看護基礎教育における正確な血圧測定のための「状況基盤型教育プログラム」の開発と効果の検証：無作為化比較対照試験

Development and Effectiveness of “Situation-based Educational Program” for Accurate Blood Pressure Measurement in Basic Nursing Education: A Randomized Controlled Trial

要旨

　目的：正確な血圧測定の実践能力習得にむけた「状況基盤型教育プログラム」を開発し，その効果を検証する．

　方法：A大学2年次生の介入（状況基盤型教育）群23名，対照（従来型教育）群25名に無作為化比較対照試験を実施した．「バイタルサインの正確な測定 実践能力チェックリスト（VSAMチェックリスト）」を用いた客観的臨床能力試験（OSCE）と「状況対応能力自己評価表」を用いて効果を比較した．

　結果：VSAMチェックリストでは，測定方法の説明や安楽の保持など，患者への対応力を示す4項目で介入の効果が認められる傾向にあった．状況対応能力自己評価得点は8項目で両群に教育前後の得点の有意な上昇がみられ，中でも「患者の状況の変化にうまく対応することができる」は両群ともに5段階のうち1.1以上と最も上昇した．

　結論：本教育プログラムは，患者への対応力を高める効果の可能性が示され，看護基礎教育において効果的な教育手段となり得る．

　Purpose: The purpose of this study was to develop “situation-based educational program” for obtaining competency in accurate blood pressure measurement and to verify its effectiveness.

　Methods: A randomized controlled trial was conducted with 23 second-year students of Auniversity in the intervention (situation-based education) group and 25 students in the control (conventional education) group. The effectiveness was compared between both groups using Objective Structured Clinical Examination (OSCE) with “Competency Checklist for Vital Signs Accurate Measurement (VSAM Checklist)” and the “Situational Response Competency Self-Assessment Scale (SRCS Scale)”.

　Results: The results of the VSAM checklist tended to show effects of the intervention on 4 items regarding the competency of flexible response to patients' needs and situations, including “explaining the measurement method” and “maintaining comfort”. The results of SRCS Scale in 8 items indicated significant main effect of education. In particular, the score of “I can response well to changes in the patient's situation” increased by more than 1.1 out of 5 points in both groups.

　Conclusion: This program has been shown potential effectiveness of enhancing the competency of flexible response to patients' needs and situations, and could be an effective method in basic nursing education.