新進護理師執行核心可信賴護理專業活動表現與留任之關係

目的：近年來以可信賴專業活動（entrustable professional activities, EPAs）來評價學員是否能將核心能力轉化成實際醫療行為在醫學教育中越發被重視。然而，對於臨床護理教育而言，EPAs顯然是新興的學習成效評值工具。面對初入職場的新進護理師，臨床教師須要可有效評估其學習成效以及臨床護理任務勝任程度的工具。故探討新進護理師執行核心可信賴護理專業活動與DOPS、mini-CEX、360度評量表之關係，並進一步了解EPAs評值結果能否反映新進護理師留任情形。方法：本研究採描述性相關性研究，以2020年1月至12月北部某醫學中心222位新進護理師為研究對象，分析EPAs評分結果與DOPS、mini-CEX、360度評量表評分結果之關係，並進一步比較不同留任狀況包括依時簽約、延長試用、離職之新進護理師之EPAs評分結果是否有差異，研究資料以描述性統計、Spearman's rank correlation coefficient和Kruskal-Wallis檢定進行分析。結果:新進護理師執行核心可信賴護理專業活動評分（40.2±11.6）與DOPS（4.3±0.6）、mini-CEX（6.3±1.1）、360度評量表評分（4.2±0.4）之r值分別為：0.310（p=0.001）、0.009（p=0.922）、0.229（p=0.010）;不同留任狀況包括依時簽約（42.5±0.9）、延長試用（25.5±2.9）、離職（29.6±3.6）之新進護理師之EPAs評分結果有差異（p<0.001）。結論：新進護理師執行核心可信賴護理專業活動與DOPS、360度評量結果具相關性，可協同其他多元評核表評估新進護理師執行實際醫療的能力。EPAs評值結果亦能反映新進護理師留任情形，評分40分以上者可依時簽約，依進度正常接受教育訓練，而評分未達30分者多會選擇離職或需延長試用，延長訓練時間。EPAs雖然無法完全取代所有評量，但可以提供新進人員教育訓練與多元評核能力的參考之一。

關鍵字

新進護理師；可信賴護理專業活動；留任

並列摘要

Purpose: In recent years, there has been an increasing emphasis in medical education in evaluating whether students can translate their core competencies into practical medical behaviors by using entrustable professional activities (EPAs). However, EPAs are an emerging learning effectiveness evaluation tool obviously for clinical nursing education. Clinical teachers need tools that can effectively assess new nurses' learning effectiveness and competency in clinical nursing tasks. The purposes of this study were to investigate the relationship between the EPAs and the scores of DOPS, mini-CEX, 360-degree evaluation, and to understand the relationship between the EPAs and the retention of the new nurses. Methods: This study used a described correlation design. The study collected the scores of DOPS, mini-CEX, 360-degree evaluation, EPAs and the retention of 194 new nurses from a medical center in the north Taiwan, from January to December 2020. Descriptive statistics, Spearman's rank correlation coefficient and Kruskal-Wallis were used for statistical analysis. Results: The relation of the scores of EPAs (40.2±11.6) and DOPS(4.3±0.6), mini-CEX(6.3± 1.1), 360-degree evaluation (4.2±0.4) of the new nurses were 0.310(p =0.001), 0.009(p=0.922), and 0.229(p=0.010) respectively. There were statistical differences between the scores of EPAs and the conditions of retention including agency on time(42.5±0.9), prolong probation period (25.5±2.9), resign (29.6±3.6) of the new nurses (p <0.001). Conclusions: The scores of EPAs of new nurses were related to the scores of DOPS and 360-degree evaluation. We could use EPAs along with multiple assessment to evaluate the competencies of practical medical behaviors. The scores of EPAs could also reflect the retention of the new nurses which above 40 indicate agency on time and the new nurses could receive clinical training by the schedule, below 30 indicate prolong probation period or resign. Although the EPAs couldn't replace all of the other evaluation tools, it could provide one of the references for the education and the multiple evaluation of the competencies of new nurses.

並列關鍵字

new nurse ； EPAs ； retention

主題瀏覽