探討遊戲教學輔以OSCE對新進學員評估病人意識狀態及處置成效

Exploring the Effectiveness of Game-Based Teaching Augmented with OSCE on Novice Learners' Assessment and Management of Patient Consciousness State

10.6582/JTSSH.202212_9(2).0004

王靜慧(Jing-Huei Wang)；徐富美(Fu-Mei Hsu)；郭麗玲(Li-Ling Kuo)；陶菁(Tao Ching)；陳乃瑗(Nai-Yuan Chen)；陳佳婉(Chia-Wan Chen)；盧怡萍(I-Ping Lu)；蘇敬惠(Ching-Hui Su)

意識狀態 ； 客觀結構式臨床測驗 ； 遊戲教學 ； Conscious State ； Objective Structured Clinical Examination ； Game-Based Teaching

台灣擬真醫學教育期刊

9卷2期（2022 / 12 / 01）

47 - 59

繁體中文;英文

背景與目的：意識狀態（GCS與瞳孔反應）是種客觀可靠的評估工具，用於描述頭部創傷病人意識受損程度，是新進學員基本且重要的專業技能。本研究導入遊戲教學與客觀結構式臨床測驗（OSCE）來指導新進學員，評量學員對意識狀態評估、團隊溝通技巧、關懷與維護病人安全之專業能力，以探討教學成效。研究方法：採用單組前後測實驗，於2023年3-5月針對到職第二個月新進學員31名，引導每位學員參與意識狀態評估之遊戲教學後，接受OSCE訓練與回饋檢討。本研究利用自擬問卷了解學員對OSCE感受，並透過成對t檢定比較知能與行為趨向程度之差異。研究結果：分析31名學員測驗結果，在知能後測之總成績有明顯進步（86.13±9.1 VS 90.32±8.36, p=.000），且在臨床表現上，藉由行為趨向量表檢測，在教學技巧介入後各分項皆有顯著上升（p<.05）。本研究進一步將OSCE評量結果，進行學員學習診斷分析出6種類型，提供臨床教師依其屬性執行個別性教學。結論：藉由遊戲教學結合OSCE教學教案設計，可增進學員學習動機與興趣，並有效提升學員對於意識狀態評估與處理之能力，作為臨床教學方案設計之參考。

Objective: Consciousness status assessment (GCS and pupil reactions) is a reliable and objective tool used to evaluate the extent of impaired consciousness in patients with head trauma. It is a fundamental and professional skill for new nurse. This study incorporates game-based pedagogy and OSCE to provide guidance, evaluating learners' proficiency in consciousness state assessment, team communication, caring, and patient safety maintenance, aiming to explore the effectiveness of the instructional approach. Methods: A single-group pre-post-test experiment was conducted from March to May 2023, involving 31 participants in their second month of employment. After participating in game-based teaching on consciousness state assessment, each learner underwent OSCE training and received feedback. A self-designed questionnaire was used to understand participants' perceptions of the OSCE, and paired t-tests were employed to compare differences in cognitive and behavioral tendencies. Result: Analysis of the test results for the 31 participants revealed a significant improvement in the total scores of cognitive post-tests (86.13±9.1 vs. 90.32±8.36, p=.000). In clinical performance, detected through the behavioral tendency scale, significant improvements were observed in all subcategories after the intervention of teaching techniques (p<.05). The study further categorized the OSCE assessment results into six types, providing clinical instructors with insights for individualized teaching based on learner attributes. Conclusion: Integrating game-based teaching with OSCE instructional design enhances learner motivation and interest, effectively improving new nurses' abilities in consciousness state assessment and management. This approach can serve as a reference for designing clinical teaching programs.