發展情境模擬導向創意教學模組於國民中小學教師教學增能介入成效研究-以珍惜急診醫療資源議題為例

Abstract

摘要 國人非急迫狀況下頻仍使用急診室已造成健保嚴重的挑戰，本研究以珍惜急診醫療為例發展情境模擬導向的促進珍惜急診醫療資源創新教學模組，並探討其對於提升國民中小學教師未來從事「合理使用急診醫療資源」教學知能的成效。 本研究共有414位國中小學教師參與，其中有214位教師參與以情境模擬導向教學模組教師增能研習作為實驗組，另外有200位教師則參與線上自我學習課程作為對照組。實驗組的介入乃透過急診室微小模型模擬各種急診情境的體驗闖關活動與實際參與情境式桌遊遊具教學的觀議課，對照組則以實驗組的介入教學內容錄影於線上觀賞自學。兩組均在課程前後填答評估教師增能的問卷，包括合理使用急診醫療資源的認知、教師的教學態度與技能與自我效能。問卷資料利用McNemar test、paired t test和generalized estimating equations (GEE)等加以分析。 研究結果發現參與情境模擬導向創意教學模組的實驗組較接受線上影片自學的對照組在課程前後改善幅度較大。情境模擬為基礎的教師增能教學模組適於提供給國中小教師作為實施合理使用急診醫療資源的教學課程。

關鍵字：情境模擬導向、珍惜急診醫療資源、教師增能Abstract Background: More than 80% of patients who visited Emergency Department (ED) was not urgent in Taiwan in 2019. It causes insufficient medical services and a latent fiscal threat to the Nation Health Insurance (NHI). This study adopted simulation-based educating modules to explore the effect in teaching competence among primary and middle school teachers for efficient AEDRU (adequate emergency department resource usage) education in the future.

Method: The subjects were 414 elementary and junior high school teachers in Taiwan. 214 participants attended the simulationbased workshop as the simulation-based group, whereas 200 participants took an online self-learning module as the self-learning group. The workshop was created by an expert panel for decreasing the unnecessary usage amount of ED medial resources. The materials are lecture, board games, miniature ED modules, and simulation-based scenarios. A teaching competence questionnaire including ED knowledge, teaching attitude, teaching skills, and teaching self-efficacy was conducted among participants before and after the intervention. Data were analyzed via McNemar, paired t test and the generalized estimating equations (GEE).Results: The study showed that teachers who participated in the simulation-based workshop had improved more in teaching competence than those who received the online self-learning module. In addition, there were significant differences between the pretest and post-test among the two groups in teaching competence..Conclusion: The simulation-based workshop is effective and it should be spread out. When students know how to use ED medical resources properly, they could affect their families. It can help the ED service to be used properly and benefits the finance of the NHI. The health care cost will be managed while also improving health.Key words: adequate emergency department resource usage (AEDRU), simulation-based workshop, teacher empowerment