간호학의 중심개념을 기초로 한 대학 간호교육 과정 모형

Abstract

오늘날 새로이 제시하고 있는 인간과 환경 그리고 건강을 중심으로 한 새로운 간호 정의와 현대 간호 이론 모형의 제시는 간호교육자료로 하여금 지금까지의 전통적인 의학모델에 따른 간호교육과정에서 탈피하여, 보다 나은 건강관리에 대한 사회적인 요구와 급속히 증가하고 있는 간호학의 지식을 충분히 수렴시킬 수 있는 새로운 교육과정에 대한 필요성을 절감하게 만들었다. 따라서 본 “간호학의 중심개념을 기초로 한 대학간호 교육과정 모형”에 대한 연구는 간호학의 중심개념을 확인하고 이를 기초로 다른 학문과 구별되는 간호학의 분명한 구조를 제시하고 교과내용의 전체적 구조를 뚜렷이 나타내려는데 그 목적을 두었다. 본 연구는 간호이론에 관한 간호학문헌을 비롯하여 교육과정 전반에 관한 교육학 관계문헌등 광범위한 고찰을 중심으로 간호이론과 교육과정과의 관계 및 간호교육과정 구성경향을 분석규명하였으며, 현대 간호이론 중 체계이론(system theory)과 발달이론 (developmental theory)을 배경으로 한 간호학의 중심개념 선정, 학습계열의 초점 선정, 중심개념 선정, 학습계열의 초점 선정, 중심개념과 초점과의 상호작용을 분석 규명하였다. 첫째로 그 중심개념은 개인과 가족 그리고 지역사회 집단을 위한 최대의 건강 목표(개념A), 주변환경요인과 끊임없이 상호작용하며 적응하는 인간의 적응(개념B),개인, 가족, 지역사회 집단 및 전문직을 위한 전문적 임무(개념C), 기능기술, 의사 소통술, 간호과정의 방법을 포함하는 간호술(개념D)로 확인되었으며, 이 네 가지 중심 개념들은 동시에 전문직 간호업무에 필수적인 목표, 이론, 태도, 기술과 관련된다. 둘째로, 학습계열의 초점은 학습자로서, 가족과 지역사회의 일원으로서 그리고 후보생으로서 학생(초점Ⅰ), 가족의 일원으로서의 환자(초점Ⅱ), 사회의 단위로서의 가족(초점Ⅲ), 전문가로서의 간호원(초점Ⅳ)으로 선정되었다. 셋째, 최대의 건강목표, 인간의 적응, 전문적 임무,간호술 등 네 가지의 중심개념과 학생, 환자, 가족, 간호원의 학습계열의 초점과의 수평적 수직적 상호작용은 학습내용과 학습경험을 결정하며 간호교육과정 모형 형성의 기초가 되었다. ; The typical nursing curricula in baccalaureate degree programs focus their content and learning experiences around block sequence of five clinical specialities. The rigid nature of this organization presents problems in helping the student build on previous learnings to synthesize materials and to conceptualize on a broad basis. The purpose of this study is to provide a model for curriculum development based on core concept relevant to the study of nursing. A planned sequential focus allows for the exploration of the core concepts in increasing depth. It also permits for a greater adaptability in the selection of the content and learning experience to fit in with the needs of a rapidly changing society. The step used in evolving this construct are as follows: 1. Review of the literature for the rationale underlying this study, for selecting core concepts and for planning the developmental sequence. 2. Identification of core concepts basic to nursing theory and practice. 3. Selection of a developmental focus for each phase of the program based on learning theory. 4. Development of content based on interaction of core concepts with focus for each phase of the program. 5. Selection of learning experience. The following core concepts relate to the goal, theory attitudes and skills necessary for professional practice as they were presented in this study: A. Maximum Health Goal : The goal of nursing is to maximize the health potential of individual, family, to the community and to the profession. B. Man’s Adaptation : Man is in continual interaction with and adapts to his environmental forces. C. Professional Commitments : The nurse has a professional commitment to the individual, family, to the community and to the profession. D. Skills: Nursing skills include technical competencies, communication skills, nursing process. The following is the suggested sequential focus for developing the core concepts in depth: Phrase Ⅰ The student as a learner, member of a family and community, and entering a profession. Phrase Ⅱ The patient as a member of a family. Phrase Ⅲ The family as a unit of a society. Phrase Ⅳ The nurse as a profession. Some of the propositions relating to the development of the proposal are as follows: 1. The core concepts should relate to the goal, theory, attitude and skills of professional nursing. 2. Core concepts should be interdependent and interrelated. 3. A phase is equal to the sum of the states of the interaction of the core concept with the focus. 4. The focus for the phase represents the major emphasis that is to be given to the specific core concept. 5. The focus changes with each phase. 6. The focus is deduced from the objectives and should be compatible with laws of learning. 7. Content is the result of the interaction of the core concepts with focus for each phase. 8. Learning experiences are selected that will make the content meaningful and applicable. 9. The learning experiences are planned for prior the selection of clinical agencies. If a particular experience is not available, then modifications can be made in the plan. 10. The selection of related non-nursing courses is determined by the core concepts. The placement of the courses in the curriculum is determined by the focus. The implementation of this proposal requires a strategy of planned change. Five steps are suggested ; (1) study, (2) development, (3) trial, (4) evaluation, (5) adoption. This proposal has implications relating to the type of evaluation for the preservice baccalaureate programs by the profession. The most important implication is the need for experimentation and tryout of the proposal. Although the construct was conceived and planned for the nursing major, with some adaptation it could be also as an experimental model for other professional education programs.