[[alternative]]A Study on the Use of Objective Structured Clinical Examination for Communication Competency Assessment for Nurses

[[abstract]]本研究旨在探討出院準備情境模擬溝通教學介入後，護理人員之溝通能力、溝通自我效能、客觀結構式臨床測驗評量與學習滿意度之成效探討。採實驗性研究設計(experimental design)，以台北市某醫學中心N0~N2護理人員為研究對象，共78人；實驗組40人接受情境模擬溝通教學課程，控制組38人採傳統課室案例討論教學；研究工具包括：溝通能力查檢表、溝通自我效能評量表、學習滿意度問卷及客觀結構式臨床測驗評量(出院護理指導查核表及標準化病人回饋表)。在教學課程介入前後，兩組皆接受前後測，介入後4週進行客觀結構式臨床測驗評量。以SPSS17.0電腦統計套裝軟體進行資料分析，包括描述性統計分析(次數分配、百分比、平均數與標準差)及t-tests、ANCOVA、Mann-Whitney test等統計方法。研究結果顯示：(一)溝通教學介入後，控制組與實驗組於溝通能力查檢表及溝通自我效能評量表前後測得分有顯著差異。(二)溝通教學介入後，控制組與實驗組於溝通能力查檢表及溝通自我效能評量表得分有顯著差異，且實驗組高於控制組。(三)溝通教學介入後，控制組與實驗組於學習滿意度得分有顯著差異，且實驗組高於控制組。(四)溝通教學介入後，控制組與實驗組於客觀結構式臨床測驗評量之考官評量得分有顯著差異，且實驗組高於控制組；但標準化病人評量得分無顯著差異。未來研究建議可將客觀結構式臨床測驗評量擴大至其他依實務設計不同情境教案之護理能力評量，並可進行長期追蹤及質性研究。[[abstract]]This study evaluated the effectiveness of a simulation-based intervention on enhancing nurse communication performance and communication self-efficacy in discharge planning process. The effects of the intervention on the results of an Objective Structured Clinical Examination (OSCE) assessment and a learning satisfaction survey administered to nurses were also evaluated. In this experimental design study, a total of 78 nurses within the nursing ladder N0-N2 were recruited from a major hospital in Taipei City. The experimental group (40 nurses) was given the simulation-based intervention. 38 nurses in the control group attended traditional lectures on communication. The Communication Skills Checklist, Communication Self-Efficacy Scale, Learning Satisfaction Survey, and OSCE (Discharge Checklist for Nurses and Standardized Patient Survey) were used as assessment tools for communication performance and learning satisfaction evaluation. Both groups were measured before and after the intervention. The OSCE was administered to both groups in the fourth week of intervention. Data were analyzed using SPSS 17.0, descriptive statistics (frequency distribution, percentage, mean, and standard deviation), t-tests, ANCOVA, and Mann-Whitney test. Results revealed (1) the mean scores for communication skills and communication self-efficacy for both groups showed statistically significant differences before and after intervention. (2) Significantly higher mean scores for communication skills and communication self-efficacy were seen in the experimental group compared with the control group. (3) Significant differences were found in the mean learning satisfaction scores for both groups before and after intervention, with the experimental group having higher scores. (4) Significant differences were found in mean OSCE scores for both groups before and after intervention, with the experimental group having higher scores. However, no significant differences were found in mean assessments scores from standardized patients. Further long-term follow-up or qualitative research may be conducted to investigate the use of OSCE for other types of nursing competency assessment

A Creative Approach to Teaching Diabetic Foot Examinations

[[abstract]]足部病變是糖尿病常見的慢性併發症，也往往是病人必須住院治療的主要原因之一。正確且完整的執行糖尿病患足部檢查，可以延緩或減少足部病變的機率，進一步也能降低截肢與死亡的發生率。為提升護理師學習「足部檢查」步驟及工具應用之學習成效，使其能熟練的運用於臨床工作提升照護品質，本文呈現運用「曼陀羅思考法」及「心智圖」等創意思考技法，將教學內容進行擴散思考及檢核分析，找出可行教學策略；並以「口訣」及「圖像記憶」創意教學法，來協助護理師對「糖尿病足部檢查」技術流程之學習，進而執行正確的足部檢查以預防糖尿病人的足部病變發生。 Foot infections are a common chronic complication and a major reason for hospitalization in patients with diabetes. Performing foot examinations correctly and thoroughly may reduce diabetic foot risks and save patients from amputation and death. To assist professional nurses to learn the procedures and tools involved in foot examination, this study proposes that nurse trainers use creative thinking methods, such as those of Mandala, and mind mapping to conduct divergent thinking and analysis of training content define feasible training strategies. This study also proposes the use of rhymes and graphics such as creative mnemonics to help professional nurses expedite their learning of foot examination and preventive foot care techniques

台灣旅遊行為與旅遊動機及工作績效之研究

[[abstract]]本研究旨在探討在職人員其旅遊動機、旅遊行為與工作績效的相互影響。採問卷調查方式，對象與範圍為清泉崗機場與桃園國際機場，調查近年來在職人員旅遊經驗者，有效問卷共得312份。研究結果發現： 1. 不同性別的在職人員在旅遊動機及工作績效中沒有顯著差異，在旅遊行為中有部份顯著差異。 2. 不同年齡的職業人員在旅遊動機中沒有顯著差異，在旅遊行為、工作績效中有部份顯著差異。 3. 不同教育程度的在職人員在旅遊動機中沒有顯著差異。在旅遊行為、工作績效中有部份顯著差異。 4. 不同職業的在職人員在旅遊動機中、工作績效沒有顯著差異。在旅遊行為中有部份顯著差異。 5. 不同年資的在職人員在旅遊動機中沒有顯著差異。在旅遊行為、工作績效中有部份顯著差異。 6. 不同收入的在職人員在旅遊動機中沒有顯著差異。在旅遊行為及工作績效中有部份顯著差異。 7. 台灣地區在職人員之旅遊動機與旅遊行為有部份顯著差異。 8. 台灣地區在職人員之旅遊行為與工作績效有部分顯著差異

The Use of OSCE to Evaluate the Competency of Discharge Nurses

[[abstract]]Background: Clear directions and explanations from nurses related to health behaviors and discharge procedures have been shown to effectively reduce the risk of patient readmission. Nurses thus need to develop good communication skills in order to ensure that their communications help patients become better-informed and less anxious about discharge procedures. Purpose: This research evaluates the communication skills of nurses following two different education interventions. Methods: Experimental design principles for education interventions were followed in this research. Medical nurses certified at the N to N2 level in a municipal hospital in Taipei City were enrolled as participants (N = 78) and divided into an experimental group and control group using stratified purposive randomization. The experimental group received clinical scenario-based simulation education for communication. The control group received standard class-based education for communication. Both groups received a pre-test evaluation and an OSCE post-test evaluation. Results were analyzed using SPSS 17.0 software. Results: Independent t-test results revealed significant increases in communication skills (t = 3.406, p ＜ .05) in both groups, with the increase in the experimental group (M = 5.00, SD = 0.82) significantly greater than the increase in the control group (M = 4.11, SD = 1.41). However, the mean scores from the post-test standardized patient survey found no significant differences between the two groups in terms of communication skills. Conclusion: The results indicate that the clinical scenario-based simulation education intervention is more effective than traditional class-based education in enhanc\ng the communication skills of nurses