隨著現今醫療環境的複雜性不斷增加，病人安全是醫療照護品質重要核心之一。過去研究指出，剛畢業的護理學生由於缺少實際經驗，往往在處理臨床問題時遭遇困難。使用模擬臨床情境是一種有用的教學方法，可增加學生對真實情境的熟悉程度。因此，許多護理教育工作者已嘗試將虛擬實境技術運用在護理課程，讓學生有更多在模擬真實情境個案中進行演練的機會。然而，在一般的教學環境中，即使透過虛擬實境技術進行情境式的體驗，教學者仍然無法在學習過程中針對個別學生遭遇的問題提供即時回饋或引導。隨著科技的進步，聊天機器人已廣泛運用在各個領域，其可提供一對一對話及根據使用者上下文的談話內容給予回饋的優勢。因此 ，本研究嘗試使用聊天機器人結合虛擬實境的學習模式，提供學生在情境式體驗過程中個別引導及回饋。為了驗證這個模式的成效，本研究將針對護理課程的輸血安全培訓開發聊天機器人及虛擬實境學習環境。本研究採用準實驗研究設計，參與者為，一所護理專科學校兩個班級；其中一個班級為實驗組，以基於聊天機器人的虛擬實境學習模式進行學習；另外一個班級則為控制組，以一般的虛擬實境學習模式進行學習。研究結果發現使用聊天機器人結合虛擬實境的學習模式進行學習的學生，相較於使用一般虛擬實境學習模式，在學習成就、學習動機、批判性思考能力、學習態度、自我效能、問題解決能力、科技受度等方面皆有較佳的表現。由此可知，將聊天機器人結合虛擬實境的學習模式有助於提昇學生的在輸血安全培訓的各方面表現。

With the increasing complexity of today's healthcare environment, patient safety is one of the most important issues of health care quality. Previous research has shown that recent nursing graduates often encounter difficulties in dealing with clinical problems due to a lack of practical experience. The use of simulation technologies to provide clinical situations is a potential approach to enabling student's to experience the contexts of practical problems. Therefore, many nursing educators have attempted to use virtual reality technology in nursing curricula to provide students with more opportunities to practice in simulated practical cases. However, in a traditional teaching environment, even with the provision of a contextualized experience through virtual reality (VR), the instructor is still unable to provide immediate feedback or guidance to individual students when they encounter problems during the learning process. With the advancement of technology, chatbots have been widely used in various fields, offering the advantage of one-to-one conversations and feedback based on the contexts in which the users are situated. Therefore, this study attempts to proposed a chatbot-based virtual reality model to provide students with individual guidance and feedback during the VR-based contextualized experience. To validate the effectiveness of this model, a chatbot-based VR environment was developed for blood transfusion safety training in a nursing curriculum. A quasi-experimental research design to evaluate the effectiveness of the proposed approach. The participants were two classes of students in a nursing school. One class was the experimental group using the chatbot-based VR system, while the other class was the control group using the conventional VR system. The experimental results showed that students who used the chatbot-based VR mode had better performance in terms of learning achievement, motivation, critical thinking skills, learning attitude, self-efficacy, problem-solving skills, and technology acceptance than those who used the conventional VR mode. This implies that the combination of chatbot and virtual reality learning model can help improve students' performance in all aspects of transfusion safety training.

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