建構與驗證「藥學系六年制學生專業能力自我效能量表」

Development and Validation of A Scale to Measure Pharm.D. Students' Self-Efficacy in Professional Competencies

洪佳安(Jia-An Hung)

指導教授 ： 林淑文

共同指導教授 ： 蕭斐元(Fei-Yuan Hsiao)

國立臺灣大學/醫學院/臨床藥學研究所/碩士(2017年)

https://doi.org/10.6342/NTU201701193

摘要

研究背景：
自我效能（self-efficacy）是增進學習動機、產生學習行為的一大重要因素，確保學生在專業能力上具備良好的自我效能，不但能協助學生逐漸邁向成功，亦能做為教師由學生主觀認知的角度出發，評估教學成效的有力證據。臺大藥學系近年來已順利轉型為六年制Pharm.D.（Doctor of Pharmacy）學位，在此特別的時間點，建構一個量表來測量並觀察藥學生的專業能力自我效能的變化，將成為未來教育評估的重要參考依據之一。

研究目的：
本研究期望建構一個藥學專業能力自我效能量表，並進行信效度的驗證，同時對臺大藥學系高年級學生進行橫斷性的調查，以比較不同學制及年級之間自我效能的差異。

研究方法：
本研究透過完整的文獻回顧、焦點團體會議、內容效度審核、認知訪談預試等流程建構量表之構面與問項，並實際對臺大藥學系高年級學生進行施測，再經項目分析、分構面探索性因素分析、效標關聯效度及內部一致性檢定來驗證量表的信效度。最後以Student’s t-test、Mann-Whitney U-test及Kruskal-Wallis one-way analysis of variance ranks進行不同學制及年級之間自我效能的差異檢定。

研究結果：
本研究依照文獻回顧、焦點團體等資料，建構出包含五個構面（人際關係及溝通技巧、專業素養、藥事照護、醫療體制下之臨床工作、從工作中學習與成長）之「藥學系六年制學生專業能力自我效能量表」，共119個問項，每個問項的I-CVI均大於0.83，整份量表的S-CVI/Ave為0.98。施測後共回收了81份有效問卷（有效回收率94%），經項目分析及分構面探索性因素分析後，保留了53個問項，量表整體的內部一致性係數為0.969（各構面均達0.9以上）。在效標關聯效度上，近兩年學習成績較高者比起較低者，在專業素養、藥事照護以及量表整體得分上有顯著較高的自我效能（p < 0.05）。
而在橫斷性調查中顯示，六年制之六年級學生的自我效能在總分或各構面得分上，都比四年制之四年級、六年制之四年級與五年級三組學生還高，且在專業素養、藥事照護、醫療體制下之臨床工作、從工作中學習與成長等構面上，與六年制之四年級學生達到顯著差異（p < 0.05），另在藥事照護構面上，亦顯著地高於四年制之四年級學生（p < 0.05）。

結論：
本研究建構之自我效能量表具有良好的信、效度，未來之藥學教育研究者可以利用此量表來評估、觀察、監測學生的專業能力自我效能，收集來自學生端主觀的能力評估依據，做為教學成效的參考資料。

關鍵字

藥學專業能力 ； 藥學教育 ； 自我效能 ； 量表建構

並列摘要

Background:
Self-efficacy is crucial for students to be motivated and successfully strive for active learning. Students with high self-efficacy in professional competencies may not only reassure themselves to attain achievement, but their subjective assessments are also powerful evidence to evaluate effectiveness of teaching. The Bachelor of Science (B.S.) program in National Taiwan University School of Pharmacy has transited to 6-year Doctor of Pharmacy (Pharm.D.) program recently. It is crucial to develop a scale to measure pharmacy students’ self-efficacy of professional competencies as an evidence for an evaluation of educational outcomes.

Objectives:
We aimed to develop a scale to measure pharmacy students’ self-efficacy of professional competencies and to evaluate the reliability and validity of the scale. Besides, we also aimed to explore the differences of students’ self-efficacy of 2 programs and years by a cross-sectional survey.

Methods:
The scale was developed based on literature review, interview of focus group, experts review and pretest with cognitive interview. We collected surveys from senior pharmacy students. We performed item analysis, stratified exploratory factor analysis, criterion-related validity and Cronbach’s alpha to validate the scale. Lastly, we compared the differences of self-efficacy between programs and years by Student’s t-test, Mann-Whitney U-test and Kruskal-Wallis one-way analysis of variance ranks.

Results:
Five constructs (interpersonal and communication skills, professionalism, pharmaceutical care, system based practice, practice based learning and improvement) and 119 items had been established based on literature review and experts’ opinions. The content validity index showed satisfying results (All I-CVIs higher than 0.83, S-CVI/Ave 0.98). A total of 81 students (94% response rate) responded the survey. After item analysis and stratified exploratory factor analysis, 53 items had been retained. The Cronbach’s alpha was 0.969 for the whole scale (All constructs higher than 0.9). For criterion-related validity, students group of superior academic performance showed significantly higher self-efficacy than students group of inferior academic performance in the constructs of professionalism, pharmaceutical care and the total score (p < 0.05).
In the cross-sectional survey, 6th year Pharm.D. students showed highest self-efficacy in all five constructs and the total score compared to the rest of students. Specifically, the former demonstrated significantly higher self-efficacy than 4th year Pharm.D. students in the constructs of professionalism, pharmaceutical care, system based practice, practice based learning and improvement (p < 0.05). In addition, 6th year Pharm.D. students also showed significantly higher self-efficacy than 4th year B.S. students in the construct of pharmaceutical care (p < 0.05).

Conclusions:
The newly developed scale demonstrated good reliability and validity. It may serve as a psychometrically sound tool for pharmacy educators and researchers to measure pharmacy students’ self-efficacy in professional competencies, and hence an evidence for educational outcomes evaluation.

並列關鍵字

Pharmacy professional competency ； pharmacy education ； self-efficacy ； scale development

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