客觀性結構式臨床測驗(OSCE)應用於護理系課程之成效

The Effectiveness of an Objective Structured Clinical Examination (OSCE) Training Program in Nursing

10.6235/TVE.2404

王秀禾(Hsiu-Ho Wang)；孫嘉玲(Jia-Ling Sun)；陳美慧(Mei-Hui Chen)；洪兆嘉(Chao-Chia Hung)；周培萱(Pei-Hsuan Chou)；賴玉敏(Yu-Ming Lai)；林育興(Yu-Hsing Lin)；陳櫂豐(Zhao-Feng Chen)

客觀性結構式臨床測驗 ； 課程 ； 發展 ； objective structured clinical examination ； curriculum ； development

技術及職業教育學報

6卷2期（2015 / 08 / 01）

1 - 15

繁體中文

近10年來客觀性結構式臨床測驗已成為全球各地醫護教育訓練的一部份。目前臺灣的OSCE應用仍以醫學教育為主，而臺灣護理教育擬將OSCE列入未來護理師考試之一部分。本研究之目的為發展一個客觀性結構式臨床測驗（OSCE）課程於大學護理系，並探討其課程實施成效。課程發展過程採專家建議之步驟，進行OSCE課程規劃、OSCE課程準備，透過焦點團體方式發展護理系OSCE藍圖及討論OSCE教案內容，OSCE教案採專家內容效度審查。研究結果發展出OSCE藍圖、OSCE六個課程、OSCE教案之標準病人影片、考官訓練及標準病人訓練等；並進行OSCE考試，在胰島素注射及注射前後評估與衛教，課程整體滿意度總平均為3.54，學生考試平均分數為85分；產後評估及尖峰呼氣流速計的使用課程整體滿意度總平均為4.25，產後評估學生考試平均分數為92分，尖峰呼氣流速計平均分數為90分。本研究結果可作為各校護理科系發展與推動OSCE之參考。

Objective Structured Clinical Examination (OSCE) has become a part of global health care education and training for the past 10 years. OSCE applications are currently in medical education on Taiwan. OSCE maybe included a part of the future of nursing licensure examination. The purposes of this study were to develop a curriculum for nursing and to evaluate the outcome of the OSCE training program. Curriculum development using expert recommendation, include OSCE curriculum planning, OSCE preparation course. Development OSCE blueprint and discuss OSCE course content through focus groups. OSCE curriculum was reviewed by the expert validity. Result showed developing an OSCE blueprint, OSCE six courses, OSCE standards patient teaching videos, examiner training and standardized patient training. About OSCE examinations, the curriculum of insulin injections and assessment on satisfaction, the average scale of OSCE satisfaction was 3.54, and the students had an eighty-five average. The curriculum of postpartum assessment and peak expiratory flow meter, the average scale of satisfaction was 4.25, and the students had 92 average on postpartum assessment and 90 average on peak expiratory flow meter. It is expected that these results can offer references of nursing development and promote OSCE.

