護理系學生反思層次及護理能力之初探─以最後一哩實習為例

Level of Reflective Thinking and Nursing Competence of Nursing Students: A Preliminary Study Using the ＂Last-Mile＂ Practicum

柯麗瑛(Li-Ying Ko) ； 陳淑月(Shu-Yueh Chen)

《澄清醫護管理雜誌》 16卷4期 (2020/10) Pp. 60-72

摘要

目的：本研究目的在探討護理系學生在畢業前進行最後一哩實習前後其反思層次及護理能力的變化。方法：本研究採問卷調查法，為比較性研究設計，於2014年12月至2015年6月間以立意取樣，針對中部某科技大學護理系四技及二技學生共計248名，在最後一哩實習前後會議進行兩階段資料收集，經前後測有效配對問卷為217名，整體問卷之有效率為87.5％，資料以SPSS20.0 for Windows進行描述性、獨立樣本t檢定、成對樣本t檢定、單因子變異數分析、皮爾森積差相關等統計分析。結果：研究結果發現：一、護生進行最後一哩實習後，反思層次中「習慣性行動」、「反思」及「批判性反思」三個構面明顯較實習前進步，皆達統計學上顯著差異；在八大核心能力都有進步，以「基礎生物醫學科學」進步最多，其次為「批判性思考能力」。二、影響護生反思層次之因素：在「習慣性行動」，男性得分高於女性（t=2.70, p=0.008）；「批判性反思」，二技平均得分高於四技（t=-2.56,p＜0.05）；「反思」，實習平均成績高分組（80-90分）平均得分高於低分組（60-79分），達顯著差異（t=2.35, p＜0.05）。影響護生護理能力之因素：惟實習平均成績高分組（80-90分）其八大項核心能力平均得分皆高於低分組（60-79分）的學生，呈顯著差異（p＜0.05）。三、護理系學生「反思層次」與「護理能力」有顯著之正相關。結論：本研究發現在最後一哩實習後，學生的反思層次及護理能力都有明顯的進步，可作為護理教育課程規劃之參考。

關鍵字

護理系學生 ； 最後一哩實習 ； 反思層次 ； 護理能力

並列摘要

Purposes: The purpose of this study was to investigate differences in nursing students' level of reflective thinking and nursing competence before and after participation in the pre-graduation ＂last-mile＂ practicum. Methods: Data were collected using a questionnaire survey conducted from December, 2014 to June, 2015. Respondents consisted of 248 nursing students, selected through purposive sampling, who were attending four-year or two-year technical programs at a science and technology university in Central Taiwan. Two-stage data collection was performed at meetings held before and after completion of the last-mile practicum. A total of 217 valid paired questionnaires were collected, yielding an overall valid response rate of 87.5%. Data were statistically analyzed using descriptive statistics, independent and paired-samples t-tests, one-way ANOVA, and Pearson's correlation analysis. Results: Results indicated the following: (1) After completing the last-mile practicum, the habitual action, reflection, and critical reflection constructs of reflective thinking were significantly improved in nursing students. Improvements were also observed in the eight core nursing competencies, with basic biomedical sciences showing the greatest improvement, followed by critical thinking ability. (2) Factors influencing reflective thinking were as follows: (i) Gender: males scored higher than females in the habitual action construct (t=2.70, p=.008); (ii) Technical program: the average score in the critical reflection construct was higher in two-year technical program students than in four-year technical program students (t=-2.56, p＜0.05); (iii) Average practicum score: the average score in the reflection construct was higher in students with higher average practicum scores (80-90 points) than in students with lower average practicum scores (60-79 points) (t=2.35, p＜0.05). Average practicum scores were shown to be the influencing factor of nursing competence, as these scores in all eight core nursing competencies were higher in students with higher average practicum scores than in those with lower average practicum scores. (3) A significant positive correlation existed between nursing students' level of reflective thinking and nursing competence. Conclusions: These study results may serve as a reference for the planning of future nursing education programs.

並列關鍵字

Nursing students ； Last-mile practicum ； Level of reflective thinking ； Nursing competence