Pai Hsiang-Chu, Ko Hui-Ling, Eng Cheng-Joo, Yen Wen-Jiuan
Department of Nursing, Chung-Shan Medical University, Chung Shan Medical University Hospital, No. 110, Sec.1, Jianguo N. Rd., Taichung City 40201, Taiwan, ROC.
Department of Nursing, Min-Hwei Junior College of Health Care Management.
J Prof Nurs. 2017 Jul-Aug;33(4):287-292. doi: 10.1016/j.profnurs.2017.01.003. Epub 2017 Jan 24.
The effectiveness of simulation learning and the effects of anxiety in the simulated situation have been understudied. In addition, research on the association between learning effectiveness and students' clinical care performance in the hospital setting is very limited in Taiwan. The aim of this study is to examine the mediating effect of self-reflection and simulation learning effectiveness on the clinical nursing performance of nursing students. A Prospective, longitudinal, and correlational design was used. The study was conducted from December 2014 to July 2015. Participants were 293 nursing students in southern Taiwan. A structural model was specified and tested using partial least squares structural equation modeling to examine the relationships between the variables. The results revealed that the model was robust in terms of its measurement quality (reliability, validity, and goodness of fit), with the data's explaining 38.3% of variance in nursing competence. As self-reflection and learning effectiveness were added into the structural model, the effect of anxiety on nursing competence was still significant, but the regression coefficient (β) estimate of -0.41 (p<0.05) changed to β=-0.15 (p<0.050),indicating that self-reflection and learning effectiveness mediated the relationship between anxiety and nursing competence. Nursing competence was negatively affected by anxiety and positively affected by self-reflection (β=0.49, p<0.05) and simulation learning effectiveness (β=0.10, p<0.05). The teacher's encouraging learning can have a positive influence on students' self-reflection and learning effectiveness, which then decreases the effect of anxiety on nursing competence and further promotes students' clinical care ability.
模拟学习的有效性以及在模拟情境中的焦虑影响尚未得到充分研究。此外，在台湾，关于学习效果与学生在医院环境中的临床护理表现之间关联的研究非常有限。本研究的目的是检验自我反思和模拟学习效果对护理专业学生临床护理表现的中介作用。采用前瞻性、纵向和相关性设计。研究于2014年12月至2015年7月进行。参与者为台湾南部的293名护理专业学生。使用偏最小二乘结构方程模型指定并测试了一个结构模型，以检验变量之间的关系。结果显示，该模型在测量质量（信度、效度和拟合优度）方面表现稳健，数据解释了护理能力中38.3%的方差。当将自我反思和学习效果纳入结构模型时，焦虑对护理能力的影响仍然显著，但回归系数（β）估计值从-0.41（p<0.05）变为β=-0.15（p<0.050），表明自我反思和学习效果介导了焦虑与护理能力之间的关系。护理能力受到焦虑的负面影响，受到自我反思（β=0.49，p<0.05）和模拟学习效果（β=0.10，p<0.05）的正面影响。教师鼓励学习可对学生的自我反思和学习效果产生积极影响，进而降低焦虑对护理能力的影响，并进一步提升学生的临床护理能力。
