본 연구는 2009년부터 2018년 최근 10년간 대한간호학회지와 분과학회지에 게재된 개념분석 연구의 통합적 문헌고찰 연구이다. 총 30편의 논문을 간호의 메타패러다임, 개념의 종류, 개념분석 방법, 활용정도 등 분석하였다. 결과로 간호의 메타패러다임은 인간 23편, 간호 5편, 건강 1편, 환경 1편으로 인간이 가장 많았으며, 개념의 종류는 모두 추상적인 개념으로 확인되었다. 개념 분석 방법으로는 워커 & 아벤트가 13편, 하이브리드 방법이 10편, 진화론적 방법이 7편으로 워커 & 아벤트 방법이 가장 많았으나 2018년도 이후에는 모두 하이브리드 방법이었다. 도구개발로의 진행은 확인되지 않았다. 연구 결과를 토대로 간호패러다임의 다양성과 이를 바탕으로 한 도구 개발도 필요하다.

본 연구는 간호대학생의 비판적 사고, 셀프리더십과 학습 몰입 정도를 파악하고, 학습 몰입에 미치는 영향을 확인하고자 시도 되었다. 연구 대상자는 D 광역시, G 광역시에 소재한 2개 간호학과 2학년 학생 196명을 대상으로 하였으며, 2018년 11월 26일부터 12월 7일까지 자료수집하였다. 수집된 자료는 SPSS 21.0 프로그램을 사용하여 기술 통계, t-test, ANOVA, Pearson 상관계수, 다중회귀분석으로 분석하였다. 연구결과 일반적 특성에 따른 학습 몰입은 학교 성적, 전공 만족도, 대인관계에 따라 유의한 차이를 보였고, 학습 몰입은 셀프리더십(r=.738, p<.001)과 유의한 양의 상관관계가 있는 것으로 나타났다. 또한, 학습 몰입에 영향을 미치는 요인은 학교 성적(β=-.212, p=.011), 전공 만족도(β=.248, p=.001), 셀프리더십(β=.598, p<.001)으로 나타났으며, 학습 몰입에 대한 이들 변인의 설명력은 58%로 나타났다. 본 연구 결과를 토대로 간호대학생의 학습 몰입을 향상시키기 위해서는 전공 만족도와 셀프리더십을 증진시킬 수 있는 프로그램 개발이 필요할 것으로 생각한다.

본 연구는 병원간호사의 간호조직문화, 조직커뮤니케이션만족, 직무착근도의 관계를 확인하고, 직무착근도에 미치는 영향요인을 파악하기 위함이다. C시 소재한 대학병원에 근무하고 있는 간호사 238명을 대상으로 2017년 8월 1일∼8월 10일까지 자료수집 하였다. 자료는 SPSS WIN 22.0 통계 프로 그램을 이용하여, 기술통계, t-test, ANOVA, Pearson’s correlation coefficient, Stepwise Multiple Linear Regression으로 확인하였다. 본 연구결과 간호조직문화는 5점 만점에 평균 3.32±0.33점 이었고, 조직커뮤니케이션만족은 5점 만점에 평균 3.19±0.37점 이었으며, 직무착근도는 5점 만점에 평균 3.19±0.44점이었다. 일반적 특성에 따른 직무착근도의 차이는 연령(F=9.00, p<.001), 학력(F=13.24, p<.001), 직위(t=-5.42, p<.001), 결혼(t=-3.11, p=.002), 근무경력(F=10.55, p<.001), 근무형태 (F=10.99, p<.001)에서 유의한 차이가 있었다. 직무착근도와 간호조직문화(r=.502, p<.001), 조직커뮤니케이션만족(r=.673, p<.001)은 양의 상관관계가 있었다. 직무착근도에 영향을 미치는 요인으로 조직커뮤 니케이션만족(β=.575 p=.000), 근무경력 ‘10년 이상’(β=.342 p=.000), 간호조직문화(β=.203 p=.000), 근무경력 ‘5년 이상∼10년 미만’(β=.121 p=.000)의 순이었고, 모형의 설명력은 57.4%이었다. 이상의 결과에 따라 병원간호사의 간호직무에 착근도를 높이기 위하여 조직커뮤니케이션만족도를 수시로 파악하고, 근무경력, 간호조직문화 등을 고려한 간호실무 및 교육중재 프로그램 개발이 필요하다.

