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

Applying the Clinical Reasoning Educational Model to Promote Critical Thinking Disposition in Undergraduate Nursing Students

10.6847/TJPMHN.202308_18(1).03

徐瑩媺(Ying-Mei Shu)

批判思考意向 ； 臨床推理 ； 精神科護理學 ； Critical thinking disposition ； clinical reasoning ； psychiatric nursing

精神衛生護理雜誌

18卷1期（2023 / 08 / 01）

14 - 23

繁體中文;英文

背景：批判思考技能是護理人員照護病人中必要的能力，而批判性思考意向是批判思考技能的先決條件，惟批判思考意向之學習介入後相關學習成效，以及影響因素之研究闕如。因此，本研究目的在探討運用臨床推理教學模式對護理系大學生的批判思考意向之成效及影響因素。方法：本研究採類實驗單組前後測之研究設計，收案對象是技職院校護理系四技三年級49位學生，使用臨床推理教學模式於精神科護理學課程，以「批判思考意向量表」為成效評量工具，資料分析應用獨立樣本t、成對樣本t和SPSS 28版統計軟體。結果：護理系大學生經過臨床推理教學後可提升學生的批判思考意向（p<.05），其中系統性與分析力（p<.005）與整體與反省（p<.05）有進步，達顯著差異，而心胸開放和智識好奇心有進步，未達顯著。結論：實施臨床推理教學可以刺激學生應用先備知識，正面影響學生的批判思考意向，本教學模式可做為實施批判思考教學的參考。

Background: Critical thinking skills are a key professional competency for nurses and critical thinking disposition is the prerequisite for critical thinking skills. However, studies research on the effectiveness of clinical reasoning interventions and its factors are limited. This study explored the effectiveness of and influencing factors in the clinical reasoning model for the critical thinking disposition of undergraduate nursing students. Methods: This study adopted a quasi-experimental one-group pretest and posttest research design and used the Critical Thinking Disposition Scale to assess outcomes. This study recruited 49 third-year students from the nursing department of a technical vocational college. Data were analyzed using independent-sample t tests and paired t tests implemented using SPSS for Windows (Version 28). Results: Implementing the clinical reasoning teaching model improved the critical thinking disposition of the nursing students (p < .05), including with respect to their systematicity and analyticity (p < .005) and their overall introspection (p < .05). The students' open-mindedness and inquisitiveness improved nonsignificantly. Conclusions: Through the clinical reasoning teaching model, students can apply prior knowledge, which positively affects their critical thinking disposition. This teaching model can serve as a reference for the implementation of critical thinking teaching.

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