應用多元教學策略提升訓練中專科護理師之臨床照護能力

專科護理師應具備豐沛臨床知識與技能，必須能評估及辨識臨床問題做出合理判斷，再以系統性陳述臆測病人診斷。有鑑於2014年訓練中專科護理師甄審口試通過率僅38.8%，低於全國平均通過率50.5%，為提升訓練中專科護理師臨床照護能力，進而提升專科護理師證照考試通過率，故引發動機成立專案小組，以尋求有效策略。專案執行期間2015年04月至2015年11月，進行問題導向案例分析、病歷巡查及次專科情境模擬，並使用客觀結構式臨床測驗評量工具等多元教學策略，提升專科護理師對病史詢問、身體評估、臨床決策和鑑別診斷等臨床照護能力。針對每位專科護理師學習間的個別差異，隨時調整教學策略，提供專科護理師適性的教學內容，於2015年專科護理師甄審口試通過率由38.8%提升至90.9%，高於全國平均66.2%，達顯著成效。為能持續維持，之後將專科護理師培訓課程列入標準化，並進行定期追蹤管理。本專案運用多元教學策略，提升了專科護理師應具備之核心特質構面，以確保其之臨床能力，能提供病人更專業之照護品質。

關鍵字

多元教學；專科護理師；臨床照護

並列摘要

Nurse practitioners (NPs) should have full-scale expertise to evaluate and distinguish clinical issue and capability of comprehending and describing patient's diagnosis systematically. According to 2014 NPs oral examination, the qualification rate was 38.8%, which is lower than nationwide average of 50.5%. In order to enhance the clinical capability of novice nurse practitioners, we established a NPs training project to improve the qualification rate. The project started at April of 2015. The project included objective-structured clinical tests for problem-oriented case study, chart run, scenario and stimulation to enhance novice NPs' capability of demographic questionnaire, physical examination, differential diagnosis, and decision making. The study plans for individual NP are subjected to case by case adjustment according to individual advantages and disadvantages. With the suitable lecture, the NPs oral qualification rate increases from 38.8% to 90.9% in November of 2015, which is higher than national average of 66.2%. The NPs training procedure is listed in employee training SOP. The NPs training procedure program includes multi-disciplinary courses to improve NPs' clinical practice ability so that it could provide professional patient-center holistic care.