進階身體評估案例討論
Advanced Physical Assessment case discussion
| 節 | 週五 |
|---|---|
3 10:10–11:00 | 進階身體評估案例討論 YN414 2 節連堂 |
4 11:10–12:00 |
* 根據陽明交大上課時間表所列
Course Description The purposes of the course are to advance students' physical assessment, clinical reasoning, differential concept and debriefing skills through holistic and whole body system scientific based to play a role of advance practice nurse. Students will be able to take a comprehensive health history to assess physical and mental status of the clients. The students will also learn how to develop an appropriate scenario and conduct a physical assessment examination. 該課程的目的是架構在完整全身系統科學知識基礎以增進學生的身體評估、臨床推理和反饋技巧，發揮並提升護理專業。學生將能夠獲取全面的健康史，以評估病人的身心狀況。學生將學習如何發展適當的教學方案與進行身體評估檢查。 Course Objectives 1.Taking history based on patient’s chief compliant to assess physical and psychosocial status of adult clients 2. Perform relevant physical assessment based on the patient’s information 3. Synthesize the subjective and objective findings from the disease history and physical examination provide differential diagnoses and problem list according to evidence-based practice. 4. Perform advanced skills to collect subjective and objective data to facilitate differential diagnosis process. Subjective data refers to history taking, review of system and interview related to underlying health conditions. Objective data refers to physical examination results 5. Develop case scenario and plan physical assessment skill examination 6. Understand role and function of instructor, rater and feedback provider 7. Demonstrate debriefing skills for physical assessment skill examination 1.根據病人的主訴收集病史以評估成年病人的身體和心理社會狀況 2.根據病人的資料進行相關的身體評估 3.根據綜合主客觀資料來自病史和身體檢查的結果，以實證提供鑑別診斷和可能之健康問題 4. 執行進階技能來收集主觀和客觀數據，以完善鑑別診斷過程。 主觀數據是指藉由跟健康狀況相關的病史與訪談及系統性回顧。 客觀數據是指身體檢查結果。 5.制定案例情境並考核其身體評估技能 6.了解評估者和反饋提供者的角色和功能 7.展現身體評估技能及反饋技巧 Teaching Strategies & Methods This course will be delivered by lecturing and class discussion with physicians along with various topics as listed on the weekly class schedule Using flipped classroom and inquiry-based learning methods, students need to read case materials, relevant literature, and understand the teacher's questions before class. Each topic will be deliberate by the lecturer first which provide the possible differential diagnosis under a specific symptom or more symptoms through clinical reasoning process. Then, followed by case discussions with a student-centered manner and practice physical assessment to narrow down differential diagnosis through evidence based scientific knowledge and critical thinking. DxR clinician and HTC virtual human will be used during the class. DxR is a problem-based learning case studies created from real patient data. Virtual human is integrating generative AI and the platform enables rapid development of metaverse-based training modules—from drafting scenario scripts to designing voice-based interactive communication and relevant actions—significantly accelerating the production of immersive learning content.
教學策略/教學方式 本課程將透過講課和討論以及每週課程表中列出的各種主題進行與醫師協同授課。 運用翻轉教學與探究性教學，學生需要於課前先閱讀個案資料、相關文獻與了解教師提問。先每個主題將由教師首先授課，透過臨床推理過程提供在特定症狀或更多症狀下可能的鑑別診斷。 然後，以學生為中心的方式進行案例討論，並通過基於證據的科學知識和批判性思維進行身體評估，以聚焦鑑別診斷的範圍。 在課堂中將使用 DxR Clinician，這是一個基於真實病人數據所建立的問題導向學習案例平台。 新的教學方式含跨學院邀請醫學系教師協同授課、運用翻轉教學與探究性教學及線上虛擬病例軟體(DxR Clinician)練習。HTC Virtual human 虛擬人整合生成式 AI 技術，使該平台能夠快速開發以元宇宙為基礎的訓練學習模組，包含從情境撰寫及語音互動溝通設計，到相關行為設定，進而提升沉浸式學習的效率。
Course Evaluation: 1. Class preparation and participation (10 %) 2. Group discussion (10%) 3. Physical assessment skill practice (40%) 4. Charting (SOAPIE)(40%) Outcome: The family nurse practitioner (FNP) students can gain experience with different kind of patient problems that they might not have experience, and faculty can review students’ clinical reasoning skills from the platform and various teaching strategies/ interaction. 課程評值: 1.課前準備與參與（10%） 2.小組討論（10%） 3.身體評估技能練習 (Virtual Human VH 4.0)（40%） 4.病歷書寫（SOAPIE; Virtual Human VH 4.0）（40%） 成效:家庭專科護理學生可以藉此獲得不同類型病人的照護經驗，即使他們可能沒有相關的臨床經驗。教師則可以通過該平台與多元創新方式互動檢視學生的臨床推理能力。
| 週次 | 主題 |
|---|---|
| 第 1 週 | 6/26 Course introduction DxR practice or Virtual Human 4.0 |
| 第 2 週 | 7/4 Urinary incontinence and Confusion in older adults History taking and interviewing Clinical reasoning and differential diagnosis GU system/Physical examination skills |
| 第 3 週 | 7/4 Urinary incontinence and Confusion in older adults Related system/Physical examination skills Case study discussion |
| 第 4 週 | 7/11 History taking and interviewing practice – DxR practice or VH.4.0 Clinical reasoning, differential diagnosis and charting practice |
| 第 5 週 | 7/18 Pediatric common symptom 1 History taking and interviewing Clinical reasoning and differential diagnosis Related system/Physical examination skills |
| 第 6 週 | 7/18 Pediatric common symptom 2 History taking and interviewing Clinical reasoning and differential diagnosis ENT and Neurological system Physical examination skills |
| 第 7 週 | 7/25 Older Adults-Common health problems History taking and interviewing practice Case study homework |
| 第 8 週 | 7/25 Older adults Unintended weight loss History taking and interviewing Clinical reasoning and differential diagnosis Case study homework |
| 第 9 週 | 7/25 Sleep problems History taking and interviewing Clinical reasoning and differential diagnosis Related system/Physical examination skills |
| 第 10 週 | 8/1 History taking and interviewing practice – DxR practice orVH4.0 Clinical reasoning, differential diagnosis and charting practice |
| 第 11 週 | 8/1 History taking and interviewing practice – DxR practice or VH 4.0 Clinical reasoning, differential diagnosis and charting practice |
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Required reading: 1. Dains, E. J., Baumann, C. L. & Scheibel, P. (2017). Advanced Health Assessment & Clinical Diagnosis in Primary Care.(5/e) St Louis: Mosby. 2. Daniel Maldonado (2018). SOAP for Family Medicine. Wolter Kluwer 3. Seidel, H.M., Ball, J.W., Dains, J.E., & Benedict, G.W. (2017). Seidel’s Guide to Physical Examination. (8/e) St Louis: Mosby. Suggested reading: 1. Bickley, S. L. (2016). Bates’ physical examination. New York: Lippincott. 2. Friedman, H.H. (2017). Problem-oriented medical diagnosis. New York: Lippincott Williams & Wilkins. 3. Seller, H.S. (2017 ). Differential diagnosis of common complaints. Philadelphia: W.B. Saunders.
- 聯絡方式
- 童恒新 教授 henghsin@nycu.edu.tw 護理館504A 胡慧蘭 教授 sophiahu@nycu.edu.tw 護理館303 劉佩青 助理教授 ressy@nycu.edu.tw 護理館312