Department of Nursing, National Taichung University of Science and Technology, Room 415-4, 193, Sec. 1, Sanmin Rd., Taichung 403, Taiwan.
Nurse Educ Today. 2021 Dec;107:105116. doi: 10.1016/j.nedt.2021.105116. Epub 2021 Aug 28.
Physical examination and health assessment skills are essential components of nursing practice, and the critical elements to be taught merit further investigation.
To develop and evaluate a physical examination and health assessment course based on a self-directed learning framework.
An action research design was employed.
A baccalaureate nursing program of the university of science and technology in central Taiwan.
A convenience sample comprising 23 teaching faculty members and 41 enrolled second-year students was recruited.
Structured questionnaires were developed for data collection. A paired t-test and the Kruskal-Wallis test were used for data analysis.
The course consisted of four parts: health history taking from a holistic perspective, examination skills in diverse systems, case exercise and discussion, and final objective structured clinical examination. Statistical significance was found in the areas of physical examination skills, critical thinking, and case analysis. Participants with mid-to high-level self-directed learning had significantly higher scores than those with low-level self-directed learning on physical examination skills and problem assessment. Internal and discriminant validity were supported.
The study results provide evidence supporting the use of self-directed learning framework in curriculum design. The course integrated necessary knowledge and skills enabled students to practice physical examination, and assessment skills may enhance student confidence in approaching patients in clinical encounters. However, the study was a descriptive design. The generalization of the results needs to be further validated by an experimental study.
体格检查和健康评估技能是护理实践的重要组成部分，值得进一步研究的关键要素是需要教授的内容。
基于自主学习框架，开发并评估体格检查和健康评估课程。
采用行动研究设计。
中国台湾中部一所科技大学的学士学位护理课程。
招募了一个便利样本，包括 23 名教学教师和 41 名二年级注册学生。
开发了结构化问卷进行数据收集。采用配对 t 检验和 Kruskal-Wallis 检验进行数据分析。
该课程包括四个部分：从整体角度进行健康史采集、多种系统的检查技能、案例练习和讨论，以及最终的客观结构化临床考试。在体格检查技能、批判性思维和案例分析方面发现了统计学意义。具有中等到高水平自主学习能力的参与者在体格检查技能和问题评估方面的得分明显高于具有低水平自主学习能力的参与者。内部和判别效度得到支持。
研究结果为在课程设计中使用自主学习框架提供了证据支持。该课程整合了必要的知识和技能，使学生能够练习体格检查和评估技能，这可能会增强学生在临床接触中接近患者的信心。然而，该研究是描述性设计。结果的推广需要通过实验研究进一步验证。
