臨地実習における学習内容に対する学生の到達度の認識 : 臨地実習開始前，中，後における自己評価の変化の分析から

臨地実習指導における教育的な介入への示唆を得ることを目的に，３年課程短期大学３年次学生を対象に，臨地実習開始前・中期・終了後に，国立大学医療技術短期大学部看護学科協議会臨地実習委員会A グループが作成した「臨地実習固有の学習内容」を用いて，学生の臨地実習固有の学習内容に対する到達度の認識に対する調査を行った．その結果，以下の結果が得られた．
①自己評価得点は，実習開始前と比べて終了時に自己評価が有意に上昇したもの（以下上昇群）と，上昇しなかったもの（非上昇群）の２群に大きく分類できた．
②上昇群のうち，段階的に評価が上昇した項目は７項目であった．
③学生は，認知領域は高く自己評価し，学習内容に到達したと認識していた．
④学生は１４項目は終了時に至っても，到達レベルに達していないと自己評価しており，それらの項目は，コミュニケーションや看護過程，理論との照合など看護を深める取り組みに関する内容であった．
以上のことから，教育的な介入として，学生がコミュニケーション技術を有効に用いながら，看護過程を展開し，看護実践を深めることができるように，カンファレンスを有効に活用し，場面を捉えて，学生の学習状況にあわせて，丁寧に指導を行うことが必要であると考えられた．学年進行に伴う到達レベルの詳細な明示など，学生の成長を長期的な視点に立って支援することの必要性が示唆された．

Objectives : The purpose of this study was to : assess the nursing students’ recognition of their achievement of their educational goals in clinical practice ; and discuss the clinical teaching interventions of nursing education by means of self-evaluation for the students at a 3-year nursing junior college.
Methods : We used the self-evaluation questionnaire (62 questions). Self-evaluation was performed three times : the first was before clinical practice (hereinafter first evaluation), at the middle point of clinical practice (middle evaluation) and after the clinical practice (final evaluation).
Results :
１．There ware 2 patterns in self-evaluation scores. One was rise, and the other was not rise by comparison between first evaluation and final evaluation.
２．Only 7 scores were improved among 62 questions. They were classified cognitive domain, and they were recognized by the nursing students to be achieved of their educational goals.
３．In the final evaluation there were 14 items for which they had not achieved their educational goals. They were the following items : comparing their clinical practice experience with nursing theory, performing clinical practice while thinking about the nature of nursing and using communication skills, and the process of nursing diagnosis.
Conclusions : Nursing students need educational intervention. That is, they need teachers to teach them, or to think with them, how to use the nursing process to overcome patients’ problems in each clinical situation by means of communication skills. It is also important to make effective use of conferences at school to so that student’s can shore experiences.