在護理醫療環境中，護理人員必須學習面對面病患，在緊急狀況時更需要進行基本病理的研判與處理；因此，護理課程強調知識和臨床技能的結合與應用，並重視處理現場各種狀況的熟練程度。然而，在傳統護理課程教學中，知識學習和臨床技能訓練通常是在不同的課程中各自進行；同時，由於受限於教師人力，在教導護理標準作業流程時經常採用一對多的授課方式，學生練習和獲得回饋的機會往往不足。如何提供結合知識學習和臨床技能訓練的學習環境和工具，來增進學習者的學習成效及投能的熟練程度，已成為護理教育的重要課程。為了解決這些問題，本研究提出具即時回饋與學習導引機制之臨床護理學習環境與工具，以協助學生改善學習成就及操作技能。為了評量所提出的方法與工具的成效，本研究實際在護理專科學校的身體評估課程中設計學習活動；經由實驗結果顯示，本研究不僅可以提升學生的學習態度及興趣，對改善其學習成就有明顯的助益。

In medical environment, nursing staff should learn to face patients and precede basic pathologic process in an emergency. For this reason, nursing courses emphasize the combination and the application of knowledge and clinical skills as well as the proficiency in dealing with various situations. Nevertheless, knowledge learning and clinical skill training are usually conducted in different courses proceeded in different classes; moreover, with the short of teachers, the nursing process is often taught in a one-to-many manner, such that students receive insufficient practice and feedback. Consequently, it becomes an important and challenging issue to provide the learning environment and tools to link the knowledge instruction with the clinical skill practice for nursing education. In order to solve these problems, this study proposes the development and applications of clinical nursing learning environments and tools for providing instant feedback and learning guidance to help students improve their learning achievement and operation skills. Furthermore, for evaluating the effect of the proposed method and tools, this study designs learning activities for the course of physical assessment in nursing colleges. From the experimental outcomes, this study not only could enhance the learning attitudes and interests of students, but the learning achievement is apparently promoted.

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