情境模擬溝通教學對提升護理人員學習成效之研究

論文名稱(中/英文)	研究生	指導教授
情境模擬溝通教學對提升護理人員學習成效之研究 A Study of learning effectiveness of scenario-based communication teaching among nursing staffs.	黃玉純	許麗齡博士
[ 摘要 ]
本研究旨在探討情境模擬溝通教學課程介入後，新進護理人員之溝通自信心、溝通能力與課程學習滿意度之成效探討。研究方法採類實驗不等組前後測設計；研究對象為北部某A、B、C三家教學醫院護理人員，共118人；實驗組53人接受情境模擬溝通教學課程，控制組65人採傳統課室教學介入；在教學課程介入前後，兩組皆接受前後測。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以次數分配、百分比、平均數與標準差進行研究對象個人背景資料、是否接受過溝通相關課程及分布情形等。以Mann-Whitney U test、Pearson 2 test、Fisher’s Exact test、Sing Test、McNemar Test、Regression等統計方法，呈現推論統計分析。研究結果顯示：(一) 控制組與實驗組各自接受不同方式的教學活動，兩組前後測在通自信心自評表、溝通能力查檢表及標準化病人評核溝通能力的得分皆達顯著差異，且前測優於後測；顯示課程的介入，有助於溝通自信心與溝通能力的增加。(二) 在控制各依變項之前測平均分數、在該醫院總年資、所有醫院之總年資、及以往在學校是否曾參加溝通課程的混淆變項下，比較兩組間依變項，僅發現評審員評價實驗組新進護理人員之溝通能力量表(JECAS)平均分數(7.08, SD = 1.91)，統計上顯著不同於(F(1, 109) = 22.53, p <0.0001) 控制組之平均分數(5.81, SD = 1.80)，且此模式可解釋48.7%評審員評價新進護理人員之溝通能力變異量。本研究結果建議：可規劃護理人員之職前及在職教育訓練，運用各種臨床溝通情境，透過參與情境中的活動，學習者才能真正掌握知識，以提升護理人員的溝通能力。此外，建議未來可依各種護病溝通情境，拍攝溝通教學影片，以符合護理人員不同層級及工作屬性。亦可深入探討課程介入後，長期追蹤一個月、三個月或六個月之學習成效，以暸解護理人員學習之延宕記憶及影響程度。
[ Abstract ]
This thesis aimed to explore the effect of an intervention in the form of a scenario-based communication course on a group of nurse staffs communication confidence, communication ability, and satisfaction with the course. Using nonequivalent quasi-experimental pretest-posttest design, this study selected 118 new nurses working at teaching hospitals A, B, and C in northern Taiwan as the sample population. 53 out of the 118 new nurses were assigned to receive the scenario-based communication course, whereas the remaining 65 new nurse were chosen as the control group receive a different kind of intervention, namely the traditional-style classroom lecture. I conducted pretest and posttest to both groups before and after the intervention. Data analysis was conducted using SPSS 17.0 statistics software and focused on descriptive statistics, the sample’s personal background by frequency distribution, percentage, mean values, and standard deviation, and the ratio and distribution of novice nurses in the sample who had taken communication-related courses prior to this research. Inferential statistics analysis was performed using Mann-Whitney U test, Pearson 2 test, Fisher’s Exact test, Sing Test, McNemar Test, and regression. The results showed that: (1) Both groups before and after the intervention were significant different in the findings of Self-Confidence Communication Scale (SCCS), Self-evaluation Communication Ability Scale (SECAS) and Judge-Evaluation Communication Ability Scale (JECAS) of the pre post-tests; showing that intervention programs could increase nurses’ communication confidence and communication ability. (2) Using ANCOVA statistics comparing post-test scores of SECAS, JECAS, SCCS, and TSS (Teaching Satisfaction Scale) between groups. Significant differences (p <0.0001, F (1, 109) = 22.53, adjusted R2 =0.487) of in JECAS (Judge-Evaluation Scale). Principal recommendations drawn from the study findings are as follows: Clinical scenario-based communication training can be introduced to pre and in-service education to have experienced a real sense of communication to improve their communication ability through hands-on practice. In addition, videos showing a good variety of communication scenarios between nurses and patients might be to the benefit of the many different types and levels of nurses. Follow-up studies on the intervention’s effect on communication performance of the new nurses in 1, 3 and 6 months period would provide an insight into the delayed memory of the novice nurses and the intervention’s influence on them