Flipped Classroom: A New Teaching Strategy for Integrating Information Technology Into Nursing Education

[[abstract]]目前護理教育仍以「教師為中心」的傳統講授的教學模式，無法激發學生的批判性思考及培養自主學習的能力。近年來隨著資訊科技快速發展及教育理念變遷，發展出「翻轉教室」的概念及教學模式，它完全顛覆傳統的教學模式，讓e世代學生透過智慧型手機或平板電腦等資通訊科技工具在課前進行相關學習活動，課堂中增進老師與學生互動機會，藉以激發學生思考、引導解決問題，鼓勵合作學習及活用知識，落實以學生為中心的教育理念，此種以學生為中心的教學模式與護理教育理念及培育學生的專業能力不謀而合。在國際間翻轉教室蔚為潮流之際，國內各領域教育界也開始推動翻轉教室的教學模式，然而翻轉教室不論在國內外護理教育尚在萌芽階段，因此本文說明翻轉教室的概念及推展產生的迷思、國際間醫護教育應用翻轉教室的經驗及面臨議題，以做為國內護理教育未來推動翻轉教室教學策略的參考。 The traditional ＂teacher-centered＂ instruction model is still currently pervasive in nursing education. However, this model does not stimulate the critical thinking or foster the self-learning competence of students. In recent years, the rapid development of information technology and the changes in educational philosophy have encouraged the development of the ＂flipped classroom＂ concept. This concept completely subverts the traditional instruction model by allowing students to access and use related learning activities prior to class on their smartphones or tablet computers. Implementation of this concept has been demonstrated to facilitate greater classroom interaction between teachers and students, to stimulate student thinking, to guide problem solving, and to encourage cooperative learning and knowledge utilization in order to achieve the ideal of student-centered education. This student-centered model of instruction coincides with the philosophy of nursing education and may foster the professional competence of nursing students. The flipped classroom is already an international trend, and certain domestic education sectors have adopted and applied this concept as well. However, this concept has only just begun to make its mark on nursing education. This article describes the concept of the flipped classroom, the implementation myth, the current experience with implementing this concept in international healthcare education, and the challenging issues. We hope to provide a reference for future nursing education administrators who are responsible to implement flipped classroom teaching strategies in Taiwan

三民主義教學研究會第四十三次理監事聯席會議紀錄

[[issue]]8

An Effective Instrument of Clinical Nursing Education-the Electronic Portfolio of Learning Process

[[abstract]]國內護理臨床教育的教學與評量方式存在著許多問題，引起護理教育界重視，例如學習目標、學習活動、學習評量之間缺乏連貫與回饋的機制，是一大隱憂。因此，極需建置學習歷程管理之機制，做為學生由入學至畢業的專業能力學習過程記錄，並兼能改善護理實習課程之間缺乏相關性與連續性的問題，也可以記錄、追蹤及輔導護理系學生在專業核心能力的養成過程，作為教學評鑑及課程改善之依據。由相關研究發現，學習歷程檔案具有記錄學習歷程的功能，未來學生可以將其學習歷程與成果透過雲端技術儲存於公用或私用的學習雲端，成為可攜帶式個人學習檔案，也可延伸成為個人護理專業檔案，學生進入職場後仍可繼續記錄其執業經驗，成為專業履歷，最終達成可攜式專業檔案的目標。 The problems with clinical teaching in current nursing education have caught the attention of many educators. For example, a lack of connection and feedback mechanism among learning goals, activities, and evaluation has been stressed. Thus, there is an urgent need for an effective strategy to manage students' learning process from their entry to the completion of the program and to improve the connection of various core nursing curricula. The literature shows that learning portfolio has demonstrated the positive function of recording the learning process. It can be utilized to document, tract, and assist the students' development of core competence, and to facilitate course evaluation and accreditation. It is hoped that students can manage and store their works and achievements through cloud technology. Furthermore, the learning portfolio can be eventually extended to portable electronic professional portfolios which can record their nursing practice and experiences

Performance analysis of distributed and centralized models for electronic medical record exchanges

