小児看護学実習において「実践と理論の統合」を必要とする学習課題の構造

Structure of Learning Tasks Required for “Integration of Practice and Theory” in Clinical Practice of Child Health Nursing

要旨

　目的：小児看護学実習において，実践と理論の統合を必要とする学習課題とその構造を明らかにする．

　方法：直接実習指導に当たる教員が，参加観察法を用いて実践と理論の統合を必要とする場面の記述を行い，質的分析を行う．

　結果：52場面から10のサブカテゴリを見出し，そこから6つのカテゴリに分類できた．カテゴリは実践的理解と，病気の子どもの理解と対応に大きく2つの課題群に分けられた．

　実践的理解には【健康障害に対する知識の活用不足】と【初学者の思考スタイル】があった．病気の子どもの理解と対応には【子どもの表現の真意の理解不足】，【子どもの反応と症状との関連の検討不足】，【子どもとの人間関係スキルの未熟さ】と【子どもに適したアプローチ方策の立案困難】があった．

　結論：学習課題の構造は，その基盤として初学者が陥りやすい思考スタイルを背景とした実践的理解に関する課題群を有していた．その基盤の上に，病気の子どもの理解と対応に関する課題群が積みあがっており，その両課題群が相互に関連していた．

　Objective: To clarify learning tasks requiring integration of practice and theory as well as its structure in clinical practice of child health nursing.

　Method: A qualitative analysis was conducted on a description of a situation in which a teacher who directly instruct the practice to integrate the practice and theory based on participant observation method.

　Results: 10 sub-categories extracted from 52 scenes were classifed into 6 categories. Those categories were roughly divided into two groups, i.e., practical understanding as well as understanding and response to sick children.

　Practical understanding included [Lack of utilization of knowledge for health disorders] and [Thinking style of novice learners]. Understanding and response to sick children included [Lack of understanding on real meaning of children's expression], [Lack of consideration of relationship between children's response and symptoms], [Immature skill to establish relationship with children] and [Difficulty in planning approaching methods suitable for children].

　Conclusion: The structure of learning tasks that require integration of practice and theory had, as its base, the task group on practical understanding against the background of thinking styles that beginners are likely to fall into. The task group on understanding and response to sick children was piled upon the base, these two groups being related to each other.