以實證概念探討護理擬真情境教學於非操作型技術的成效與應用

The Effectiveness and Application of Non- Technical Skills on Nursing Simulation Education: An Evidence-Based Approach

柳秋芳(Chiou-Fang Liou)

《台灣擬真醫學教育期刊》 2卷2期 (2016/02) Pp. 4-15

https://doi.org/10.6582/JTSSH.2016.2(2).01

摘要

近年國際間普遍認同擬真情境教學是有效的教學策略。擬真情境教學學習的優點是提供學生安全的學習環境，演練以及精進各項技能。醫療報告指出發生病人安全疑慮事件的危險因子大多是人為，例如與團隊溝通不當，或是無法辨識病人病情改變等非操作型技術。本文為了能了解非操作型技術在擬真護理情境教學的學習成效，產生以下問題：(1)使用在擬真情境教學的非操作型技術的成效指標的種類？(2)擬真情境教學的非操作型技術的成效？因此，使用PubMed, CHIANL,以及華藝線上圖書館搜尋並篩選2008-2015年間有關擬真情境教學與非操作型技術相關的中，英文全文文獻共15篇。整合文獻結果顯示情境教學的成效指標(1)非操型技術成效指標有情境察覺、臨床能力、團隊合作與溝通、批判性思考；(2)社會心理指標，包括提昇學生與學員的自信與減輕焦慮。模擬情境教學能有效的提昇臨床工作者以及學生的臨床能力，團隊合作與溝通，以及跨團隊溝通等非操作型技術。未來應可以在進行成效指標的建立等相關的研究。擬真情境教學在發展學生的情境察覺，批判性思考的成效目前沒有定論。建議未來可以增加相關的研究以建立證據支持其成效。

關鍵字

擬真情境教學 ； 非操作型技術 ； 臨床能力 ； 溝通與合作 ； 情境察覺

並列摘要

Simulation education has been recognized as the effective teaching strategy worldwide in recentyears. The benefit of using simulation is to provide students a safety environment to learn,rehearse and refine both technical and non-technical skills (NTS). Human error, for example, incorrectlypracticing non-technical skills (inappropriate communication and unable to recognizepatient's deterioration) may raise concerns regarding patients’ safety. The focus of this article is onthe understanding the effectiveness of NTS on simulation education. Two questions were generated:(1) what are the standards used to evaluate the NTS, and (2) the effectiveness of NTS on simulationeducation. Hence, using key words and searching engines, including PubMed, CHINAL,and Airrti Library, total of 15 articles were identified and retrieved. Reviewing and synthesizingliterature reveal standards evaluating the effectiveness of simulation include (1) NTS consisting ofsituation awareness, clinical competence, communication and cooperation, and critical thinking,(2) additional standards associated with psychosocial factors including improving confidence anddecreasing anxiety. Literature also concluded that simulation education effectively increases clinicalcompetence, cooperation and communication, and interdisciplinary communication on cliniciansand students. Further studies could be focus on finding the gold standards with the elementsof nursing professions for evaluating the effectiveness of simulation education. However,up to date, the effectiveness of situation awareness and critical thinking on simulation educationwas inconclusive; thus, increasing the volumes and quality studies on these topics are needed.

並列關鍵字

simulation education ； NTS ； clinical competence ； communication and cooperation ； situation awareness