[[abstract]]Electronic medical record exchanges can save time and reduce cost by eliminating redundant data and typing errors. The major steps of record exchange consist of querying information from database, encoding data into messages, and sending and decoding messages. Three medical-record-exchange models were proposed in the past, including the distributed, centralized, and indexed models. In this paper, the queuing theory is applied to evaluate the performance of the three models. We estimate the service time for each queue of the CPU, database and network, and predict the response time, probable bottlenecks and system capacities of each model

The Development of an Incident Event Reporting System for Nursing Students

[[abstract]]Incident events may occur when nursing students are present in the clinical setting. Their inexperience and unfamiliarity with clinical practice put them at risk for making mistakes that could potentially harm patients and themselves. However, there are deficiencies with incident event reporting systems, including incomplete data and delayed reports. The purpose of this study was to develop an incident event reporting system for nursing students in clinical settings and evaluate its effectiveness. This study was undertaken in three phases. In the first phase, a literature review and focus groups were used to develop the architecture of the reporting system. In the second phase, the reporting system was implemented. Data from incident events that involved nursing students were collected for a 12-month period. In the third phase, a pre-post trial was undertaken to evaluate the performance of the reporting system. The ASP.NET software and Microsoft Access 2003 were used to create an interactive web-based interface and design a database for the reporting system. Email notifications alerted the nursing student's teacher when an incident event was reported. One year after installing the reporting system, the number of reported incident events increased tenfold. However, the time to report the incident event and the time required to complete the reporting procedures were shorter than before implementation of the reporting system. The incident event reporting system appeared to be effective in more comprehensively reporting the number of incident events and shorten the time required for reporting them compared to traditional written reports

Development and Testing of an Instrument to measure Interactions in Synchronous Distance Education.

[[abstract]]The advance of computer and network technology has made it possible for students to flexibly acquire real-time information through distance education, allowing life-long learning. As in previous studies, the researchers found that students generally experienced less instructional interaction in distance education as compared to the traditional classroom setting. The purpose of this study was to develop and test a reliable and valid instrument to evaluate instructional interactions in synchronous distance education. Based on a literature review and researcher experience, a 36-item interaction scale was developed and administered to 100 students from two different schools. Data were collected and the reliability and validity of the scale were tested. The results showed that the scale had a Cronbach's alpha coefficient of 0.901. Factor analysis was used to test the construct validity and 29 items were extracted and divided into seven different interaction factors. These seven factors explained 72.69 % of the total variance. Furthermore, the results showed that the scale had good internal consistency and construct validity, and would therefore provide an effective and useful tool for evaluating interaction in synchronous distance education. Use of this instrument can help teachers to understand interactions taking place in a synchronous distance education environment and provide guidance for the future development of distance education programs for various disciplines

