基礎看護学におけるSP参加型の授業と臨地実習の連繋―学生の臨地実習の体験のふりかえりから

Linking Preclinical Lessons with Simulated Patient Participation and Clinical Training-students Looking back on Their Clinical Training Experiences

要旨

研究目的は，基礎看護学におけるSP参加型の授業と臨地実習のつながりを明らかにすることである．A看護大学の2年生で研究協力の得られた5名を対象に，質的帰納的研究方法を用いて実習前から終了時までの行動やその時々の気持ちなどを自由に話してもらい逐語録し，カテゴリー化と構造化をはかった．その結果，抽出されたカテゴリーは【SPの参加によって真に迫る臨地実習の体験をした】，【臨地実習前に知りえた情報から患者像を意識に浮かべた】，【SP参加型の学修から患者との出会いの場面における自分の姿を思い描いた】，【SP参加型の学修から想い描いた出会いを実践し，患者に受け入れられた手ごたえを感じた】，【自分なりに患者のことを想い，手さぐりでケア(援助)を実施した】，【実施，失敗，修正を繰り返しながら患者に見合ったケア(援助)を見出した】，【臨地実習を通して真の患者像に迫れた】の7つで，時間的経過と学習内容によって構造化された．学生は，はじめての臨地実習において早期から患者との関係を築くことができ，SP参加型の学修がいかされていた．

Abstract

　The purpose of this study was to clarify how preclinical lessons with Simulated Patient (SP) participation link with clinical training. The subjects were five A Nursing University second year students who agreed to participate in this study. Using the qualitative reductive method, we made tape recordings of the subjects talking freely about their activities and emotional responses, from prior to the commencement of clinical training until after its completion. Transcriptions of the recordings were categorized and encoded. Seven categories were identified according to the passage of time and learning methods: “Through the SP participation I experienced something close to clinical practice,”“From the classroom role-playing, I could envisage patient types before the clinical training,”“Through the SP participation classes I could imagine myself interacting with patients,”“Putting into action techniques I derived from the SP participation classes, I felt that patients accepted me,”“In my own way, I tried to do my best for the patients, providing care (assistance)to patients through trial and error,”“Through a process of repeated practice, failures and corrections, I worked out a way of providing care (assistance) suited to each patient,”and “I gained understanding of real patients through clinical training.”These results suggest that students put their experiences with SP participation classes to good use, and soon developed good relationships with their patients when they commenced clinical training.