應用問題導向學習於新進護理人員倫理培訓計畫之行動研究

本研究運用行動研究法（Action Research），實施問題導向學習（Problem-Based Learning, PBL）於新進護理人員倫理培訓計畫，以期改善新進護理人員的倫理課程學習成效。本研究場域為研究者任職的中部某精神專科教學醫院，於2013年01月至2016年12月期間，以四個步驟進行：行動準備期、課程發展期、課程實踐與反思期、行動反思與成長期，透過此步驟確定行動規劃、培訓PBL知能、發展及實施倫理PBL課程，過程中持續反思與修正。本研究對象有：（一）PBL核心小組成員8名：該院護理科教學研究發展組組長及組員、執業5年以上之資深護理師、以及學界專家；（二）PBL學生成員18名，該院新進二年內護理人員。研究資料包括：PBL核心小組成員會議錄音逐字稿、研究者反思札記和PBL學員焦點團體訪問錄音逐字稿，資料以質性內容分析法進行分析。本行動研究結果如下：（一）PBL核心小組成員的行動歷程：影響PBL核心小組成員合作(Cooperative)的因素包括時間限制、工作文化及平等關係；（二）PBL學員的學習經驗：在過程中，倫理的知能接軌，並透過討論得以展開倫理對話與眼界，最後思維倫理本質；以及（三）研究者反思：在實施問題導向學習歷程中，須依據實際運作情況修正和調整促進者角色至最適合的情況。行動研究強調實務行動者即研究者，以及運用彈性的行動策略來探索問題及解決問題。因此，本研究計畫因反應實際研究場域情境的變化及需要而彈性調整。本研究結果作為日後相同性質醫院應用PBL於新進護理人員倫理培訓計畫之之參考。

關鍵字

行動研究；新進護理人員；問題導向學習

並列摘要

The object of this study is the application of problem-based learning for newly employed nursing staff in ethics training program to improve the effectiveness of ethical learning. We used action research process to implement the PBL course at Central Psychiatric Teaching Hospital from January 2013 to December 2016. There are four steps: action preparation period, curriculum development period, curriculum practice and reflection period, action reflection and growth, through these steps to determine the action plan, training PBL knowledge, development and implementation of ethical PBL course, continuous reflection and correction process. We enrolled (1) 8 members of the core team: the head and members of the teaching and research development group of the Nursing Department of the hospital, over 5-year senior nurses as well as academic professionals; (2) 40 PBL members from 2-year newly employed nursing staff who attend post-graduate 2-year training programs. Qualitative data will be collected from PBL core group members meeting transcripts, PBL reflection meeting transcripts, and reflective journal for qualitative content analysis. The results of this research are as follows: (1) The course of action of the members of the PBL core team: the cooperative factors affecting the PBL core team members including time constraints, work culture and equality relations; (2) PBL students' learning experience: ethical knowledge integration, and through discussion to expand the ethical dialogue and vision, the last thinking ethical essence;and(3) the researcher's reflection: in implementing the problem-oriented learning process, the role of the facilitator will be modified and adjusted to the most appropriate situation, depending on the actual operation. Action research emphasizes practical actors, researchers, and the use of flexible action strategies to explore and solve problems. Therefore, in order to reflect the real situation of the study field, the action plan of the study was changed and the role of the researcher was flexible. The results of this study provide reference for newly employed nursing staff in ethics training program in hospitals of the same nature.