2020-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/696400摘要：以「核心能力為導向(Competence-Based)」學習以成為護理教育課程發展趨勢的，新進護理師的專業訓練及養成，是奠定日後護理專業從業人員相當重要的基石，護生畢業後進入職場之生命末期照護能力，是否能順利轉銜至臨床進階實務?或者符合醫療現場單位主管的期待?EPAs及評量表可以引導臨床教師如何教導（coach)新進人員學習, 故EPA的建構在醫學專業培訓領域中日益蓬勃發展，但鮮少應用於護理領域。爲評估護理師於醫療現場之臨床勝任能力與表現，本研究計劃目的：發展畢業生於臨床醫療實踐現場適用的能力評核機制，並透過質性訪談過去修習過安寧缓和療護課程的“畢業生及單位主管”，在非安寧及安寧病房的服務需求，以評量該生於修習安寧緩和療護課程的成效及生命末期照護能力。擬循序分三階段（三年）達成下列目標：【第一年】調查整合期：採團體共識會議及行動研究法(action research)，調查及訪談過去能力發展及EPAs設計之成效，1)將修習過本研究團隊研發課程之醫學院護理大學畢業生作訪談，所學到之生命末期照護核心能力與職場執業的落差、探究優點及不足之處，也詢問單位主管對學員與其他同期的同仁臨床能力表現之差異。2)進行專家會議，發展生命末期照護EPAs。延續已發展「生命末期照護」能力，本研究將持續發展「生命末期照護」核心能力之課程教材與網路課程建置。邀請修習過安寧緩和療護之護理畢業生、單位主管(護理長)之訪談者，進行焦點「專家團體共識會議」，完成生命末期照護可信賴專業活動(EPAs)評量表，建置eprofolia等數位學習環境。【第二年】建置培訓期：整合、修正或新增歷年來設計之教材與評量工具、實作：建立生命末期照護的EPAs 工具適用且具信、效度之「核心能力」評量工具，實施第一年度發展完成八大核心能力各項課程，檢視本土多媒體輔助教材，針對已建置e化網路學習平台之數位學習環境，以及八大核心能力之本土教材的滿意度進行試教。同時訂定、評估臨床護理師生命末期照護能力，將各層級EPAs評值表發展完成，生命末期照護繼續教育課程並建置教學平台。採單組前後測準實驗法，舉辦種子教師陪訓，培養種子教師有能力進行臨床護理師的生命末期照護能力EPAs評值活動，並測量其一致性的結果【第三年】評估推廣期：舉辦「臨床護理教師成長營」，宣導已建置之教學平台及生命照護課程教學教材內容，提昇臨床護理師之生命末期照護品質。<br> Abstract: Currently, competence-based learning has been implemented in the curriculum development of nursing education. There is existing question that can a nursing student has ability to face end-of-life care after graduation smoothly? Whether the nursing managers accept his/her competence of caring of the end-of –life patients? It is a very important milestone that new entry nurses’ professional training and development is for future nursing professionals. EPAs and rating scales can guide how to teach and learn.The purpose of this research plan is to develop graduates' ability appraisal mechanism applicable to clinical medical practice sites. It is planned to pass a qualitative interview with “graduates and unit managers” who have taken the “Tranquility Relief Therapy” course in the past to learn about non-anning and tranquility wards As a modification and integration of the developed end-of-life care and nursing professional courses. In addition, I also interviewed the unit manager to observe the end-of-life care ability of the student at the medical site on weekdays? Does it meet the needs of the medical site? And what are the trusted activities that the unit manager expects to be ideal? In addition to modifying the original course content, develop appropriate levels End-of-life care capabilities, entrutable professional activities activities (EPAs), and rating scales. In the future, the integration of entrutable professional activities activities (EPAs) into nursing teaching will help curriculum developers develop ability-oriented curriculum design. First year，survey integration period: survey and interview the past capacity development and the effectiveness of EPAs design. 1) Interviews with medical university nursing graduates who have taken courses developed by this research team will learn the core skills of end-of-life care. 2) Conduct expert meetings to develop end-of-life care for EPAs. Continuing the developed 'end-of-life care' capabilities, this study will continue to develop curriculum materials and online courses for the 'end-of-life care' core competencies. Interviewees of nursing graduates who have taken tranquility therapy and the unit manager (Chief Nursing) are invited to conduct a focus group expert meeting to draft the core competencies of EPAs for end-of-life care at all levels of clinical nurses, as well as the contents of each EPA curriculum Appropriateness of teaching goals while seeking school and hospital partners.Second year, Establish training period: integrate, revise or add textbooks and assessment tools designed over the years, and implement: Applicable, credible, and effective 'core competence' assessment for the establishment of end-of-life care EPAs tools. Tools, implement the first year of development and complete the eight core competencies courses, and review the local multimedia auxiliary teaching materials, and test the satisfaction of the digital learning environment with the e-learning platform and the eight core competencies of the local teaching materials. Teach. At the same time, the end-of-life care ability of clinical nurses will be determined and evaluated, the EPAs rating tables at all levels will be developed. Third year Evaluation and promotion period: use of results, implementation and promotion: enhance the nurse's willingness to care at the end of life. Promote end-of-life clinical continuing education courses with willing hospital partners可信賴專業活動醫學教育理論學習型態成人學習理論entrustable professional activities (EPAs)medical education theorylearning styleThe Adult Learner