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본 연구는 임상실습과 고충실도 모형을 활용한 시뮬레이션 실습(HPS 실습) 및 표준화 환자를 활용한 시뮬레이션 실습(SP 실습)을 모두 이수한 졸업예정자와 졸업자의 학습성과 별 실습교육 경험을 조사하여 효율적인 실습교육을 위한 기초자료를 제시하고자 수행되었다. 연구 대상자는 간호학과 졸업예정자 59명과 졸업 후 1년 미만의 신규간호사 51명을 포함한 총 110명이 었다. 연구도구는 실습교과목의 학습성과 관련 효과적인 실습방법을 선택하는 문항과 실습경험에 대한 개방형 질문으로 구성되었다. 실습교과목 학습성과 7개 항목 중 졸업예정자와 졸업자 모두 임상실습이 효과적이라고 응답한 항목은 ‘이론적 지식의 실무 적용’(p<.001), ‘환자, 보호자, 의료진과 의사소통’(각각p<.001, p=.036), ‘간호 전문직관과 간호 실무의 법적, 윤리적 기준의 이해’(p<.001), ‘비판적 사고를 통한 간호과정의 수립 및 적용’(p<.001)으로 총 4개 항목이었다. 졸업예정자와 졸업자 모두 HPS 실습이 효과적이라고 응답한 항목은 ‘핵심기본간호술의 선택 및 수행’(각각 p<.001, p=.003)으로 1개 항목이었다. 졸업예정자에서만 ‘간호 리더십 역량의 제고’ 항목은 SP 실습이(p=.002), ‘간호 요구상황의 이해 및 대처방법 확인’ 항목은 HPS 실습이(p=.021) 효과적이라고 응답한 반면, 졸업자는 통계적으로 유의한 실습방법이 나타나지 않았다. 실습경험에 대한 면담결과 임상실습은 관찰위주의 실습으로 직접 간호 수행이 제한적이었고, 시뮬 레이션 실습은 직접 간호 수행은 가능하지만 실습상황이 제한적이었다. 본 연구결과를 바탕으로 실습교육 학습성과 항목에 따라 효과적인 실습방법을 강화하되 임상실습 시 학습자의 능동적인 참여와 시뮬레이션 실습 시 우수한 시나리오의 개발 및 충분한 선행학습을 유도함으로써 효율적인 실습교육이 이루어지기를 기대한다.
This study is a descriptive research study performed to present basic data for efficient practical training by investigating clinical nursing practice education experience by learning outcomes of graduates and expected graduates who completed clinical practice, Highfidelity Patient Simulator Simulation practice (HPS practice) and Standard Patient Simulation practice (SP practice). Subjects are 110 people in total including 59 expected graduates and 51 graduates, whose clinical nursing career have less than one year. Research tools are consist of 2 forms of questions which are selected questions and open questions. Selected questions ask effective way of clinical practice by learning outcomes of clinical practice. Open questions ask about clinical practice experiences. Result of study shows that questions which were answered as effective clinical practice by both expected graduates and graduates are 4 out of 7 clinical course learning outcomes. Those 4 questions of affirmative answers were ‘Practical application of theoretical knowledge’ (p<.001), ‘Communication between patient, caregiver and medical staff’ (p<.001, p=.036, respectively), ‘Understanding Legal and Ethical standard of nursing specialty intuition and nursing practice’ (p<.001) and ‘Establishing and Application of nursing course through critical thinking’ (p<.001). One question that HPS practice was answered effective by both expected graduates and graduates is ‘Selection and Nursing of core basic nursing skills’ (p<.001, p=.003, respectively). Another question that SP practice was answered effective by only expected graduates is ‘Enhancement of Nursing Leadership competence’ (p=.002) and one question that HPS practice was answered effective by only expected graduates is ‘Understanding and Confirming action plan of Nursing needs situation’ (p=.021). No significant practice method was found for graduates. Interview results of clinical practice shows that clinical practice was limited to observation centered which was unable to perform direct nursing and though direct nursing was possible at simulation practice, acting environment was limited as well. In conclusion, we expect efficient clinical education will be performed by enhancing effective practical method by learning outcomes of clinical education and by driving active participation of learner and by developing excellent scenario of simulation practice which could provide enough precedent learning.
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practice education, practice methods, simulation, clinical practice, learning outcomes.