The purpose of this study was to identify the relationship between bullying, nursing work environment, reality shock and factors of influence on turnover intension. Data were collected from 381 nurses who were under the charge nurse at a hospital with more than 600 beds in Seoul. The collected data were analyzed using the SPSS24.0 program. The mean score for turnover intension was 3.61 ± 0.89. The intension of turnover was correlated with bullying in the workplace (r=0.197, ρ=.001), the nursing work environment (r=-.409, p=.001), and reality shock (r=.572, p=.001). Variables affecting turnover intension were the work department(β=-0.018, ρ=.049), working environment(β=-0.424, ρ<.000), and reality shock(β=0.654, ρ<.000). The total amount of explanation for turnover intension was 37.3%. The degree of turnover intension of nurses was affected by work in general wards, the experience of workplace bullying and the nursing work environment. To reduce turnover intension, nursing work needs to be analyzed and efforts are needed to establish an effective communication system.

본 연구는 간호대학생의 간호사 이미지, 임상수행능력, 전공만족도가 간호전문직관에 미치는 영향을 파악하기 위해 2018년 10월 15일부터 19일까지 G시의 간호대학 2, 3학년을 대상으로 설문조사하였다. 자료분석은 기술통계, t-test, ANOVA, 다중회귀 분석방법을 이용하였다. 연구결과, 간호전문직관은 간호사 이미지(r=.70, p<.001), 임상수행능력(r=.23, p<.001), 전공만족도(r=.62, p<.001)와 유의한 양의 상관 관계가 있었다. 임상수행능력은 간호사 이미지와 양의 상관관계가(r=.14, p=.015) 전공만족도는 간호사 이미지(r=.55, p<.001), 임상수행능력(r=.14, p=.012)과 양의 상관관계가 있었다. 간호전문직관에 영향을 미치는 요인으로는 전공만족도(β=.32, p<.001), 사회적 이미지(β=.31, p<.001), 전문적 이미지(β=.21, p<.001), 임상수행능력(β=.09, p=.018) 순이었으며 설명력은 59.9%이었다. 따라서 간호대학생의 긍정적 간호전문직관 확립을 위해서는 간호사 이미지, 전공만족도 및 임상수행능력 향상을 위한 다양하고 체계적인 교육프로그램 개발이 필요하리라 생각된다.

본 연구는 종합병원 간호사의 감정노동, 직무스트레스와 간호업무성과 정도를 살펴보고 간호업무성과에 미치는 영향을 확인하기 위한 서술적 조사연구이다. 연구 대상자는 G 광역시에 소재한 200∼400병상 규모의 종합병원 2곳에 근무하는 간호사 132명이었고 자료수집 기간은 2019년 8월 20일 부터 9월 2일까지였으며 본 연구자가 직접 구조화된 설문지를 이용하여 조사하였다. 수집된 자료는 SPSS 21.0 프로그램을 이용하여 빈도와 백분율, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient 및 Multiple regression analysis로 분석하였다. 연구결과, 대상자의 간호업무성과에 미치는 영향요인은 회복탄력성(β=0.58, p<.001), 현 직위가 수간호사인 경우(β=0.21, p<.01), 현 근무지경력(β =0.18, p<.05)이었다. 또한, 추정된 회귀모형의 적합도에 대한 F통계량은 30.901(p<.001)으로 매우 유의 하였고, 설명력은 42.4%인 것으로 나타났다. 본 연구결과, 종합병원 간호사의 간호업무성과에 회복탄력성이 가장 큰 영향요인으로 확인되었고, 수간호사일수록, 현 근무지경력이 많을수록 간호업무성과가 높 은 것으로 확인되었다. 따라서 연구결과를 토대로 간호업무성과를 향상시키기 위한 방안을 모색하고 이에 대한 중재프로그램을 개발하는 기초 자료로 활용될 것으로 기대된다.

