情境模擬教學介入對急診工作人員因應暴力事件之學習成效
| 論文名稱(中/英文) | 研究生 | 指導教授 |
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情境模擬教學介入對急診工作人員因應暴力事件之學習成效 responding the emergency room violence |
陳皓羽 | 李皎正教授 |
| [ 摘要 ] | ||
| 急診室為醫療職場暴力事件發生頻率最高的場所，暴力事件會影響急診工作人員的留任率，文獻指出急診工作人員缺乏因應暴力事件的能力，因此本研究採單組前後測之類實驗設計，以台北市某區域教學醫院急診室工作人員為研究對象，包含醫師、護理師、警衛、社工四個職類，共34人，依循Kolb ( 1984 )經驗學習理論為課程設計架構，以標準化病人模擬急診暴力事件作為臨床案例，實施體驗、觀察與反省、抽象概念化、主動實驗等教學歷程之介入及學習成效評量。評量工具為「急診室工作人員因應暴力事件自我效能量表」及「急診室工作人員因應暴力事件應變能力評核表(checklist)」，在教學介入前、後及介入後兩週，進行因應暴力事件自我效能及應變能力之評量。以SPSS 22.0版進行資料分析，包含描述性統計（平均數、標準差、百分比、最大值、最小值）及皮爾森積差相關、運用廣義估計方程式（Generalized estimating equation, GEE）等推論統計。研究結果顯示研究對象之教育程度與自我效能的後測與延宕測達顯著正相關(r=.474, r=.437, p< .001)，處理暴力事件次數與自我效能的前測及應變能力的前測達顯著正相關(r=.343, r=.379, p< .001)，訓練時數與自我效能的前測達顯著正相關(r=.357, p< .001)；在因應暴力事件之自我效能(Wald χ2 = 85.202, p< .001)及應變能力(Wald χ2 = 443.372, p< .001)之後測及延宕測分數皆大於前測；四個職類急診工作人員間於因應暴力事件之自我效能(Wald χ2 = 1.986, p> .575)及應變能力(Wald χ2 = 3.547, p.> .315)均無差異。本研究結果顯示情境模擬教學介入有助於急診工作人員提升因應暴力事件之自我效能及應變能力，此教學方案可提供醫院規劃急診工作人員因應暴力事件課程之參考。 | ||
| [ Abstract ] | ||
| Workplace violence is a critical issue for emergency department in hospital because emergency department has the highest frequency of workplace violence that affects reappointment of emergency staff in medical workplace. Unfortunately, emergency workers lack the ability to respond to the violence. Previous findings showed that simulation instruction can enhance emergency staff to face violence event. This research designed as one-shot study with pretest, posttest, and delays test in north Taiwan. The curriculum framework of simulation for clinical violence was developed with Kolb (1984) experiential learning theory. Visiting staff, resident, intern, nurse, guard, and senior social worker working in emergency department and above 3 months who voluntarily participates in this study are the objects of this research. The instruments are “Scale of Self-Efficacy on dealing with violence event”, and “Evaluating form of performance on dealing with violence event”. The data in this study was analyzed by SPSS 22 for windows including descriptive statistics (M, SD, percentage, maximum, and minimum) and inferential statistics (Pearson and Generalized estimating equation). The result showed correlation between demography variables (gender, age, work experience, and education) and independent variables (self-efficacy and adaptability). The findings are followed: 1. education significantly correlated to post-test and delay test of self-efficacy(r=.474, r=.437, p< .001); 2. frequency encountered violence significantly correlated to pre-test of self-efficacy and adaptability(r=.343, r=.379, p< .001); 3. training hours significantly correlated to pre-test of self-efficacy(r=.357, p< .001); 4. post-test and delay-test of both self-efficacy (Wald χ2 = 85.202，p.< .001) and adaptability (Wald χ2 = 443.372，p.< .001) were significantly higher than pre-test; 5. However, no difference among occupations was found. The further study may extend to multi-hospital for increasing sample size and for longitudinal study. | ||