編輯的話：護理教育的挑戰與省思

Editorial Remarks: Challenges and Reflections on Nursing Education

10.6847/TJPMHN.202308_18(1).01

蕭秋月(Chiu-Yueh Hsiao)

精神衛生護理雜誌

18卷1期（2023 / 08 / 01）

2 - 4

繁體中文;英文

資訊科技的快速發展和日新月異的醫療新知對於健康照護的提供模式及臨床實務的人力需求產生顯著影響。護理人員的專業角色功能除了必備的臨床技能外，更需要專業的知識、問題解決及批判性思考等能力，並能善用團隊資源與其他專業人員協同合作。常見的傳統護理教學策略包括課堂講授、示範教學、專題演講、研討會或工作坊。護理教育透過多元與創新的教學策略（如：問題導向學習、臨床推理教學模式、情境模擬），以自我導向的學習方式，引導學習者將習得的知能融入於臨床實務，提升學習動機，增進同儕間的討論與團隊合作，進而發展終身學習的能力。本期總共收錄了一篇專欄稿、兩篇研究稿、一篇專案以及一篇個案報告。本期專欄為「以病人為中心的照護實踐－真人圖書於精神衛生護理教育之應用」，感謝國立台北健康大學護理系魏秀靜副教授應邀撰寫。該文闡述如何藉由真人圖書館為一種教學策略，讓學生透過與真人圖書互動對話，以病人為師，瞭解病人的需求和經驗；提升學生同理心、文化敏感度和專業團隊間的協同合作能力，並提供以病人為中心的照護（魏，2023）。本期有兩篇研究稿，皆為量性研究。徐瑩媺（2023）在其「運用臨床推理模式促進護理系大學生批判思考意向：以精神科護理學課程為例」研究中，探討運用臨床推理教學模式對護理系學生的批判思考意向之成效及影響因素；採類實驗單組前、後測之研究設計。研究結果顯示，護理學系學生之護理專業成績表現優良，自認邏輯能力良好及對護理有興趣者，其批判性思考意向較佳；臨床推理教學對護理系學生批判思考意向有正向效果。另外，運用臨床推理教學模式可提升護理學系學生的批判思考意向，尤其是系統性與分析力和整體與反省思考。建議透過臨床推理教學模式融滲護理專業課程，可做為培養學生批判性思考意向能力之教學策略。另一篇研究稿為「精神科醫療從業人員對新冠肺炎防護知識、態度與意識關聯探討」，葉佳佑等人（2023）發現當精神科醫療專業人員照顧疑似或確診新冠肺炎時，產生焦慮及壓力的情緒反應；整體防護態度呈正向且以女性態度較正向。另外，良好的防護意識時易有較正向的防護態度。本期所收錄的專案，「提升精神科急性病房護理師急救處置能力的改善專案」中，劉雅惠等人（2023）運用製作急救用物圖片、修訂急救車查檢表、製作急救教學影片、舉辦情境模擬與團隊資源管理教育訓練，成功改善護理人員急救處置正確率、急救流程熟悉度和急救用物之正確辨識。此專案所擬訂的急救情境模擬與團隊資源管理教學可提供傳統護理臨床教育急救訓練之參考。在「運用正念認知療法於一位雙相情緒障礙症鬱症發作個案之護理經驗」的護理個案報告中，照護對象為一位雙相情緒障礙症鬱症發作的男性個案。個案因婚姻問題及經濟壓力，反覆出現自殺意念及企圖而住院治療。照護期間，除了與個案建立與其建立治療性人際關係外，運用簡式健康量表（Brief Symptom Rating Scale，簡稱BSRS-5）評估個案情緒困擾程度，並協同心理師指導個案分別運用正念認知療法（Mindfulness-Based Cognitive Therapy; MBCT）因應壓力源和蘇格拉底法駁斥非理性信念，找尋內外在資源並擴展壓力調適的生活。另外，藉由病房Line視訊關懷，觀察個案於出院後在工作表現、家人相處和因應能力方面皆有改善（李、許、翁，2023）。護理教育與護理專業發展緊密相關。因應人工智慧與相關科技的研發（如：聊天機器人）與實證護理的發展，傳統護理教育模式亦須隨著健康照護和科技的躍進而改革，以提升護理專業知能及改善臨床照護品質。因此，如何運用資訊科技的創新教學與現今或未來的護理專業發展接軌，發展創新教學策略及跨領域合作模式實為一重要的護理專業發展議題。

