看護学生の実習での技術経験の実態と主観的到達度に影響を及ぼす因子—中国地方の複数の看護系教育機関を対象とした分析

The Status of Experiences of Nursing Skills in Clinical Practice among Nursing Students and Factors Influencing the Subjective Attainment Level: An Analysis of Several Nursing Education Institutions in the Chugoku Region

要旨

目的：看護学生の臨地実習での技術の経験と主観的到達度（以後，到達度）の実態および，到達度に影響する因子を明らかにし，到達度向上のための方策を検討する．

方法：卒業前の看護学生300人を対象に，属性と臨地実習での29技術の経験の有無と到達度，経験回数について自記式質問紙調査を実施した．分析は，属性と経験回数は単純集計，経験回数の到達度はMann-WhitneyのU検定により比較し，到達度への影響する因子については，判別分析を行った．

結果：バイタルサインの測定は経験率，到達度ともに100％であったものの，排泄の援助など7技術の経験率は50％以下であった．また，大学と専門学校を対象とした到達度に関しては，最も影響する因子は，23技術が「経験の有無」，2技術が「教育課程」，1技術が「性別」であった．すべての技術の到達度は，「3回以上」で有意に向上していた．

結論：技術により到達度に最も影響される因子が異なっていた．また，臨地実習で技術を3回以上経験することで到達度の向上が期待できることが示唆された．

Objectives: This study aimed to clarify the experiences and subjective attainment level (attainment level) of nursing skills among nursing students during clinical practice, as well as the factors influencing attainment levels to identify strategies to improve these levels.

Methods: A self-administered questionnaire survey was conducted among nursing students before their graduation. The survey collected data on attributes, whether they had clinical experience of 29 fundamental nursing skills in clinical practice, the number of such experiences, and their attainment levels of these skills. Descriptive statistics were used to analyze participant attributes and the number of experiences. The Mann-Whitney U-test was used to compare the attainment level and the number of experiences. Factors influencing attainment level were analyzed by discriminant analysis.

Results: The study included 300 nursing students. The experience rate and attainment level for vital signs measurement were 100%; however, the experience rates for seven other nursing skills, including assistance with toileting, were 50% or less. The factors most influencing the attainment levels were as follows: prior experience for 23 nursing skills, presence of a hospital affiliated to the nursing education institutions for two skills, and the nurse's gender for one skill. The attainment levels for all nursing skills markedly improved when the skills were experienced three or more times.

Conclusion: The factors that most influenced the attainment levels of nursing students differed between the skills being assessed. The results suggest that the attainment level could be improved by ensuring that the student nurses experience fundamental nursing skills at least three times during clinical practice.