On the Security Mechanisms for P2P Networks

在點對點網路中，我們使用檔案分享、視訊會議、數位學習、分散式計算、電子商務等應用。然而在點對點網路系統中，仍缺乏安全性的處理而導致會有一些安全性的攻擊。而點對點網路的安全性相關議題有匿名性、認證、可信任模型、安全路由、安全付費機制等等。在本論文中，我們提出四種安全及具效率的機制：(1)一個基於多播之相互匿名點對點檔案分享機制；(2)一個peers之間協助認證機制;(3)可信任點對點推薦系統改進機制(4)一個基於信任值及貢獻度之可任何及避免free riders機制。 在第一個研究主題中，我們針對在要求者及回應者相互匿名需求上，提出一個多播IP為基礎來達到相互匿名之點對點檔案分享機制。為了避免在初始時要求者及回應者就被攻擊並曝光，因此他們會選擇一群可信任的使用者一起加入此次分享。在經過匿名程度、安全性及效率分析後，我們的機制的確可以有效地提供相互匿名的需求。 在第二個研究主題中，我們認為可利用具備高運算能力peers來幫助無法計算複雜處理之低運算能力peers。當低運算能力的使用者需要運算大量資料，如大量的簽章，若有其他的peers來分攤計算花費，將可有效降低其運算時間。因為，在此研究主題，我們提出一peers之間互相協助之認證機制。由具高運算能力的使用者來幫忙分攤低運算能力者的大量簽章運算，藉由我們的機制來加速其運算速度。 在第三個研究主題中，我們著重於安全的點對點推薦系統。點對點推薦系統指得使用者會發送給特定使用者其喜愛的項目推薦值，使用者可參考其值來決定是否要求下載。然而我們無法保證沒有惡意的使用者來偽造、竄改或不正確的資訊來欺騙我們。Jung在2009年提出了一個基於風險發現的可信任機制，但此機制的訊息可能會被不合法的修改或者鄰居之間會有共謀的現象發生。因此我們在此研究主題中，提出一個改進的方法來改進Jung所提出的機制的缺點。除此之外，我們的方法還可以達到不可偽造及不可否認的需求。 我們針對可信任網路及預防freeriders這兩個議題，在最後一個研究主題中，我們提出一個新的可信任點對點網路機制。我們利用貢獻值來確認其使用者是否為freerider。資源要求者及回應者則可利用信任值來決定是否要求下載或者提供檔案。In P2P networks, people use for files sharing, video conference, digital learning, distributed computing, e-commerce, etc. However, the weak security process of current P2P systems may lead to some security attacks. Thus, we need to cosider the security issues such as anonymous, authentication, trust model, secure routing, secure payment system, etc. In this dissertation, we shall propose four secure and efficient schemes for the following research subjects: (1) a mutual anonymity protocol based on multicast for pure file sharing P2P network systems; (2) a peers assisted authentication protocol on P2P networking systems; (3) an improvement trust P2P recommendation system; and (4) a trust and free riders prevention model for P2P networks based on reputation and contribution values. In the first research subject, we focus the mutual anonymity communications mean both the initiator and responder cannot know each other. Hence, we proposed a pure P2P network system with mutual anonymity for file sharing. We use the multicast IP concept to achieve mutual anonymity. In order to prevent the initiator guessed by adversaries if the router that provides the multicast IP compromised by adversaries, the initiator starting the session, it chooses a number of peers to join this multicast group together at the same time. After the anonymity degree, security, performance analysis, our scheme can provide mutual anonymity while still fulfilling essential requirements. For the second research subject, peers with high computational capacity can vastly improve a network''s ability to handle complex computations or transfer large amounts of data. Large signatures generally require large amounts of time for mobile peers to compute. However, if peers are able to share their computational capacity, this processing time can be reduced. In this subject, we proposed a peer assisted authentication scheme for RSA signatures in decentralized peer to peer networks. Our scheme can speed up computation, while still fulfilling essential requirements. For the third research subject, we focus on the secure P2P recommendation networks. In P2P recommendation networks, the peer propagates the recommendation value of the specific item to her/his neighbor who is interest in this item. However, we could not guarantee that there are no malicious peers to provide fraud or adversarial information to fool us. In 2009, Jung proposed a trustworthy knowledge diffusion model on Peer-to-Peer network based on risk discovery. However, the message can be modified and neighbors can collusive during transmission. In this subject, we proposed an improvement method to improve these drawbacks; in addition, our proposed method can achieve the extra requirements of unforgeability and non-repudiation. For the last research subject, we focus on two important security issues: maintaining trusted network and preventing free riders. In subject, we use contribution value to identity who is a free rider. The requester and responder could use the reputation evaluation to decide whether downloading or providing the request file.1 Introduction 1 1.