看護基礎教育における模擬患者を導入した看護過程の教育効果とその課題

Effects of the teaching method using the simulated patients (SP) on the nursing process (NP) in the fundamental nursing education were examined. Learning quality with the SP was qualitatively analyzed from the self-evaluation of the understanding and the content of the reports of the students. The following results were obtained.
In both student groups, "necessity of NP on nursmg practice" and "importance of based on the nursing theory" were high score. Understanding of "how to collect the data about the patients" was higher and "how to write the factor-related map" was lower in case of SP than the paper-patients.
The learning factors were identified as "the component of NP", "the concept of NP", "perspective of nursing" and "nursing philosophy", which consisted of 22 categories. Influence factor consisted of three categories was found.
The students experienced the knowledge to form interpersonal relationships through implementation of the NP with SP and also were able to learn how to solve problems based on the relationship with patients.
　紙上事例による看護過程の学習方法を補完するために,情報収集から評価に至る全過程を,模擬患者を用い実践に即して体験する演習を試みた。演習後に行った理解度の自己評価,および学びを綴ったレポート内容を分析し,次の結果を得た。
　自己評価の比較では「看護過程を展開する必要」,「看護理論に基づいて行う必要」に関する理解が,紙上事例で学んだ学生群,模擬患者で学んだ学生群共に高かった。「情報収集の方法」の理解は模擬患者群が,「関連図の書き方」の理解は紙上事例群で有意に高かった。レポートの分析により,22のカテゴリーからなる4つの学習内容の因子〔看護過程の構成要素〕〔看護過程の概念〕〔看護の視点〕〔看護観〕,および,3つのカテゴリーからなる〔影響因子〕が抽出された。
　模擬患者に対して実践的に看護過程を展開することで,看護過程の本来の在り方である“患者との関係を基盤とした問題解決思考の過程"を学習したと考える。