본 연구의 목적은 간호 교육의 교수 수준을 향상시키기 위한 관리 방법을 모색하는 것이며, 응급 간호를 예로 들어 간호학전문교육과정 에서 PDCA 관리시스템을 응용하기 위한 것이다. 교육 프로그램 작 성(Plan), 구체적인 교육교수 실시(Do), 교육효과에 대한 형성 평가하 는 동시에 교육효과의 피드백(Check) 및 교육실시방안의 총결과수정 (Action) 4단계로 이루어진다. 끝임 없이 새로운 PDCA 순환을 통해 간호학의 교육품질을 최적화 실시하였다. 우리학교를 선택함에 2019년 1월-6월 및 2019년 7월-12 월 두 차례로 나누어 간호실습에 참가한 간호생이 각 50명, 컴페어팀 및 관찰팀으로 설정되었다. 컴페어팀은 전통교육법을 응용해 간호교 육을 진행하고 관찰팀은 간호교육에서 PDCA 순환법을 적용하였다. 두 팀 실습간호생의 종합능력테스트 정황 및 교육만족도를 비교한 결과 관찰팀 간호생의 이론적 지식, 기초 간호 기능, 전문 간호 기능 과 종합 간호 기능 등 각 방면의 성적평가는 컴페이팀 보다 높았다. 그 외에 간호교육에 대한 총 만족도도 컴페이팀 보다 훨씬 높았다. 이렇게 실행한 결과 PDCA 관리방법을 응용해 간호학 전문 교사팀 의 교육능력을 향상시키는 동시에 간호학 교육품질을 향상 촉진해 간호 인재를 배양하고 능력을 강화시킬 수 있을 것이다.

Purpose: This is a group pretest-posttest design study that aim to examine the effect of smart problem-based learning (PBL) teaching method using flipped learning to meta-cognition, academic self-efficacy, and satisfaction level of nursing students. Method: The subjects were 76 students who took basic nursing practice, which is a major subject, from August 29 to December 13, 2018. A questionnaire was used to measure meta-cognition in web-based self-directed learning. The self-efficacy measurement used a scale consisting of self-regulating efficacy, task difficulty preference, and confidence. The measurement of practical satisfaction is a 5-point Likert scale that employs a questionnaire. Flipped learning uploaded a 10-minute lecture video, and the subjects learned through PC or smartphone. PBL teaching was developed in two modules: gavage and indwelling urinary tract. Results: Result showed a significant improvement of meta-cognition after education than before education (t=3.21, p=.043). Academic self-efficacy was not significantly changed before and after education. Practice satisfaction was significantly improved after training than before training (t=-2.19, p=.032). Conclusion: The smart PBL teaching method using flipped learning is an effective teaching and learning strategy for nursing majors. Nursing students with high meta-cognition will be able to perform well in their learning outcomes; therefore, this positive performance experience will enhance self-efficacy.

Purpose: This study examined the effects of simulation-based education for high-risk maternity on evaluating problem-solving process, self-leadership, critical thinking disposition, and selfefficacy of nursing students. Method: This study was a one-group pretest-postest test design with 81 junior nursing students as participants. Data were collected from September 4 to December 11, 2019, after students completed their simulation practice class. Students completed a survey on their problem-solving process, self-leadership, critical thinking disposition, and self-efficacy at the beginning and end of the class. Data were analyzed using descriptive statistics, paired t-test, and Pearson’s correlation coefficients using the SPSS WIN 21.0 program. Results: Students’ problem-solving process (t=-7.06, p<.001), self-leadership (t=-3.08, p=.003), critical thinking disposition (t=-2.12, p=.037), and self-efficacy (t=-6.01, p<.001) showed significant improvement after the simulation-based education for high-risk maternity. There was a positive relation between problem-solving process and self-leadership (r=.52, p<.001), critical thinking disposition (r=.39, p<.001), and self-efficacy (r=.53, p<.001). Conclusion: There is a need to supplement the limitations of clinical practice education by providing a simulation-based education environment similar to a hospital since the experience of clinical practice alone is not sufficient to improve students' knowledge and skills. Results of this study may be used as a basic data for efficiently performing simulation-based education on high-risk maternity.