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Research Motivation . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.3 Research Objectives and Major Contributions . . . . . . . . . . . . . 7 1.4 Research Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 1.5 Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 2 Related Work 11 2.1 Anonymity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2.1.1 Anonymity Protocols . . . . . . . . . . . . . . . . . . . . . . . 11 2.1.2 Review Ye et al.''s Scheme . . . . . . . . . . . . . . . . . . . . 13 2.2 Assisted Authentication . . . . . . . . . . . . . . . . . . . . . . . . . 14 2.2.1 Lee et al.''s Protocol . . . . . . . . . . . . . . . . . . . . . . . 14 2.2.2 Hwang et al''s Scheme . . . . . . . . . . . . . . . . . . . . . . . 16 2.2.3 P2P Authentication and Signature Schemes . . . . . . . . . . 17 2.3 Trusted with Recommendation and Reputation . . . . . . . . . . . . 18 3 A Mutual Anonymity Protocol based on Multicast for Pure File Sharing P2P Networks 21 3.1 System Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 3.1.1 Notations and Assumptions . . . . . . . . . . . . . . . . . . . 22 3.1.2 Our Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 3.1.3 CGM and GD Algorithms . . . . . . . . . . . . . . . . . . . . 24 3.2 Analysis of the Proposed Scheme . . . . . . . . . . . . . . . . . . . . 25 3.2.1 Accomplishment of the Requirements . . . . . . . . . . . . . . 25 3.2.2 Security Analysis . . . . . . . . . . . . . . . . . . . . . . . . . 28 3.2.3 Performance Analysis . . . . . . . . . . . . . . . . . . . . . . . 29 4 Peers Assisted Authentication Protocol in P2P Networks 33 4.1 System Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 4.1.1 Notations and Assumptions . . . . . . . . . . . . . . . . . . . 34 4.1.2 Initialization . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 4.1.3 Sending Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 4.1.4 Computing Phase . . . . . . . . . . . . . . . . . . . . . . . . . 37 4.1.5 Deriving Signature Phase . . . . . . . . . . . . . . . . . . . . 37 4.1.6 Batch Verifying Phase . . . . . . . . . . . . . . . . . . . . . . 37 4.1.7 An Example . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 4.2 Analysis of Our Scheme . . . . . . . . . . . . . . . . . . . . . . . . . 39 4.2.1 Analysis of Requirements . . . . . . . . . . . . . . . . . . . . . 40 4.2.2 Security Analysis . . . . . . . . . . . . . . . . . . . . . . . . . 40 5 An Improvement on Trustworthy P2P Recommendation System 44 5.1 Preview of Jung''s Method . . . . . . . . . . . . . . . . . . . . . . . . 44 5.2 The proposed method . . . . . . . . . . . . . . . . . . . . . . . . . . 47 5.2.1 Recommendation �ow . . . . . . . . . . . . . . . . . . . . . . 48 5.2.2 Malicious Peers Detection . . . . . . . . . . . . . . . . . . . . 51 5.3 Analysis and discussion . . . . . . . . . . . . . . . . . . . . . . . . . . 52 5.3.1 Security analysis . . . . . . . . . . . . . . . . . . . . . . . . . 52 5.3.2 Comparison . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 6 A Trust and Free Riders Prevention Model for P2P Networks Based on Reputation and Contribution Values 55 6.1 Our Proposed Method . . . . . . . . . . . . . . . . . . . . . . . . . . 55 6.1.1 Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 6.1.2 Free Rider Decision . . . . . . . . . . . . . . . . . . . . . . . . 57 6.1.3 Responder Decision . . . . . . . . . . . . . . . . . . . . . . . . 58 6.1.4 Update and Feedback . . . . . . . . . . . . . . . . . . . . . . . 59 6.2 Simulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 7 Conclusions and Future Works 64 7.1 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 7.2 Future Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Bibliography 6

