運用擬真情境教學結合翻轉教學於膀胱化學灌注照護技術之教學成效

The Educational Effectiveness of Combining Simulation Scenarios with Flipped Teaching in Bladder Chemical Instillation Care Techniques

10.6582/JTSSH.202212_9(2).0002

黃喬伶(Chiao-Ling Huang)；莊子葳(Tzu-Wei Chuang)；謝佳君(Chia-Chun Hsieh)；王維那(Wei-Na Wang)

膀胱化學灌注 ； 擬真情境 ； 翻轉教學 ； Bladder Chemical Instillation ； Simulation Scenarios ； Flipped Teaching

台灣擬真醫學教育期刊

9卷2期（2022 / 12 / 01）

24 - 35

繁體中文;英文

背景與目的：這個教案因應對新冠疫情調整病房以適應泌尿科的新需求。膀胱癌是泌尿科常見的惡性疾病，其中一種治療方法是膀胱灌注化學藥物，適用於未深度侵犯肌肉層的情況。在執行這項技術時護理師可能面臨技巧不熟練和緊張，步驟可能出錯，且護理指導不足，可能導致化療藥物滲漏至皮膚，甚至引發組織壞死等不良副作用。因此，本研究旨在透過模擬情境教學來提高護理師在正確執行膀胱化學灌注護理技術方面的能力，並研究這種教學模式對提升護理師在這一技術領域的知識和自我效能的效果。研究方法：本研究採單組前後測類實驗設計，於2023年7月1日至7月16日共收案36位護理師，研究介入措施包括「膀胱化學灌注照護技術」的翻轉與擬真教學，以比較執行膀胱化學灌注照護技術的知識與自我效能之前後變化。研究結果：教案介入後，護理師執行膀胱化學灌注照護技術的平均知識得分由83.6分提升至92.5分，呈顯著差異（p<0.01）；護理師在執行前檢視、備齊用物、執行過程和護理指導之自我效能分數也有顯著提升（p<0.01）。結論：本研究運用擬真情境及一站技能測驗執行多元評量，有效提升護理師執行膀胱化學灌注照護技術的能力與自信心。整體課程滿意度高達94.8%，在質性回饋中，多數學員表示此教學模式能增加臨場感，建議將其用於新進人員的培訓。

Objective: Bladder cancer is a prevalent malignancy within the urinary system. Bladder instillation of chemical drugs is a treatment method for cases that haven't deeply invaded the muscular layer. However, nurses often lack proficiency and confidence in this technique, leading to improper execution and incomplete guidance, resulting in adverse effects like skin extravasation and tissue necrosis. This study aims to enhance nurses' proficiency and confidence in bladder chemical instillation care through simulation-based training, evaluating its effectiveness. Methods: Using a single-group pre-posttest quasi-experimental design, we enrolled 36 nurses between July 1th and July 16th, 2023. The intervention included flipped teaching and simulation-based training for 'bladder chemical instillation care techniques.' The study assessed the changes in knowledge and self-efficacy before and after the intervention. Results: Following the intervention, nurses' average knowledge scores significantly increased from 83.6 to 92.5 (p<0.01). Their self-efficacy levels in pre-inspection, material preparation, execution, and guidance also improved(p<0.01). Conclusion: This study employed simulation scenarios and structured clinical skill assessments, effectively improving nurses' competence and confidence in bladder chemical instillation care. With a high overall course satisfaction rate of 94.8%, participants appreciated the increased realism and recommended the teaching model for new staff training.