1. Gnanathasan, C. A.,Abdullah, J.,Achike, F. I.(2012).Promoting Students' Acceptability: A Survey of Examinees (Students) and Examiners (Faculty) Perception of OSCE in a Malaysian Medical School.Journal of Medical Education,16(1),9-12.
   連結：
2. 張博彥、謝正源、王如娥、沈振庭、高森永、張聖原、何善臺(2007)。以標準化病人評估實習醫學生於急診醫學之臨床能力。醫學教育，11(1)，27-38。
   連結：
3. 劉克明、黃裕勝(2003)。應用英美醫學生臨床技能測驗模式落實臺灣醫學生臨床技能測驗評估。醫學教育，7(1)，15-21。
   連結：
4. Barratt, J.(2010).A focus group study of the use of video-recorded simulated objective structured clinical examinations in nurse practitioner education.Nurse Education in Practice,1(3),170-175.
5. Barry, M.,Noonan, M.,Bradshaw, C.,Tighe, S. M.(2012).An exploration of student midwives' experiences of the Objective Structured Clinical Examination assessment process.Nurse Education Today,32(6),690-694.
6. Brosnan, M.,Evans, W.,Brosnan, E.,Brown, G.(2006).Implementing objective structured clinical skills evaluation (OSCE) in nurse registration programmes in a centre in Ireland: A utilisation focused evaluation.Nurse Education Today,26(2),115-122.
7. Clarke, S.,Rainey, D.,Traynor, M.(2011).Using the Objective Structured Clinical Examination (OSCE) to assess orthopaedic clinical skills for the registered nurse.International Journal of Orthopaedic and Trauma Nursing,15(2),92-101.
8. Harden, R. M.,Stevenson, M.,Downie, W. W.,Wilson, G. M.(1975).Assessment of clinical competence using objective structured examination.British Medical Journal,1,447-451.
9. Hodges, B. D.(2006).The objective structured clinical examination: Three decades of development.Journal of Veterinary Medical Education,33(4),571-577.
10. Hodges, B.,Regehr, G.,Hanson, M.,McNaughton, N.(1997).An objective structured clinical examination for evaluating psychiatric clinical clerks.Academic Medicine,78(2),715-721.
11. Jones, A.,Pengram, A.,Fordham-Clarke, C.(2010).Developing and examining an objective structured clinical examination.Nurse Education Today,30(2),137-141.
12. Martensson, G.,Lofmark, A.(2013).Implementation and student evaluation of clinical final examination in nursing education.Nurse Education Today,33(12),1563-1568.
13. Newell, P.,Burnard, P.(2006).Introduction to Nursing Research: Incorporating Evidence Based Practice.London:Blackwell.
14. Rushforth, H. E.(2007).Objective structured clinical examination (OSCE): Review of literature and implications for nursing education.Nurse Education Today,27(5),481-490.
15. Ryan, S.,Stevenson, K.,Hassell, A. B.(2007).Assessment of clinical nurse specialists in rheumatology using an OSCE.Musculoskeletal Care,5(3),119-129.
16. Selim, A. A.,Ramadan, F. H.,El-Gueneidy, M. M.,Gaafer, M. M.(2012).Using objective structured clinical examination (OSCE) in undergraduate psychiatric nursing education: Is it reliable and valid?.Nurse Education Today,32(3),283-288.
17. Smith, V.,Muldoon, K.,Biesty, L.(2012).The objective structured clinical examination (OSCE) as a strategy for assessing clinical competence in midwifery education in Ireland: A critical review.Nurse Education in Practice,12(5),242-247.
18. Varky, P.,Natt, N.(2007).The objective structured clinical examination as an educationl tool in patient safety.The Joint Commission Journal on Quality and Patient Safety,33(1),48-53.
19. Walsh, M.,Bailey, P. H.,Koren, I.(2009).Objective structured clinical evaluation of clinical competence: an integrative review.Journal of Advanced Nursing,65(8),1584-1595.
20. 陳玉枝(2010)。護理人員應具備的專業核心能力。護理雜誌，57(5)，12-17。
21. 廖淑娟、陳仲達、葉建宏、葉炳強(2011)。以客觀結構式臨床考試來評量七年級醫學生的醫病溝通技能。臺灣醫學，15(4)，356-363。

1. 蔡宜蓉,黃怡真,姚亭羽,林佳樺,李雅文(2021)。運用客觀結構式臨床測驗於加護病房新進護理人員臨床技能－表現評估：前驅研究。彰化護理，28(4)，29-37。
2. 簡淑慧、劉英妹、趙莉芬、黃湘萍、倪麗芬、王瑜欣(2017)。建構及檢測護理客觀結構式臨床技能測驗考題之信效度、鑑別度及難易度。護理雜誌，64(6)，67-76。
3. 魏麗香、葉蕙芳、梁維麗、張憶茹、徐慧雯、李佳蓉(2017)。導入客觀性結構式臨床測驗降低新進護理人員給藥錯誤發生率。健康科技期刊，4(1)，65-85。
4. 葉家舟,陳建霖,陳建仲,柯建新,沈炫樞(2019)。以客觀結構臨床測驗評估中醫實習醫學生中醫實習之學習成效。中醫藥研究論叢，22(1)，255-263。