in A Mixed-Typed Med/Surgical Ward

護理交接班能力為臨床護理人員必備的執業能力，卻未正式納入護理人員養成教育的實習目標中 。研究者為臨床實習指導教師之角色，為提升護生護理交接班執業能力，以溝通理論為基礎、採取身歷其境學習觀點及鷹架教學策略，運用行動研究方法螺旋模式，於臨床內外科混合型病房發展護理交接班執業能力教學方案。本研究參與者包括23位學士護士、19位護理人員、一位臨床實習指導教師級一位護理教育博士。資料來源包括教師的省思日誌及觀察紀錄、護生實習心得、檢討會會議記錄、訪談護生與護理人員的紀錄。研究發現：(1)以有效溝通理論和情境理論為基礎的護理交接班執業能力教學方案之發展，需奠基於護生、護理人員、臨床實習指導教師相互配合的理念；(2)護生護理交接班執業能力的行為展現深受其具備的先備知能之影響；(3)教師在為每位護生搭建獨特的鷹架時，需能重視護生之個別性和允許彈性的學習進度，(4)為護生選擇護理交接班執業能力的學習機會時，情境─執業能力模式有助教師對護理交接班相關情境和學習資源得觀察；(5)發展護生交接班執業能力得先後次序應先建構其接班能力，後交班能力；(6)影響本實習教學方案的實施班別之影響。本研究發現可提供未來研究者進一步研發內外科病房護理交接班執業能力訓練模組課程和教學設計之參考。

關鍵字 ：護理交接班、實習教學方案、行動研究

This study is focuses on the three circulation spiral  pattern action research process to improve nursing student practicumin in a mixed-type med/surgical ward. Eight nursing students in each and attempted to solve problems through actions on the one hand and reflected how to improve the "nursing shift report teaching program ",in hopes of developing the shift reporting ability of nursing students. The research results pointed out that teachers could prepare some professional terms that were frequently used for students the procedure and notices of shift report so that students could get used  rapidly Furthermore, teachers arranged for clinical nurses from practice departments to help nursing students to successfully complete shift reports, providing students with a sense of achievement and learning motivation and  demonstrating the positive effects of shift reports. Clinical teachers should listen to students, lead them rather than forcing them, and encourage them to reach certain standards rather then punishing them for failing to do so. Such an approach can improve the scope and strategy of the "nursing shift report program", thus improving its effectiveness.

Key  word: shift report, practice teaching program, action research