運用客觀結構式臨床測驗於乳房攝影溝通技巧之成效探討

To evaluate the effectiveness of using objective structured clinical examination in mammography communication skill

林佳儀(Chia-Yi Lin)

指導教授 ： 田雨生

中山醫學大學/醫學科技學院/醫學影像暨放射科學系/碩士(2022年)

https://doi.org/10.6834/csmu202200021

摘要

研究目的:乳房攝影影像品質之提升，除了加強擺位技巧外，溝通技巧也是重要一環，以客觀結構式臨床測驗(objective structured clinical examination, OSCE )模擬臨床情境進行教學，既不會造成病患傷害，也能加強學員臨床應變能力。本研究探討以OSCE運用於乳房攝影溝通技巧之成效探討。方法:以中部某醫學中心代訓學員與該院放射師共10名為研究對象，以「OSCE」作為實驗介入措施，對照組則為臨床講授法，探討接受訓後學員乳房攝影臨床技能表現。依變項為乳房攝影檢查造成婦女之不舒適感及影像品質，研究資料使用SPSS 20.0版進行統計分析。研究結果:接受訓練對降低受檢婦女疼痛有顯著差異( p<0.001)，降低焦慮也有顯著差異( p<0.01)，對影像品質之提升也有幫助( p=0.302);對影像品質有顯著差異( p<0.05)，雖兩組皆未達到A等級，但OSCE組有更好之影像品質。結論與建議:透過OSCE溝通技巧教學能降低婦女接受乳房攝影時疼痛及焦慮之不舒適感，且對影像品質提升也有幫助。藉由這套教學模式的建立，讓放射師可以了解婦女接受乳房攝影時之心情，以有效提升照護品質。

關鍵字

乳房攝影 ； 客觀結構式臨床測驗 ； 疼痛 ； 焦慮 ； 溝通技巧

並列摘要

Objective: To improve the quality of mammography images, in addition to enhancing the positioning skills, communication skills are also an important part. Teaching with objective structured clinical examination (OSCE) to simulate clinical situations will not cause harm to patients and can enhance the clinical communication ability of medical radiation technologists. This study evaluated the effectiveness of using OSCE in mammography communication skills.
Methods: A total of 10 trainees and in-service radiation technologists from a medical center in central Taiwan were used as the subjects of this study, a quasi-experiment design was adopted and OSCE was used as the experimental intervention. According to variable items included women’s pain and anxiety caused by mammography examinations and image quality. The data were statistically analyzed using SPSS version 20.0.
Result: There was a significant difference in pain reduction (p<.001), anxiety reduction (p<.01), and image quality improvement (p=0.302) among women who received training. After OSCE has no significant difference in the pain and anxiety, but it is still lower than control group. Although both groups did not reach A level, OSCE group had better image quality.
Conclusion: Receiving the OSCE can reduce women's discomfort of pain and anxiety during mammography, and also help to improve the image quality. By establishing this teaching model, radiation technologists can better understand women's emotions during the examination, which can effectively improve the quality of care.

並列關鍵字

mammography ； objective structured clinical examination ； OSCE ； pain ； anxiety

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