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研究生： 黃柏森
Huang, Po-Sen
論文名稱： 探討使用元認知介入措施來降低學生護士考試焦慮並提升護理臨床技能表現之影響
Using Metacognitive Interventions to Alleviate Test Anxiety and Improve Student Nurses' OSCE Performance
指導教授： 黃悅民
Huang, Yueh-Min
學位類別： 博士
Doctor
系所名稱： 工學院 - 工程科學系
Department of Engineering Science
論文出版年： 2023
畢業學年度： 111
語文別： 英文
論文頁數： 77
中文關鍵詞： 考試焦慮 、元認知 、護理教育 、群聚智慧線上學習策略 、學習判斷
外文關鍵詞： test anxiety, metacognitive interventions, nursing education, Crowdsourcing Collaborative Learning Strategy (CCLS), Judgment of Learning (JOL) techniques
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    • 考試焦慮泛指學生在承受接受測驗時的不安感，常源自於學生的認知壓力，與害怕接受失敗的結果。護理專業面對專業學科與臨床技能術科需求，護理系學生經常體驗高程度的焦慮感，比其他健康領域科系高出30%，超過一半比例學生回報尤其針對考試焦慮。考試焦慮範圍從中程度到高程度，對學生護士的學科表現與未來臨床表現有負面影響。降低學生護士考試焦慮的一直以來都是護理教育的重要議題，目前主要主流策略都集中在外部介入措施(e.g.芳香療法，放鬆訓練，音樂治療等)來協助紓緩考試焦慮，針對探討內部介入措施層面研究匱乏。這篇論文主要探討使用元認知介入措施來降低學生護士考試焦慮並提升護理臨床技能表現之影響針，針對使用群聚智慧線上學習策略與學生自我判斷技巧。

    Test anxiety is a negative feeling and uneasiness that students derive under internal cognitive pressure and fear regarding a possible failure. The nursing program can be highly stressful, with rigorous academic and clinical demands. Student nurses report 30% higher test anxiety than their counterparts in other health-related majors. Student nurses who experienced test anxiety also reported specific cognitive symptoms hindering test preparation and performance. Test anxiety is inevitable in academia when highly structured assessments and student performance tests are across the nursing curriculum. Interventional strategies to reduce test anxiety have been a crucial topic among nursing academia. Currently, the primary focus on interventional strategies is examining the external interventions (e.g., aromatic therapy, relaxation training, music therapy, etc.) to help reduce cognitive symptoms caused by test anxiety. The present study discusses the possibility of employing a metacognitive strategy of guiding student nurses' reflection on acquired knowledge to improve their assertiveness and alleviate uncertainness toward tests. This study discusses the possibility of reducing test anxiety and alleviating cognitive symptoms via Crowdsourcing Collaborative Learning Strategy (CCLS) and Judgment of Learning (JOL) techniques.

    Chapter 1 Introduction 1 1.1 The Framework of the Present Study 6 1.2 The Assumptions of the Present Study 8 Chapter 2 Literature Review 11 2.1 Test Anxiety in Nursing Education 11 2.2 Test Anxiety and Objective Structured Clinical Examination 12 2.3 Test Anxiety Interventions in Nursing Education 15 2.4 Cognitive Test Anxiety and Academic Performance 19 2.4.1 Metacognitive Intervention: Judgment of Learning 20 2.4.2 Instructional Intervention: Crowdsourcing Collaborative Learning Strategy(CCLS) 24 Chapter 3 Methodology 27 3.1 Research Design 27 3.2 Participants 29 3.3 Instrument 29 3.3.1 Consent Form 29 3.3.2 Simulated OSCE and OSCE 30 3.3.3 The Westside Test Anxiety Scale 30 3.3.4 Self-evaluation of OSCE Competence 31 3.3.5 Online Crowdsourcing Collaborative Learning Platform 32 3.4 Experimental Procedure 33 3.5 Data Analysis 36 Chapter 4 Results 38 4.1 Improvement of Clinical Competence with the Implementation of CCLS 38 4.2 Improvement in JOL Accuracy on Clinical Competence with CCLS 40 4.3 Test Anxiety Reduction on Clinical Competence with CCLS 49 Chapter 5 Discussion 56 5.1 Improvement of Clinical Competence with the Implementation of CCLS 56 5.2 Improvement in JOL Accuracy on Clinical Competence with CCLS 57 5.3 Test Anxiety Reduction on Clinical Competence with CCLS 59 Chapter 6 Conclusion 61 6.1 Limitations 62 6.2 Future Study 63 References Appendix A: The Westside Test Anxiety Scale (WTAS) 64 References Appendix B: Self-evaluation of OSCE Competence Scoresheet 65 References 66

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