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

Application the Objective Structured Clinical Examination on New Nurses' Clinical Skills in the Intensive Care Unit: A Pilot Study

10.6647/CN.202112_28(4).0007

林佳樺(Chair-hua Lin)；黃怡真(Yi-Chen Huang)；李雅文(Ya-Wen Lee)；蔡宜蓉(Yi-Jung Tsai)；姚亭羽(Ting-Yu Yao)

客觀結構式臨床測驗 ； 加護病房新進護理人員 ； Objective Structured Clinical Examination (OSCE) ； new nursing staff from intensive care units

彰化護理

28卷4期（2021 / 12 / 01）

29 - 37

繁體中文

研究問題與目的：加護病房病人疾病嚴重度高，護理人員需具備充足的臨床知識與技能，以應付複雜度高且具挑戰性的加護病房工作。本研究目的為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之評估，使其在照護病人前，可在模擬且安全的情境下學習，協助新進護理人員順利銜接臨床照護。研究方法：採前驅研究，於2019年5月至7月針對4位加護病房新進護理人員，在其接受訓練之前後，依據臨床常見技術進行OSCE教學測驗，內容包含一項知識層面、六項技術技能。資料以描述性統計進行分析。研究結果：4位加護病房新進護理人員於訓練後的測驗結果顯示知識層面分數由平均80分提升至100分、六項技術平均得分由90.2分提升至93.6分。透過客觀結構式臨床測驗，四名加護病房新進護理人員學習表現有顯著提升，以階段性時間的技術測驗及回饋，可讓新進護理人員更快了解臨床技能及可能遇見之情境。建議：研究結果可作為未來各單位新進護理人員教學發展與推動OSCE之參考，並建議可依臨床護理技術之難易度進行教育時程規劃。

Objective: Patients in the intensive care unit have a high degree of disease severity, nurses need to have sufficient clinical knowledge and skill to cope with the complex and challenging work in the intensive care unit. The purpose of this study is to apply the Objective Structured Clinical Examination (OSCE) to improve the clinical skill of new nurses in intensive care unit, provide safe learning environment in simulation to the new nurses before taking care of patients, and assist new nurses to smoothly connect to clinical care. Methods: We implemented a prospective study, which 4 new nursing staff from intensive care units were involved from May to July in 2019. OSCE which contained dimensions of knowledge and nursing 6 techniques was executed before and after intensive care training. Descriptive statistics was applied to data analysis. Results: Both of the mean scores of knowledge and nursing techniques were increased from after the OSCE re-examination. Through OSCE, the learning performance of the four new nurses in the intensive care unit has been significantly improved. Recommendations: The study results provide a reference for the teaching development for new nursing staff training and the promotion of OSCE in the future. We recommended that the education schedule can be planned according to the difficulty of clinical nursing techniques.

1. 王秀禾,孫嘉玲,陳美慧,洪兆嘉,周培萱,賴玉敏,陳櫂豐(2015)。客觀性結構式臨床測驗（OSCE） 應用於護理系課程之成效。技術及職業教育學報，6(2)，1-15。
   連結：
2. 張憶茹,梁維麗,李佳蓉,魏麗香,徐慧雯,葉蕙芳(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。
   連結：
3. 葉明珍(2007)。應屆畢業護生進入職場前預期工作壓力與企盼資源。弘光學報，51，37-50。
   連結：
4. Almuqdadi, A.,Yousef, A. M.,Khalil Majdalawi, Z. M.,Kalabani, R.,Al-Hadeed, H.(2017).Validation and evaluation of an OSCE in undergraduate Doctor of Pharmacy program.Indian Journal of Pharmaceutical Education and Research,51(3),380-387.
5. Fouad, S.,Gouda, E.,Nasser, A. A.,Kamal, D.(2019).Perception of Students, Staff and Simulated Patients towards Objective Structured Clinical Examination (OSCE).Education in Medicine Journal,11(2)
6. Lee, K. C.,Ho, C. H.,Yu, C. C.,Chao, Y. F.(2020).The development of a six-station OSCE for evaluating the clinical competency of the student nurses before graduation: A validity and reliability analysis.Nurse education today,84,104247.
7. Ryan, S.,Stevenson, K.,Hassell, A. B.(2007).Assessment of clinical nurse specialists in rheumatology using an OSCE.Musculoskeletal Care,5(3),119-129.
8. Saunders, A.,Say, R.,Visentin, D.,McCann, D.(2019).Evaluation of a collaborative testing approach to objective structured clinical examination (OSCE) in undergraduate nurse education: A survey study.Nurse education in practice,35,111-116.
9. 江如萍(2009)。因材施教─OSCE首次運用在新進護理人員訓練。志為護理─慈濟護理雜誌，8(4)，64-65。
10. 利怡慧,陳美惠,陳保佑,陳淑華,周嫚君,江明珠(2018)。運用人因工程客觀結構式臨床測驗作業流程之專案。高雄護理雜誌，35(1)，57-69。
11. 柯雅婷,郭麗玲,吳貞鋆,黃惠暄,江惠英(2018)。以擬真學法提升新進護理人員輸血反應處置與交班技巧之學習成效探討。J-TSSH，5(1)，25-34。
12. 財團法人醫院評鑑暨醫療品質策進會(2020)．108年度醫院緊急醫療能力分級評定基準及評分說明與評量．取自: https://www.jct.org.tw/lp-147-1-xCat2-2019.html
13. 張文蕙,謝素英,許麗齡(2014)。運用客觀結構式臨床測驗以評量出院準備護理人員溝通能力之研究。護理雜誌，61(3)，45-57。
14. 蔡麗紅(2018)。實施〔客觀結構式臨床技能測驗─整合型長站設計〕．於護理系臨床實作組之實驗。長庚科技學刊，28，29-45。
15. 鄭景耀,吳明芬,劉文雄(2018)。藥學客觀結構式臨床測驗（OSCE）教案設計實務。臺灣臨床藥學雜誌，26(4)，251-257。
16. 鄧喬鳳,張光喜,吳碧珠,夏珊,張瑛瑛,劉雅絃(2014)。應用客觀結構式測驗課程提升護理臨床教師教學評量之一致性。榮總護理，31(3)，265-275。

1. (2024)。提升護理人員執行灼傷病人水療作業完整性。健康科技期刊，10(2)，41-52。