Purpose: This study is examined the effects of simulation practice education with problem-based learning methods on nursing students' learning attitudes, learning satisfaction, critical thinking disposition, and problem-solving ability. Method: A quasi-experiment single group pretest-posttest design was adopted. Simulation education was conducted by utilizing problem-based learning methods to teach the following topics to nursing students enrolled in 4th grade in S city: respiratory, circulatory, and nervous system. The experiment was conducted for 12 weeks, from September to December, 2019. Paired t-test and Pearson product-moment correlation coefficient were used to analyze the collected data. Results: Learning attitude and problem-solving ability showed significant differences in the experiment. Among the sub-areas of problem-solving ability, there were significant differences in the following: problem recognition (p<.001), information gathering (p<.001), confident thinking disposition (p<.001), acceptance to carry out an adventure (p<.001), evaluation (p=.027), and feedback (p<.001). In addition, learning attitude showed significant positive correlations with learning satisfaction, critical thinking disposition, and problem-solving ability. Conclusion: The findings of this study suggest that, it is necessary to develop a variety of iterative studies and simulation scenarios to confirm the effectiveness of simulation training.

Purpose: This study aimed to identify the current status and needs of nursing education for extremely low birth weight (ELBW) infants in Korea, and to obtain preliminary information to develop a simulation-based educational program on nursing care for nurses in the neonatal intensive care unit (NICUs). Method: Descriptive survey design was adopted in developing an ELBW infant nursing education program. Data were collected from 71 NICU nurses using a questionnaire survey. Statistical Package for the Social Science (SPSS) (version 23) for windows was used to analyze the frequency, percentage, mean, and standard deviation of the collected data. Results: Seventy-one nurses working in the NICU reported that majority of them (76.1%) had experience in ELBW infants’ nursing education. The following were highly recommended for simulated training by NICU nurses: nursing intervention immediately after birth in ELBW infants (69.0%), NICU‘ initial admission nursing (66.2%), and frequency response coping nursing (57.7%). Conclusion: The study revealed that there is a considerable need for the ELBW infants nursing education program. The results of this survey will ultimately provide a basis for developing simulation-based ELBW infants nursing training programs for NICU nurses.

Purpose: Simulation-based education combined with mastery learning is more effective than simulation-based education alone. This study aimed to evaluate its effectiveness with regard to both technical and non-technical skills of simulation-based mastery learning (SBML) in blood transfusion training among undergraduate nursing students. Method: A nonequivalent control group pretest-posttest design was used. Fifty-one second-year students at a college of nursing in W city, South Korea, who had not started clinical practice were selected by convenience sampling and allocated to either the experimental or control group using the zigzag method. SBML program was consisted of a diagnostic test, repeated learning and formative assessments for non-passers. All outcome variables were measured before and after completion of the program. Results: The experimental group showed significantly increased performance scores of blood transfusion as compared to the control group (z=29.50, p＜.001), with better outcomes in number of students achieving minimum passing score (χ2 =20.07, p＜.001), self-confidence (F=17.68, p＜.001), and communication skills (z=166.00, p=.003). Conclusion: This program was effective for undergraduate students to better improvement in performance, self-confidence, and communication skills, which can ensure greater safety in the transfusion. The results suggest that SBML ensures skill acquisition for clinical practice through improved performances in both technical and non-technical skills.

