從全人健康照護觀點談護理診療思辨教育之智慧創新

The Intelligent Innovation in Nursing Diagnosis and Treatment Education: From the Viewpoint of Holistic Health Care

陳幼梅(Yao-Mei Chen) ； 蔡淳娟(Tsuen-Chiuan Tsai)

《台灣擬真醫學教育期刊》 7卷1期 (2020/06) Pp. 30-44

https://doi.org/10.6582/JTSSH.202006_7(1).0003

摘要

醫療科技複雜化、人口老年化及醫療環境巨變下，醫療需以病人為中心，提供全人照護。落實全人照護的醫學教育是醫學中心的重要任務，專業護理照護更是落實「以病人中心、全人照護」的關鍵要素。醫護團隊專業素質影響臨床照護結果甚鉅，臨床護理師必須有足夠的專業能力才能提供安全且具品質的病人照護，欲達成全人健康照護的目標，須有確實且完整的護理過程，包括評估、診斷、計畫、執行及評值五步驟，由於目前台灣對於護理診斷架構並無一致性的本土共識，加上COVID-19在實作訓練所形成的困境，因此建置一套足以厚植護理專業能力的全人照護護理診療系統，藉以訓練護理人員的臨床診療思辨能力，應該列為護理教育在智慧創新開發領域的優先目標。本文提供目前護理臨床教育方式綜論，建議護理診療思辨教育採團隊小組學習，運用數位學習、行動學習、遊戲學習或虛擬實境／擴充實境等智慧創新的教學方式，設計護理診療思辨教育和訓練成效的評量方式，提醒相關教學原理（如：Kolb經驗學習圈教育理論，以理解與轉換二個向度論述經驗學習循環的四種學習型態），並建議以Kirkpatrick評量模式檢視學員的表現，最後介紹推動人機互動創新學習科技，增加醫病互動演練機會，將思辨訓練由知識面提升到應用與實作面，在後疫情時代遠距實作臨床訓練非常重要，但有待更多研究驗證該創新臨床診療思辨教育的成效。

關鍵字

全人健康照護 ； 臨床思辨 ； 護理教育 ； 智慧創新

並列摘要

With the complexity of medical technology, the population aging, and the tremendous changes in the medical environment, patient-centered and holistic health care appear to be a critical issue in healthcare. Competent nursing care is the key to implement patient-centered holistic care, which is the foundation of patient safety and healthcare quality. To achieve the goal of holistic care, there must be accurate and reliable nursing process, including five steps of assessment, diagnosis, plan, intervention, and evaluation. The education on clinical reasoning underlying the above nursing tasks has been considered very challenging, while added by the lack of a standardized framwork of nursing diagnoses. During the pandemic COVID-19 crisis, innovated digital remote education in nursing became mandatory, especially in hands-on interactive training. This article also outlines the current nursing education on clinical reasoning and nursing process, plus the related educational theory and program evaluation framework. We also introduce innovated systems those provides human-digit interaction in virtual healthcare context. More evidence-based empirical research is required to verify the effectiveness of education in nursing diagnosis and nursing process, as a holistic nursing care.

並列關鍵字

Holistic Healthcare ； Clinical Thinking Dialectic ； Nursing Education ； Intelligent Innovation