運用客觀結構式臨床測驗提升藥學實習生於諮詢衛教之學習成效

The Use of OSCE to Improve Learning Outcomes for Pharmacy Interns in Patient Education and Counseling

紀柏羽(Po-Yu Chi)

指導教授 ： 蔡崇弘

中山醫學大學/醫學院/醫學研究所/碩士(2016年)

摘要

研究目的：藥學實習生運用多元化的方式評量學習成效，其中客觀結構式臨床測驗（objective structured clinical examination, OSCE）以模擬臨床的情境為測驗，可用來客觀地評量學生臨床能力表現。本研究探討運用OSCE介入後於藥學實習生諮詢衛教之學習成效。
研究方法：本研究採類實驗研究，單組多次測量設計，以中部某醫學中心藥學實習生36位為研究對象，OSCE為介入措施，依變項為藥學實習生於mini-CEX的臨床表現，包含七大面向評量結果、評量中能達標準的項目數及自我表現滿意度，另一個依變項為OSCE前後自我評量問卷，而問卷回饋內容進行質性研究，研究資料使用SPSS 14.0 Windows套裝軟體進行各項統計分析。
研究結果：OSCE介入後運用無母數統計方法中的Wilcoxon Signed-Rank test來分析差異性。自我評量問卷結果顯示於「禮貌與專業態度」、「藥物諮詢的溝通技巧」、「衛教工具運用與操作技巧」統計上呈現顯著差異(p<.05)。執行mini-CEX結果顯示，評量七個面向皆呈現進步，統計上具有顯著差異(p<.001)；評量七項目中能達標準5分的項目數顯著增加(p<.001)；自我滿意度有顯著增加(p<.001)。在質性研究上「藥物諮詢的溝通技巧」與「衛教工具運用與操作技巧」這兩個層面最多人回饋且印象深刻。
結論與建議：OSCE介入後顯示藥學實習生於面對病患諮詢衛教的能力有提升，OSCE確實能推動藥學實習生的學習。藉由這套教學模式的建立，讓教師可以了解藥學實習生在諮詢衛教上需補強的能力，以持續監測教學的品質。

關鍵字

客觀結構式臨床測驗 ； OSCE ； 諮詢衛教 ； 學習成效

並列摘要

Objective：Pharmacy interns using multiform assessments to evaluate learning outcomes, objective structured clinical examination (OSCE) simulated clinical situations to test students' clinical competence objectively. This research evaluates learning outcomes of pharmacy interns in patient education and counseling after using OSCE.
Method：This research is used with quasi-experimental study, single-group pretest-posttest design. Pharmacy interns in a municipal hospital in Taichung City were enrolled as participants (N = 36), after OSCE intervention, according to variable items for pharmacy interns included clinical performance assessment by mini-CEX, which contains seven projects, and the numbers of assessment scores can reach standard projects and the self-expression satisfaction degrees, another one is according to variable items for OSCE before and after self assessment questionnaire, and the questionnaire feedback contents are investigated with qualitative research, results were analyzed with SPSS 14.0 software.
Results：After OSCE intervention, Wilcoxon signed-rank test is used to analyze the difference. Self assessment questionnaire results showed the " polite and professional attitude " and " communication skills of drug information ", " using teaching tool and operating skills " statistically significant difference (p<.05). Assessment of mini-CEX shows that measured seven faces all showed, statistically significant differences in progress (p<.001) and evaluation criteria in seven projects that can achieve standard 5 points significantly increases in the number of items (p<.001); self satisfaction has increased significantly (p<.001). In qualitative research, " communication skills of drug information " and "using teaching tool and operating skills " get feedback abundantly and are impressive to most of participants.
Conclusion and Suggestion：The results indicate that after OSCE intervention, which can enhance the patient education and counseling competence of pharmacy interns.OSCE can really promote learning attitude of pharmacy interns, Through setting up the teaching mode, teachers can understand the lack of ability of pharmacy interns in patient education and counseling and keep monitoring the teaching qualities continually.

並列關鍵字

objective structured clinical examination ； OSCE ； patient education and counseling ； learning outcomes

參考文獻

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