基礎看護学実習IIの評価と課題

基礎看護学実習における効果的な実習展開方法を明らかにすることを目的に,実習目標の達成度と実習目標に関連する要因を検討した.1)実習目標の達成度は,高い順に「健康障害とそれに伴う生活の変化の理解」,ついで「日常生活援助の実施と評価」,「看護上の問題の明確化・看護計画の立案」であった.2)実習中の悩み体験は約9割,実習環境に関連した困難点は約3割の学生があったとしていた.その具体的な内容は,患者との関係作りや患者とのコミュニケーション,自分の知識や技術の不足,援助の方法,実習日程や実習記録,自己の性格や行動傾向に関する内容であった.3)「日常生活援助の評価」の行動目標は実習中の悩み体験と,「適切な情報収集の実施」の行動目標は実習環境に関連した困難点と有意に関連していた.4)「健康障害とそれに伴う生活の変化の理解」と「看護上の問題の明確化・看護計画の立案」の実習目標は,患者とのコミュニケーションの達成度と有意に関連していた.以上のことから,実習指導においては,実習中の悩みや困難点になりうる患者-看護学生関係に着目し,患者と良好な関係が成立するようコミュニケーションを中心とした支援が必要であることがわかった.また,学習課題や実習日程の検討の必要性が明らかとなった

早期体験学習としての基礎看護学実習の学習効果と実習満足度に関連する要因

Fundamental nursing practice, the first step of clinical practice, is important for nursing students to facilitate their early, gradual introduction to clinical practice. As part of this fundamental nursing practice, first-year students have been exposed to nursing practice on one day in June for the past 4 years. Factors related to the effects of this early exposure of students to fundamental nursing practice on their learning and levels of satisfaction with this style of clinical practice were investigated based on their self-evaluation. 1) Students\u27 relevant experiences before entering the college included admission to a hospital (31.6%) and one-day nursing experience (48.8%). 2) Nursing roles they had successfully observed included monitoring/recording/reporting, understanding the patient, daily life support, ensuring security and safety, environmental adjustment, respecting the patient\u27s independence, empathizing with the patient, assistance during treatment, mental support, cooperating with other professions, and guiding the patient. 3) The achievement levels of the practice goals "to observe the site of nursing practice" (p<0.01) and "to observe nurses actively performing duties" (p<0.05) were significantly correlated with students\u27 satisfaction levels. 4) The effectiveness of prior study or individual guidance on self-defined targets, an orientation held in the ward, and observation of nurses in service had significantly affected students\u27 satisfaction levels. A student\u27s success in understanding a nurse\u27s roles in the practice was significantly correlated with his/her satisfaction level. 5) An effective commitment of the tutor nurse to students\u27 learning had a significant impact on their satisfaction levels. 6) Students\u27 attitudes toward the clinical practice, such as viewing it as preferable, interesting, or wanting to be a nurse, were significantly correlated with their satisfaction levels. 7) Providing students with an opportunity to communicate with patients in the practice was significantly correlated with their satisfaction levels. These findings suggested that students viewed their early exposure to nursing practice as a valuable learning experience, and used it to develop themselves and prepare for the future. Since their interest in the clinical practice promotes their willingness to learn nursing, it is necessary to help them feel positive about the practice. Besides the importance of cooperation between clinical workers including the tutor nurse and teaching staff, and their explanations to students about the practice goals and levels, there is a need for those involved in teaching to review the practice contents. The necessity of appropriately designing the contents to facilitate students\u27 communication with patients was also suggested