以虛擬臨床診療系統訓練護理學生之病史詢問與臨床思維

The Uses of Virtual Clinical Diagnostic System in Training Nursing Students on History Taking and Clinical Reasoning

胡綾真(Ling-Chen Hu) ； 楊文琪(Wen-Chi Yang) ； 羅靜婷(Ching-Ting Lo) ； 方月燕(Yueh-Yen Fang)

《台灣擬真醫學教育期刊》 6卷1期 (2019/06) Pp. 4-13

https://doi.org/10.6582/JTSSH.201906_6(1).0001

摘要

背景與目的：虛擬模擬（Virtual Simulation）以行動能力理論為基礎，以發展醫護人員之臨床能力，已逐漸應用於醫學與護理教育，近期以虚擬病人（Virtual Patient, VP）漸發展於醫護學習者，目前甚少此科技創新應用之成果報告。本研究目標乃在建構與示範以VP所設計之「虛擬臨床診療系統（The Virtual Clinical Diagnostic Training System）」應用於護理領域，瞭解其使用滿意度，並探討此學習模式之成效。研究方法：以「虛擬臨床診療訓練系統」作為正式臨床照護課程之輔助教材，使用咳血、胸痛、腹痛與發燒等四個案例。護理學生以自願方式參加，並填寫使用後滿意度調查，該臨床照護課程結束後全體學生接受OSCE，比較實驗組與對照組OSCE的臨床能力成績表現。結果：實驗組有102位二技一年級與四技四年級護理學生參加，護理學生使用該系統之滿意度高（83.3%），可以有效地提升學習動機（85.5%），認為虛擬科技是有效的學習（82.1%）、是護理臨床學習所必要的（84.5%）。以OSCE驗證使用該系統者之臨床能力學習成效，呈現顯著提升成效（t=5.13**, p ＜ .01）。結論：以此「虛擬臨床診療系統」培訓護理學生於閱讀病例、病史收集與護理臨床思維等臨床能力是很有助益的。

關鍵字

虛擬臨床診療系統 ； 醫學擬真 ； 臨床思辨 ； 科技輔助之學習

並列摘要

Objective: Based on experiential learning theory, medical simulation has been widely used in medical and nursing education. With the advances of digital technology, virtual patient has been newly developed and introduced to enrich the training on clinical learning. However, there has been few reports on the experience of their uses. This study is to provide the Virtual Clinical Diagnostic training system enhanced by virtual patients (VP) to the nursing students, and collect their satisfaction responses at the end of the practices. Finally, the effectiveness of the learning was validated by OSCE at the semester end. Method: The study program used the Landseed Virtual Clinical Diagnostic training system and 4 virtual cases with the presentation of hemoptysis, chest pain, abdominal pain and fever. In the clinical healthcare class, students were invited voluntarily to practice with the VP system, and filled the satisfaction questionnaire. At the end of the semester, students took OSCE, and the comparison of OSCE scores were made between the control group and the study group. Results: The participants 102 nursing students. The satisfaction rate is high (83.3%), with the agreement on ＂increasing learning motivation＂ (85.5%), ＂being effective and essential on nursing education＂ (82.1%, 84.5%)。The OSCE scores are higher in study group, when compared with the scores in control group (t=5.13**, p ＜ .01). Conclusion: The Virtual Clinical Diagnostic training system was found effective in training nursing students regarding reading medical documentation, history taking and clinical reasoning.

並列關鍵字

The Virtual Clinical Diagnostic Training System ； Medical Simulation ； Clinical Reasoning ； Technology-Enhanced Learning