The purpose of this study is to evaluate the application of a web-based cost management competency enhancement program (Web-CMCEP) on nursing students. Medical services are limited and essential for maintenance of human basic life. In order to improve the quality of human life, cost management competency that enable efficient allocation of medical resources are essential. This study adopts a randomized controlled pre/post repeated measure design. The sample comprised 39 nursing students in the web-group and 35 in the textbook-group. Experimental group and control group learned respectively with Web- CMCEP and textbook for 4 weeks. The research variables were measured at 4 times: pre, post, after 4 weeks of intervention, and after 8 weeks of intervention. Data were analyzed using χ2 -test, t-test, paired t-test, repeated measures ANOVA, Friedman test, and Wilcoxon signed rank test. Significant differences were found in cost management knowledge. The web-group showed higher cost management knowledge than the text-group. At different measuring points, the Web-CMCEP led to significant increases in the following: cost management knowledge, cost management attitude, cost management behavior, cost management self-efficacy, and entrepreneurship. Based on the findings, we suggested utilizing the Web-CMCEP as a prototype in developing education programs to improve nursing students’ cost management competency and to support nursing start-ups.

Purpose: Despite the effort to bridge the disconnect between educational preparation of competent nurses and employers' expectation of new graduates, there is little known about what nursing competencies are required for new graduates. This paper aims to identify the nursing competencies expected of new graduates, both globally and in the specific Korean context. Methods: An integrative literature review was undertaken. International and Korean computerised databases were searched and 72 relevant papers were appraised using the Mixed Methods Appraisal Tool and the Data Relevance. Twenty-eight studies were selected for final data analysis. Results: Three themes with eleven competency areas were discovered: new graduates are expected to be competent in delivering an evidence-based practice with a patient-centered approach as professional nurses. Competency in evidence-based practice involves being able to integrate theory and skills, utilise contemporary evidence, and undertake a systematic approach. Patient-centred care involves ensuring patient safety, educating the patient and their family, and demonstrating sound interpersonal communication skills with a collaborative approach. New graduates are also expected to practice legal and ethical nursing care, undertake continuing professional development, and demonstrate a capacity for clinical management and appropriate professional attributes. Conclusion: Identifying nursing competencies for new graduates can add a level of detail to the current nursing competencies required for new graduates in the global and the Korean context. The findings can be used not only to inform education providers of potential gaps in preparation for practice of new graduates, but also be used to identify support needed when graduates enter nursing workforce.

본 연구는 문제중심학습(PBL) 수업을 2018년 2학기 ‘간호과정과 비판적사고’ 교과목에 적용한 후, 비판적 사고성향, 문제해결능력과 전문직 자아개념에 대한 효과를 규명하기 위하여 단일군 전⦁후 설계를 활용한 원시실험 연구이다. G도에 소재한 간호대학생 59명을 대상으로 자가보고식 설문을 실시하였다. 문제중심학습(PBL) 수업은 전통식 강의 8주, 문제중심학습(PBL) 수업 4주로 진행하였다. 자료분석은 SPSS/WIN 23.0 프로그램을 이용하였으며 일반적 특성은 빈도와 백분율, 두군 간에 차이는 평균, 표준편차, Paired t-test를 시행하였다. 연구결과, 간호대학생의 비판적 사고성향은 문제중심학습(PBL) 수업 전 (3.41±.40)보다 수업 후(3.71±.36)에 유의하게 증가하였다(t=4.39, p<.001). 문제해결능력은 문제중심학습(PBL) 수업 전(3.36±.38)보다 수업 후(3.70±.59)에 유의하게 증가하였다(t=3.97, p<.001). 전문직 자아 개념은 문제중심학습(PBL) 수업 전(2.92±.28)보다 수업 후(3.22±.50)에 유의하게 증가하였다(t=4.84, p<.001). 따라서 문제중심학습(PBL)을 간호교육에 더욱 확대하여 적용한다면 간호대학생이 갖추어야 할 핵심역량을 높이는데 효과적일 것이라고 사료된다.

