運用合作學習理論探討以網路社群方式進行非同步數位學習之護理 在職教育
Apply Cooperative Learning Community Theory on an
Asynchronous Digital Learning System for Continuing Nursing Education
中文摘要
國內護理界從民國81 年即開始全面實施進階制度，透過在職教育使護理人員達 到專業進階要求，是護理主管最基本的職責與業務之一。個案報告撰寫是N3 進 階基本開設課程，目前臨床護理人員N3 的通過比率只有四成，是國內護理界 普遍需要的在職教育課程。期望以網路學習社群方式可以克服目前護理界推動在 職教育之時空等因素的限制，成為有效的學習方式。
在職教育對臨床護理人員的專業能力提升具有意義，護理人員必須經常透過在 職進修管道，來增進專業知識及技能，以確保照護病患之品質。
本研究目的是要探討運用合作學習理論藉由網路社群方式進行非同步數位學習 的護理在職教育，評估其學習成效及其相關影響因素。於台北市某醫學中心護理 部進行為期10 週之非同步數位學習的在職教育，參與本課程共有 66 名學員，
以隨機抽樣方式分為實驗組(合作學習網路討論組)及控制組(合作學習傳統討論 組)，來評估其認知方面的學理成績、情意方面的滿意度、與技能方面的個案報告 的撰寫成績等三方面的學習成效，以及其相關影響因素。
對於當初的研究假說，其研究結果顯示認知學習成效部分：學員在具備合作學 習網路社群與無具備合作學習網路社群之認知學習成效，於第一階段網路授課 課程後，達到有非常顯著差異(實驗組 t= -4.77，p<0.05*)、(控制組 t=
-3.96，p<0.05*)，於第二階段網路或傳統討論課程後達到無顯著差異(實驗組 t=
1.18 ，p>0.05)、(控制組 t= 0.46，p>0.05)；而情意學習成效部分：本研究全體學 員在經過數位學習平台輔助合作學習之後，學習滿意度結果有92.38%傾向於滿 意與非常滿意，並認同此種具備合作學習社群的網路學習，對學員的學習成效 是有幫助的；在技能學習成效部分─學員在經過數位學習平台輔助合作學習之 後，全部學員完成撰寫個案報告初稿佔74%、完稿佔 88%，達到研究設計水準，
且個案報告初稿及完稿成績其初稿分數( t=0.06，p>0.05)，達到當初假設之無顯 著差異；但在完稿成績部分(t=-1.66，p>0.05)，也已達到當初無顯著差異之假設。
期望能以此種方式提供臨床護理人員多元化選擇，增進國內臨床護理人員在專 業提升及自我在職進修之成效
透過資訊網路科技與護理之結合，本研究期望能提供國內護理界新型態的之在 職教育模式，讓彼此可以共同分享知識、創造知識、及主動建構學習經驗，並透 過網路各式各樣的學習資源，以及學習社群成員間的互動與交流，達成護理人 員成長與知識技能提升的目標。使護理專業邁向新時代、全方位的學習方向。
英文摘要
The Nursing Ladder System began in Taiwan since 1992. Writing a qualified case report is one of the basic criteria for nurses to advance to the third year (N3). Only 40 percent of nurses are successful. The traditional face-to-face learning style of continuing education is not helpful enough for nurses because it has the
limitations of time and space and therefore scheduling and other real life problems need to be overcome by an Asynchronous Digital Learning System (ADLS).
The purposes of this study are: (1) To establish and operate a Community Based e-Learning (CBeL) model for a Continuing Nursing Education program (CNE), (2) To examine the effect of a CBeL on a CNE program for nurses, (3) To analyze the relationships among demographic data, learning readiness, learning motivation and the effect of a CBeL for a CNE program for nurses.
The Pre-post test quasi-experimental design is applied. Through purposive sampling, 66 nurses who work in the General Medical Center and were preparing to advance to N3 were the research subjects. A CBeL case report writing course was provided to the experiment group. The pre-middle-post knowledge evaluation of the CBeL course and CNE discussion course, the scores of the initial and final case report, satisfaction by students will be the research measurements. T-test and ANOVA were used to analyze data.
According original hypothesis of the research, the learning effect of knowledge, there is very significant difference(t= -4.77 and -3.96，p<0.05*) in first stage that web based lesson course, and no significant difference(experimental group t=1.18, p>0.05, control gorup t=0.46, p>0.05) in second stage that web based or team based discussion course between experimental and control groups.In the learning effect of Attitude, all students have 92.38% satitified in this whole course and feel it is helpful wrinting case report for them.
And in last the learning effect for Practice, all students had 74% finished case report draft when the first stage over and 88% finished the final case report when thesecond stage over. Also the score for draft and final report, there are no
significant difference (draft: t=0.06, p>0.05, final: t=-1.66, p>0.05) between experimental and control groups.
The CBeL model will provide a new learning style for nursing staffs and it is imperative for the development of the nursing profession.
