心臟血管身體評估情境模擬教材於行動學習APP系統之研究

論文名稱(中/英文)	研究生	指導教授
心臟血管身體評估情境模擬教材於行動學習APP系統之研究 A Study of Cardiovascular Physical Assessment through Simulation Material Using a Mobile App System	曾怡樺	許麗齡博士
[ 摘要 ]
本研究旨在探討心臟血管身體評估情境模擬案例行動學習APP系統介入後，護理學生在心臟血管系身體評估認知測驗、使用行動載具態度、認知負荷、情境案例學習、行動學習自我效能與課程學習滿意度之學習成效探討。本研究採類實驗性研究(quasi-experimental study)非對等控制組兩組前後測設計；研究對象採立意取樣，以中部某科技大學護理系二技一年級學生共207人，實驗組104人接受心臟血管身體評估情境模擬案例行動學習APP系統輔助教學課程，控制組103人接受傳統課室教學；課程介入前後，兩組皆接受身體評估知識測驗前後測，另外安排實驗組使用行動載具態度、情境案例學習及行動學習自我效能前後測，於課程結束兩組皆接受認知負荷及課程學習滿意度後測。資料分析應用SPSS 22.0進行描述性統計分析及t test、Wilcoxon Signed Ranks test、Mann-Whitney U test、Pearson χ2推論性統計分析。研究結果顯示：(一)心臟血管身體評估情境模擬案例行動學習APP系統輔助教學介入後，組內差異呈現控制組知識測驗得分後測優於前測，實驗組知識測驗得分後測低於前測，兩組後測組間差異顯示控制組優於實驗組且達顯著差異。(二)心臟血管身體評估情境模擬行動學習APP系統輔助教學介入後，實驗組認知負荷高於控制組，但未達顯著差異。(三)心臟血管身體評估情境模擬案例行動學習APP系統輔助教學介入後，控制組課程學習滿意度優於實驗組並達顯著差異。(四)心臟血管身體評估情境模擬案例行動學習APP系統輔助教學介入後，實驗組使用行動載具態度後測優於前測，但未達顯著差異。(五)心臟血管身體評估情境模擬案例行動學習APP系統輔助教學介入後，實驗組於情境案例學習後測優於前測，但未達顯著差異。(六)心臟血管身體評估情境模擬案例行動學習APP系統輔助教學介入後，實驗組行動學習自我效能後測低於前測，但未達顯著差異。(七)心臟血管身體評估情境模擬案例行動學習APP系統質性分析與整體的感受，包括：APP情境模擬案例學習、APP小組概念圖增進思考、體驗APP是一種新的學習方式、課程內容須與APP案例有關及APP系統增加圖像、心音與提問功能。本研究結果建議：持續推動情境模擬案例行動學習於護理教育、增強行政支援對科技融入教學的支持，未來可推廣至不同專業導入臨床在職校育、亦可擴大不同領域課程與不同年級之研究對象，以深入探討行動學習之成效。
[ Abstract ]
This study aimed to explore learning performances of BSN students in terms of cardiovascular assessment knowledge, cognitive load, satisfaction with the intervention, attitude towards using mobile devices, scenario-based learning, and self-efficacy in mobile-learning, following an educational intervention in the form of a scenario-based abdominal assessment mobile-learning APP. This quasi-experimental study adopted non-equivalent control group pre-test and post-test design. A purposive sample of 207 senior nursing students enrolled in a vocational university in central Taiwan was recruited. The experimental group, which consisted of 104 students, received APP-based cardiovascular assessment education. The control group, which consisted of 103 students, received lecture-based cardiovascular assessment education. Both groups were pretested and post-tested on their knowledge of cardiovascular assessment before and after the intervention. In addition, the experimental group was pre-tested and post-tested on attitude towards using mobile devices, scenario-based learning, and self-efficacy in mobile. Both groups were post-tested on cognitive load and satisfaction with the intervention after the intervention. Data were analyzed with SPSS 22.0 for Windows to obtain descriptive statistics, and inferential statistical methods including t test, Wilcoxon Signed Ranks test, Mann-Whitney U test, and Pearson χ2 were adopted. The results were as follows: (1) The control group scored higher in post-test as compared to pre-test in the cardiovascular assessment knowledge test following the intervention. There were significant between-group differences in post-test scores, with the control group scoring significantly higher than the experimental group. (2) No significant differences were found between cognitive load scores of both groups following the intervention.(3) The control group demonstrated significantly higher satisfaction with the intervention than the experimental group. (4) No significant differences were found between the experimental group’s attitudes towards the use of mobile devices at pre-test and post-test. (5) No significant differences were found between the experimental group’s scenario-based learning scores at pre-test and post-test.(6) No significant differences were found between the experimental group’s self-efficacy in mobile-learning scores at pre-test and post-test.(7) Qualitative analysis revealed factors affecting the experimental group’s overall feelings towards the cardiovascular assessment mobile-learning APP, which included the following: APP simulation learning, APP group concept map may accelerate thinking, experience new learning method of APP, the course content should be related to APP case, APP program suggested to add case graphic, cardio phony and question asking function. Based on the study’s findings, the following suggestions were recommended: situation simulation of mobile-learning should be promoted in nursing education. Enhance administrative support to technology-based teaching, which could be promote to different professional clinical vocational education in the future, furthermore, expanding different field course and objective of study in each grade to explore the effect of mobile-learning APP.