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  • 學位論文

接受二年期護理師訓練計畫之新進護理人員 核心能力評估初探

The appraisal of core competency of new nurses under the post-graduate year training program

指導教授 : 邱瓊萱

摘要


衛生署自2007年起具體實施護理人員二年期訓練計畫制度,了解目前正在接受此制度的新進護理人員(以下簡稱學員)訓練成效是值得研究的議題,評量醫事人員核心能力行為表現(Performance)的評估工具包含mini-CEX、OSCE與 DOPS,其中OSCE需花費龐大的成本,DOPS較為針對某項臨床操作技術的評核,故本研究將發展較節省評估成本、評估項目較為精簡又適用於護理人員使用的mini-CEX評估工具,也將使用此評估工具衡量新進護理人員的訓練成效。   研究方法為採用360度評量,以學員自評、臨床指導老師與同儕為他評來評估學員的訓練成效,學員自評問卷以醫學生專業素養問卷修改而成,臨床指導老師採用護理人員mini-CEX評分表、同儕採用Multi-source Feedback評分表進行他評,使用獨立樣本T檢定與變異數分析比較學員、老師與同儕評量的訓練成效。   研究結果為本研究發展之mini-CEX可適用於護理人員,學員自評的構面中較多呈現重視程度高於實踐程度的情形,且PGY2學員自評的實踐程度與重視程度皆高於PGY1學員;臨床老師他評的部分,PGY2學員的訓練成效皆高於PGY1學員,再考量學員的留任意願,具有留任意願的學員訓練成效亦較不具留任意願者佳;同儕評量部分,PGY2學員的表現亦優於PGY1學員;在360度評量的部分,學員的自評分數皆高於老師與同儕,以及PGY2學員的表現在老師與同儕的評量中皆高於PGY1學員。   對於學員、臨床指導老師、同儕、醫院以及未來研究給予建議,建議學員可尋找模範對象,透過觀察模範對象之行為表現來補強自己的不足,建議臨床指導老師給予學員接觸不同病況的病患,與學員討論不同病況應須具備的相關知識,建議同儕帶領學員與其他共事人員互動,降低溝通的困難度,建議醫院可設置雙向的訓練方案,由上至下訂定目標、訓練方式與評估方式,由下至上回報執行成果,建議未來研究可多收案不同層級的醫院,廣納其他醫事人員、病患與家屬為收案對象,藉此可更為全面的了解學員之訓練成效。

並列摘要


The Department of Health launched the post-graduate year training program for nurses and other paramedical staff since 2007. This program is aimed to enhance core competency of nurses and ultimately enhance the quality of patient care. To understand the training effectiveness is a worthy study subject. To measure medical staff core competency can use assessment tool like mini-CEX, OSCE and DOPS. This study devises mini-CEX for nurse for its easily and comprehensive use. Therefore, this study is to devise the instrument to measure the core competency and to adapt 360 degree evaluation to determine the effect of PGY program.   This study utilizes three instruments from trainees, instructors and coworkers to determine the students’ core competency. Trainees’ instrument is modified from Medical Professionalism Questionnaire, and listed as the self-reported evaluation. Instructors’ instrument is devised based on the defined core competency required by the major nurse associations from USA, Canada, and Japan, and developed the short evaluation form, that is mini-CEX. Coworkers’ instrument is adapted from the Multi-source Questions developed by Foundation in UK. This study summarizes the evaluation report from three sources, and reveals the subjective evaluation as the consequence.   The results show that the evaluation over PGY1 trainees are lower than the PGY2 trainees. Progress among different stages is evident.   We suggest that the importance of role model for trainees should be incorporated into curriculum, and further ask senior nurses to constantly check trainees’ status and challenges they have.

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