The rapid development of information technology and advancements in medical knowledge have considerably influenced the models of health care delivery and the demand for clinical practitioners. In clinical practice, nursing personnel are required to have fundamental clinical skills, professional knowledge, problem-solving and critical thinking abilities, and the ability to leverage team resources and collaborate with other health care professionals. Conventional nursing education strategies include course teaching, demonstration, lectures, seminars, and workshops. Nursing education combines diverse and innovative teaching strategies (e.g., problem-based learning, clinical-reasoning teaching models, and simulation) with self-directed learning methods to guide students in applying nursing knowledge to clinical practice, thereby increasing learning motivation, encouraging peer discussion and teamwork, and ultimately facilitating the development of lifelong learning skills. This volume features a column, two research papers, a project report, and a case study report. The column, titled "Patient-Centered Care: Implementation of Human Library in Psychiatric Mental Health Nursing Education," was written by Associate Professor Wei, Shiow-Jing from the School of Nursing at National Taipei University of Nursing and Health Sciences, to whom we wish to express our gratitude for accepting our invitation to write. The column explains how human libraries can be used as a teaching strategy. By engaging in dialogue with human books, nursing students can seek guidance from patients regarding their specific needs and experience. This increases empathy and cultural sensitivity among the nursing students; aids in the development of team coordination and collaboration abilities among the professionals; and encourages the delivery of patient-centered health care (Wei, 2023). Both research papers featured in this volume are qualitative studies. One of them is Hsu's (2023) "Applying the Clinical Reasoning Educational Model to Promote Critical Thinking Disposition in Undergraduate Nursing Students," which explored the outcomes and influencing factors of nursing students' development of critical thinking disposition under a clinical-reasoning teaching model. A one-group pretest-posttest research design was employed for the investigation. The results revealed that nursing students who had outstanding academic performance, perceived themselves to be logical thinkers, and shown keen interest in nursing demonstrated stronger critical thinking dispositions. The teaching of clinical reasoning had positive effects on the development of critical thinking dispositions in nursing students. Furthermore, the application of clinical reasoning teaching models enhanced critical thinking dispositions in nursing students, particularly in systematicity and analyticity and their overall introspection. The study recommends integrating clinical reasoning teaching models into nursing professional development courses as a teaching strategy to foster critical thinking dispositions in students. The other manuscript is "Relationship between knowledge, attitude, and awareness regarding COVID-19 prevention among psychiatric health-care professionals" by Ye et al. (2023). They reported that mental health care professionals exhibited anxiety and stress when they provided care for patients suspected of or diagnosed with COVID-19. Overall, these professionals held a positive attitude toward COVID-19 prevention, with female professionals demonstrating a more positive attitude than their male counterparts. Mental health care professionals with adequate COVID-19 prevention awareness were more likely to have a positive attitude toward COVID-19 prevention. In the project report "Improving the emergency management competency of nurse on an acute psychiatric ward," Liu et al. (2023) designed and implemented pictures of emergency supplies, revised the crash cart checklist, made videos on emergency response demonstration, and held training sessions on simulation and team resource management. These measures successfully helped the nursing personnel more accurately implement emergency treatment, familiarized them with the emergency treatment procedures, and improved their ability to recognize the emergency treatment supplies. The emergency simulations and team resource management training devised by the project could provide a basis for developing emergency training in conventional clinical nursing education. In the case study by Li, Syu, and Weng (2023), "Nursing Experience of Administering Mindfulness-Based Cognitive Therapy to a Patient Experiencing Depressive Episode of Bipolar Disorder," the case was a male patient with bipolar disorder experiencing depressive episodes. Due to marital problems and financial stress, the patient repeatedly manifested suicidal ideations and intentions, which ultimately lead to his hospitalization for treatment. During the treatment period, the researchers established a therapeutic relationship with the patient and used the Brief Symptom Rating Scale to assess the patient's emotional distress. The patient, with instructions from the researchers, who worked in coordination with a psychologist, applied a mindfulness-based cognitive therapeutic approach to help the patient cope with the stressors and employed Socrate's rationality to help him cope with irrational feelings. The aim was to enable the patient to access his internal and external resources and adapt to daily stress. The researchers followed up on the patient after hospital discharge through LINE video calls with him and observed improvements in his job performance, interactions with family members, and coping skills. Nursing education is closely related to nursing professional development. The world has seen continuous developments of artificial intelligence and related technologies (e.g., chatbots) as well as advancements in evidence-based nursing research. To keep pace with these developments in health care and technology, conventional nursing education models must be constantly updated to improve nursing students' professional competencies and the quality of clinical care. Accordingly, information technology as an essential component of developing innovative teaching strategies and interdisciplinary collaboration models for the professional development of nurses warrants further investigation.