ヒヤリハット・シミュレーション体験が看護学生のリフレクションに与える影響

本研究の目的は，ヒヤリハット・シミュレーション体験後のリフレクションの構成要素，及び「ヒヤリハット体験」がリフレクションに影響するかどうかについて明らかにすることである．「ヒヤリハット体験」は，誤薬のシミュレーションで，研究に同意の得られた５年一貫課程の最終学年の看護学生を対象に実施した．その後，体験群と対照群の両者で構成するグループによるリフレクションを行った．また，「リフレクション自己評価アンケート」を実施し，因子分析した．その結果，第１因子「事故を起こした自分の気持ちや自己の傾向への気づきと表現・分析」，第２因子「事故原因の追及と解決のためのスキルへの気づき」の２因子構造，７項目から構成されることを確認した．
第１因子の平均値の比較では体験群が対照群よりも有意に高かった（p＜０．０１）．これは，ヒヤリハットを自ら体験することがエラーを起こす可能性がある自己の傾向に気づき，振り返って熟考するリフレクションを可能にしたといえる．

The purpose of this research was to clarify the effects of simulated experience of medical accidents （HIYARIHAT） and determine whether experiencing HIYARIHAT influences nursing students’ self-reflection. Participants were nursing students who agreed to participate and were in their final （fifth） year of a nursing program. In the simulated HIYARIHAT, students were required to prepare infusion solution preparations. Following the simulation, both a group HIYARIHAT group and control group met to discuss the simulation. Both groups completed the Reflection Self-Assessment Questionnaire （RSAQ） and the data were used for factor analysis. The results revealed two factors comprised of seven items. The first factor was “Expressing and analyzing the feeling and the patterns that caused the accident”. The second factor was “Identifying the cause of the accident and the skills that can prevent it”.
The mean score for the first factor was compared between the self-reflection group and the control group. The mean score for the first factor was found to be significantly higher in the self-reflection group than in control group （p＜０．０１）. The present findings indicate that the self-reflection group noticed the patterns that might have cause an error by experiencing their own HIYARIHAT because they were able to look back and reflect.