Thesis or Dissertation 看護学生のアセスメント能力向上のための教育介入

會津, 桂子

pp.1 - 49 , 2016-03-23
Description
Aim:Recently, it has become increasingly necessary for nurses to possess a high level of clinical judgment, due to advances in medical technology and changes in the types of diseases experienced by aged patients. Therefore, high-level assessment skill education has become an extremely important part of nursing students’ education. This study therefore aims to clarify the effect of structural knowledge education based on cognitive sciences theory for advancement in nursing students’ assessment skills.Method: Participants were 17 third-year university students and 55 second-year universitystudents majoring in nursing. Examinations for assessment skill and level of structural knowledge were conducted for the 17 third-year students individually. The experiments included a nursing-scene task, free-recall task, and sorting task. Experiments were conducted before and after their clinical practice. Each student’s level of structural knowledge was calculated from the free-recall and sorting task responses, and each student's assessment skill was calculated from the nursing-scene task responses.Examinations for assessment skill and level of structural knowledge after the structural knowledge education were conducted for the 55 second-year students, who were divided into an intervention group (n=19) and a control group (n=36). The experiments included pre-examination, structural knowledge education, self-study about diabetes, and post-examination. The pre & post-examinations included a production task, concept-map task, and nursing-scene task about diabetes. Educational sessions lasting 40–90 minutes were conducted 5 times for intervention group participants individually. During the educational sessions, participants studied lung cancer or liver cirrhosis to understanding the relation between the knowledge and the clinical scene by making concept map. Both intervention group and control group participants conducted self-study about diabetes with post-examinations conducted afterward. Each student’s level of structural knowledge was calculated from concept-map task responses, and assessment skill was calculated from nursing-scene task responses.Results:Third-year students’ level of structural knowledge was significantly higher after clinical practice (p < .01). When comparing assessment skills in relation to levels of structural knowledge, the high-structured group (n = 5) had significantly higher scores in nursing problems than the low-structured group (n = 5) (p < .001). Intervention group participants’ level of structural knowledge was significantly higher after education (p<.001), and significantly higher than that of the control group participants (p<.001). When comparing assessment skills between the intervention group and control group, the intervention group had significantly higher scores in nursing problems than the control group (p < .05). The intervention group’s scores in nursing problems were also significantly higher after education (p<.001), although the control group’s scores in nursing problems did not differ pre- and post-examination.Discussion:The intervention group participants’ level of structural knowledge was significantly higher after examinations. Students with structural knowledge appeared to make assessments by using their knowledge and understanding the situation comprehensively.These results clarified that studying information while understanding the relationship between the contained knowledge and a clinical scenario facilitates the development of students’ assessment skills.
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