問題導向學習提升長照在職生於醫護課程之批判性思維特質的實踐與成效

Enhancing the Critical Thinking Dispositions of In-Service Long-Term Care Students Through Problem-Based Learning in Health-Care Education

隨著超高齡社會的來臨，長期照護需求日益攀升，照顧服務人員對疾病本質與照護內容的充分理解已成為其專業勝任力的重要基礎。然而，在教授非醫護背景之在職生醫護課程時，教師常面臨知識落差及學習動機不足的挑戰。為回應此需求，本研究採用以學生為中心的問題導向學習（problem-based learning, PBL）教學法，透過真實情境問題引導學習，期望不僅提升學習者對醫護知識的掌握，亦可強化其批判性思維特質（critical thinking disposition, CTD），進而增進長期照護專業能力。研究對象為修讀「高齡疾病概論」課程之在職專班學生29位，教學設計依循Ulger（2018）提出之PBL過程循環（PBL process cycle），並使用「精簡中文版批判性思維特質測量表」（short form of Chinese version of critical thinking disposition inventory, SF-CTDI-CV）進行前、後測比較。研究結果顯示：（1）PBL教學法介入後，學生CTD顯著提升；（2）性別及是否具備證照對CTD無顯著影響；（3）年齡及工作年資與CTD無顯著相關性。此外，質性資料的分析進一步揭示，PBL教學兼具挑戰性與趣味性，可促進同儕間的情感連結，強化資料檢索，並深化實務應用與知識傳遞。本研究回應國內多聚焦於「批判性思維」而較少探討CTD的研究缺口，提供重要實證依據，並可作為醫護課程教學創新與改進之參考，以提升整體教學品質。

As Taiwan becomes a superaged society, increasing demand for longterm care requires nurse aides to develop a comprehensive understanding of disease pathology and care practices as a foundation of professional competence. However, when delivering health-care courses to in-service students without a medical background, educators frequently encounter challenges such as knowledge gaps and limited learning motivation. To address these challenges, the present study implemented a student-centered problem-based learning approach using authentic scenarios to guide learning, increase learners’ mastery of health-care knowledge, and strengthen critical thinking disposition (CTD) and long-term care competencies. The participants were 29 in-service students enrolled in a course covering topics in geriatric illness. The instructional design followed Ulger’s (2018) projectbased learning process cycle. Additionally, the short form Chinese version of the CTD inventory was administered, and the participants’ pre- and posttest scores were compared. The results demonstrated that: (1) Students’ CTD scores increased significantly after the project-based learning intervention; (2) Gender and professional certification had nosignificant effect on CTD; and (3) Age and work experience were not significantly correlated with CTD. This study addressed a research gap in Taiwan by focusing on CTD rather than critical thinking alone and provided empirical evidence to inform the innovation of health-care curricula and enhance teaching quality.