以文獻證據及產學合作焦點團體發展實證照護課程

實證照護能銜接研究與實務之差距，護生須具備實證照護能力，以提供較佳的照護成效。目前較缺乏運用實證及產學合作發展之大學部實證照護課程。因此，本研究目的即為探討實證照護能力要項，並以現有實證證據及產學攜手共同發展與執行課程。本研究先搜尋實證教育措施之證據，再以焦點團體法輔助發展課程。階段一為專家焦點團體，邀請八位校外實證照護專家，建立大學層級實證照護能力要項及課程設計建議。階段二則為教學組焦點團體，由13位校內實證照護教學教師及本校產學合作臨床專家進行五次會議。首次會議請參與成員針對專家焦點團體結果所初擬之教學計畫討論後形成共識，接續舉行三次團體，討論課程之教學目標、單元內容及教學策略。最後一次為公聽會，邀請校內護理學院教師及產學合作機構主管參與，由計畫主持人報告完成之課程計畫並請與會者表示意見，討論修改後完成本實證照護課程教學計畫。結果顯示此課程目標為：一、瞭解實證照護的基本概念與執行步驟；二、以PICO方式詢問臨床問題；三、運用資料庫搜尋最佳文獻證據；四、運用合適工具評讀文獻並判斷證據等級；五、以最佳證據回答臨床問題之過程。採學校教師與產學機構雙師共同授課；多元且強調實作之教學方法，包括講述、示教、回示教、演練、情境模擬案例討論、分組實作及報告等；教學成果為分組完成一份文獻評析及以最佳證據回答臨床問題之報告。本課程執行後顯著提升護生實證照護能力及執行實證照護之自我效能。以文獻證據及產學合作攜手發展及執行實證照護課程有具體成效，可供護理養成教育培育實證照護能力之參考。

關鍵字

實證照護；產學合作；課程發展；焦點團體

並列摘要

Evidence-based practice (EBP) can improve patient care outcomes, and EBP competence should be part of the preregistration education for nursing students. An ideal curriculum development process would be based on the best evidence and industry-academia cooperation, but this has not previously been attempted. The purpose of the study reported here was to explore the essential components of EBP competence for undergraduate nursing students and to develop an EBP curriculum. The study employed evidence on educational interventions for EBP and focus groups to generate a consensus on a curriculum. An expert panel of eight nurses participated in the first focus group to identify a set of bachelor-level competences for EBP and suggestions for a curriculum design. Another focus group, comprising 13 experts from a school faculty and a collaborating hospital, formed a teaching group to develop a curriculum over five subsequent meetings. At the first meeting, the participants had to form a consensus on the teaching plan that had been proposed by the first focus group. Three further meetings were held to discuss the unit objectives, unit contents, and teaching strategies for the EBP course. The final meeting was a public hearing to which the nursing faculty of the school and the head of the cooperating hospital were invited. The leader of the teaching group presented the course plan and asked participants to express their views. The final EBP teaching plan incorporated discussions and suggested modifications. This process yielded the following objectives for the course: 1) to clarify the concepts of EBP and its steps; 2) to describe how to use a PICO format to ask clinical questions; 3) to explain how to search databases to obtain the best evidence; 4) to demonstrate how to apply an appropriate tool to appraise research and identify the levels of evidence; and 5) to present the process of using the best evidence to answer clinical questions. The course will be jointly taught by staff from the school and the hospital. The teaching methods will include lectures, demonstrations, response demonstration teaching, exercises, simulation case discussions, and small group presentations. The teaching outcomes are the completion of a critical appraisal and a report on using the best evidence to answer clinical questions. This course is expected to enhance the ability of nursing students to conduct EBP.