背景：最後一哩就業課程設計旨在連結理論與臨床實務之橋樑，幫助護生適應護理臨床工作，各校均安排學生修習最後一哩的課程。然而，學生進入職場後，仍出現適應不良問題，研究上探討最後一哩課程設計需求較少。

研究目的：本研究目的分別從護理臨床教師與新進護理人員的角度探討最後一哩就業課程的「教學」與「學習」經驗，進而了解最後一哩就業課程的需求內涵。

研究方法：本研究採質性研究設計，以立意取樣方式，於東北部某區域教學醫院進行收案。以深入訪談法分別訪談十一位護理臨床教師、及十位新進護理人員，並以Colaizzi（1978）內容分析法進行資料分析。

研究結果：本研究結果分別針對護理臨床教師的教學與需求，以及新進護理人員學習經驗與與需求進行分析。護理臨床教師的教學經驗，共有四個主題分別為「以對待新進護理師的心情教導學生」、「逐步引導學生展現護理師角色與職責」、「促成學生成為工作夥伴」、「擔任護理臨床教師之困境」。護理臨床教師教學需求，共涵蓋三個主題，分別為「提供適切的教學資源與環境」、「強化臨床教學能力」、「獲得情緒支持」。新進護理人員的學習經驗，共有四個主題分別為「以即將成為新進護理師的心情學習」、「逐步學習展現護理師角色與職責」、「學習護理師的專業素養與成長」、「護生到新手護理師角色轉換之困境」。新進護理人員學習需求，共涵蓋三個主題分別為「提供適切的學習資源與環境」、「強化臨床照護能力」、「獲得情緒支持」。而每個主題下各有2~4個次主題。

結論與建議：根據臨床教師與新進護理人員的經驗，最後一哩就業課程內涵須涵蓋五大項：營造友善的學習氛圍、身體評估與處理臨床照護、跨領域團隊合作與溝通技巧、交班技巧、情緒與壓力的舒壓。研究結果可作為產、學界設計最後一哩課程的參考，進而促進護生到新手護理師角色轉換，提升護理能力和留任率。

Background:

The purpose of the Last-Mile course was to bridge the gap between theory and clinical practice for nursing students in order to facilitate their transitions into work settings. Thus, the course has become part of nursing curriculum in every nursing programs. However, maladjustment is still an issue after students enter into practice settings. There are few studies that have explored the design of the last-mile course.  

Purpose

The purpose of this study was to understand the experiences of teaching and learning regarding the last-mile course from the perspectives of preceptors and new nurses, and to identify the needed contents for the Last-Mile course. 

Methodology

 This qualitative study used purpose sampling to collect data from a northeastern reginal teaching hospital in Taiwan. A total of 11 preceptors and 10 new nurses participated in the in-depth, semi-structured interviews. Colaizzi’s (1978) method of content analysis was used for data analysis.  

Results

Data regarding preceptors’ needs and teaching experiences, and new nurses’ needs and learning experiences were analyzed. Analysis on preceptors’ teaching experiences revealed four themes: teaching students with a mentality of mentoring new staff nurses, progressively facilitating students in development of professional roles and responsibilities, fostering students to become colleagues, and guiding students to face the challenges of being a preceptor. Three themes regarding preceptors’ teaching needs were identified: providing appropriate teaching resources and environment, strengthening clinical teaching capabilities, and receiving emotional support. Analysis on new nurses’ learning experiences revealed four themes: learning with a mentality of becoming a new nurse, progressively learning to demonstrate nurse’ roles and responsibilities, learning and growing in nursing professionalism, understanding the challenges in transitioning from a student nurse to a new nurse.

Three themes regarding new nurses’ learning needs were identified: providing appropriate teaching resources and environment, strengthening clinical teaching capabilities, and receiving emotional support. There are two to four sub-themes under each theme. 

Conclusion and Recommendations

Based on the preceptors and new nurses’ experiences, the contents of the LastMile course should comprise of five elements: creating a friendly learning environment, physical assessment and nursing care, inter-professional collaboration and communication skills, hand-off skills, and emotion and stress management. The results of this study may assist the design of the Last-Mile course in the academic and

practice settings to facilitate nursing students’ role transition to practice settings and to promote retention rate.