The Implementation of Distance Education in Nursing Curriculum "Teaching Principles"

[[abstract]]隨著網際網路的蓬勃發展，透過遠距教學能夠彈性且即時獲得新的資訊，故遠距教學是二十一世紀的重要教學方式。本研究目的為瞭解學生對遠距教學的滿意度，以評估護理課程實施遠距教學的成效。本研究為調查研究法，採用結構式問卷收集135位接受「教學原理」課程實施遠距教學三所學校學生的意見。研究結果發現：(1)學生對遠距教學的「教學內容」及「教學方法」感到最滿意，(2)對「師生互動」及「教學環境與設備」方面滿意度較低，(3)主播端與收播端學生對遠距教學滿意度的差異有六項，包括「上課內容吸引性」、「使用投影片及影片」、「收訊效果」、「影像清晰」、「與教師互動」及「與遠端同學互動」等項目。研究結果顯示：教學互動及教學的環境與設備是影響遠距教學品質的主要問題，這些問題與課程的本 質及授課方式有密切關係。因此未來護理專業課程採用遠距教學時應考量因素有：(1)課程本質及內容是否適合遠距教學，(2)老師是否能設計有效的教學策略，以增進師生互動的機會，(3)運用合宜的遠距教學設備，(4)評估遠距教學品質與設備成本之效益，俾使遠距教學發揮最大的教學效果。 Distance education has become an important format for instruction and training. It offers flexible learning opportunities and is responsive to the needs of a variety of audiences. The purpose of this study was to evaluate the leaching effectiveness of distance education in a required course for BSN students. A cross-sectional survey was designed. One hundred and thirty-five students from three BSN programs participated in the study. A questionnaire was employed for data collection. The results of study indicate that (1) the most satisfactory aspects for the students were items related to the teacher’s teaching styles and course content, (2) the least satisfactory aspects for the students were items related to the equipment required for distance education and the teacher-student interaction, (3) when on-site and off-site students of distance education were compared the satisfaction level for teaching, six items that showed significant differences include content interesting, use videotape, technology effect, image clarity, contact with teacher in class, contact with off-site students. The result of study demonstrated that teacher-student interaction and facilities were primary problems in distance education. It is related to the nature of the course and teaching method used. Therefore, factors need to be considered when adopting distance education in nursing courses, including (1) the adaptability of the course content, (2) teachers’ ability to design effective strategies to facilitate teacher-student interaction, (3) appropriate equipments available, (4) demonstrated effect of distance education on teaching quality and cos

Design and Development of a Tele-Healthcare Information System Based on Web Service and HL7 Standards

[[abstract]]Information and communication technologies progress rapidly and many novel applications have been developed in many domains of human life. In recent years, the demand for healthcare services has been growing because of the increase in the elderly population. Consequently, a number of healthcare institutions have focused on creating technologies to reduce extraneous work and improve the quality of service. In this study, an information platform for tele- healthcare services was implemented. The architecture of the platform included a web-based application server and client system. The client system was able to retrieve the blood pressure and glucose levels of a patient stored in measurement instruments through Bluetooth wireless transmission. The web application server assisted the staffs and clients in analyzing the health conditions of patients. In addition, the server provided face-to-face communications and instructions through remote video devices. The platform deployed a service-oriented architecture, which consisted of HL7 standard messages and web service components. The platform could transfer health records into HL7 standard clinical document architecture for data exchange with other organizations. The prototyping system was pretested and evaluated in a homecare department of hospital and a community management center for chronic disease monitoring. Based on the results of this study, this system is expected to improve the quality of healthcare services

[[alternative]]A Review of Information and Communication Technologies for Long Term Care Applications

[[abstract]]資訊與通訊科技日新月異，在國內外各領域都有很好的應用，臺灣面對著高齡及少子女化的影響，積極發展遠距電子照護服務，近年來已經有許多經驗及成功的案例。本文探討資訊與通訊在長期照護領域應用的相關中英文文獻40餘篇，依照資訊系統的開發流程，區分為資訊系統需求分析、資訊系統架構及資訊系統評估三部分探討，了解目前國內遠距照護發展的現況，並且彙整了包括重視個人化及人性化設計、維護個案隱私及資訊系統安全、採用醫療資訊交換標準、行動通訊設備的應用、透過藍芽及Wi-Fi無線傳輸資料、建立雲端運算服務、建立遠距照護的商業營運模式及跨資訊及照護領域的人才培育等八個議題，作為開發未來長期照護服務統發展的努力方向。[[abstract]]Information and communication technologies progress rapidly and find useful applications in numerous fields all over the world. Facing to the impact of an aging population and a low birth rate in Taiwan, we need to develop Tele-healthcare services actively. There have been many successful cases and experiences in recent years. In this study, we are going to review the literatures relevant to the Information and communication applications in the field of long term care. As an effort to suggest a long term care service system, we will also investigate the following 8 important issues, including paying attention to the personnel and individualized designing, maintaining the cases privacy and information system security, use medical information exchange standards, apply mobile communication devices, transferring data through wireless, performing cloud architecture services, building business model and cultivating cross multidisciplinary experts