Purpose: The purpose of this study was to identify the effects of learner-directed debriefing based on the clinical judgement model (LDCJM) on nursing students’ critical thinking disposition, selfdirected learning, problem-solving ability, and debriefing experience after simulation. Method: This study used a quasi-experimental design with 38 sophomore nursing students from one university. They were divided into an experimental group (n=20) and a control group (n=18). Collected data were analyzed by the Chi-square, the Mann-Whitney U-test, and the Wilcoxon signed-rank test using the WIN SPSS 22.0 program. Results: The experimental group that had participated in the LDCJM indicated significantly higher self-directed learning (U=23.50, p<.001), problem-solving ability (U=94.50 p=.011), and debriefing experience (U=87.00, p=.006) when compared to the control group. Conclusion: The results indicate that LDCJM is an effective learning strategy to improve self-directed learning, problem-solving ability, and debriefing experience. Further study is needed to identify the effects of various debriefing skills.

Purpose: This study, as presented by Kern, Thomas, and Hughes , aims to verify the effectiveness of clinical inference education through digital storytelling programs based on Smith and Mann’s (2002) mobile education model in accordance with the six stages of the medical course development model. Based on the mobile education model of Smith and Mann (2002), the effectiveness of clinical reasoning education is verified through the mobile education program. Method: A single group pre-post test design that evaluates the clinical reasoning education effects of the mobile education program was used. Results: A statistically significant improvement was observed in clinical inference capacity from before intervention (t=-9.81, p<0.001); there was also a greater difference in the average value after intervention than before intervention in all of the results. Conclusion: This study suggests that while scenarios were constructed around five cases of high-risk Infant with respiratory and mechanical problems, in the future, additional scenarios should be developed to include different body systems.

Purpose: This study aimed to investigate the correlation between self-efficacy in communication, flow, and nursing students’ competence in communication, and examined the effect of self-efficacy on communication, and the effect of flow on competence in communication. Method: Data of 123 fourth-year nursing students were collected using structured self-report questionnaires in simulation-based education. The data were analyzed using descriptive statistics, the independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and hierarchical multiple regression. Results: Self-efficacy in communication, flow, and competence in communication were positively correlated. The final regression model showed that self-efficacy in communication and flow accounted for 31.4% of the variance in predictions of competence in communication. Additionally, self-efficacy in communication was the most influential factor. Conclusion: The study supports a strategy to improve self-efficacy in communication and flow by improving nursing students’ competence in communication in simulation-based education.

Purpose: This study was conducted to provide simulation training on evidence-based practical training and to examine its effects. Method: Data were collected from 83 students at C University, between October 1, 2018 and December 31, 2018. This training was conducted over a 5-week period. Data were analyzed using descriptive statistics, the Friedman test, the Wilcoxon signedrank test, and Repeated Measure ANOVA, all after the normality test. Results: There was a significant difference between the two groups in evidence-based practice beliefs, competence, nursing profession perspective, critical thinking tendencies, and problem-solving ability (p<.001). More specifically, there was a greater improvement in evidence-based practice knowledge, critical thinking tendency, and problem-solving ability than in the existing simulation exercise. Conclusion: Being effective in enhancing the ability to provide evidence-based practice beliefs, competencies, nursing profession perspectives, and, especially in evidence-based practice knowledge, critical thinking tendencies, and problem-solving skills, it is necessary to link evidence-based education and existing simulation training.

Purpose: The National League for Nursing/Jeffries Simulation Theory (NLN/JST) is a middle-range theory widely used in nursing simulation education. Although the NLN/JST was revised in 2015, there is still no formal critique of the theory. The purpose of this study is to present a critique of the NLN/JST. Method: This study comprehensively analyzes and evaluates the theory using Fawcett and DeSanto-Madeya’s (2013) framework. Results: The theory demonstrates positive social and theoretical significance, testability, and empirical and pragmatic adequacy. Nevertheless, semantic clarity and internal consistency need to be made clearer. Conclusion: The NLN/JST is a suitable framework for nursing simulation education. The theory considers not only participants but also patients and systems as outcomes of simulation education, and is able to incorporate situation-specific backgrounds. That said, it is still necessary to develop a systematic nursing curriculum for clinical reasoning competence of both nursing students and nurses, given the wide range of clinical situations they may encounter.