《临终关怀》课程中的小组合作学习行动研究

Group cooperative learning action research in the course of hospice care

目的：应用行动研究方法，探讨小组合作学习在临终关怀课程中的应用效果。方法将82名护生分组，其中合作学习组40人，传统教学组42人。在《临终关怀》教学前后，采用善终期望认知和态度测评量表，评估两组护生认知及态度；教学后自制学习效果自评及反馈调查表，评估合作学习组效果。采用SPSS 17.0，对组间和组内数据比较，行t检验、χ2检验或Fisher确切概率法。结果教学前两组护生善终期望认知及态度之间差异均无统计学意义（P〉0.05）；教学后合作学习组护生的认知水平、态度较教学前有明显提高（P〈0.05），对临终患者生理需求认知度优于传统教学组（t=5.398，P=0.001），且个人对死亡认知及接受死亡教育态度更为积极（t=2.992，P=0.004；t=3.661，P=0.001）。尽管有95%的合作学习组护生认为，该教学有助于提高学习兴趣和培养综合实力；但接受小组合作学习方式的护生只占50%。结论基于合作学习理念的行动研究，可有效提高护生善终期望认知和改善护生态度，对培养和锻炼学生自主、创新、合作学习能力具有积极促进作用；同时，对教师能力提出较高要求，可推动教师自身成长。但具体实践中，学生对小组学习的接受度有待提高。

Objective To explore the effect of action research based on group learning in hospice care module for nursing students. Methods 82 students were divided into cooperative learning group （40） and conventional teaching group （42）. The cognition and attitude of good death questionnaire was used to evaluate teaching effect before and after teaching of hospice care. After teaching, self-feedback and self-feedback questionnaire were made to evaluate the effect of cooperative learning group. SPSS 17 was used to make comparison of data between groups and within groups, and t test, chi square test or Fisher exact probability 2 were also used . Results There were no difference between two groups of nurses before teaching. The students＇ cognitive level and attitude in cooperative learning group increased significantly, especially their cognitive level of physiological needs （t=5.398, P=0.001）, cognition and attitude of death education in intervention group was higher than control group （t=2.992, P=0.004; t=3.661, P=0.001）. Although 95% of the nursing students of the cooperative learning group thought group cooperative studying could improve their interests and cultivated their comprehensive abilities, only 50% could accept this kind of studying methods . Conclusions Action research based on group cooperative studying can improve students＇ cognitive level and attitude of good death, and it is also good for cultivating their ability of au-tonomous learning, innovation, cooperation, and meanwhile, educational action research is a good way to improve both teaching effect and research ability of teacher staffs, but in practice, students＇ acceptance of group learning needs to be improved.