浅谈如何提高护生的临床实习效果

目的：提高护生的临床实习效果。方法：加强对护生岗前培训和提高人际关系适应能力；带教师资的管理；严格执行实习计划结；认真考评。结果：提高护生操作技能；养合格护士。结论：加强对护生和带教老师的管理。认真作好考评工作。提高护生的临床实践经验，为今后独立工作奠定良好基础。     

临床护理师资管理和培训体系的构建

目的建立系统的、科学的临床护理师资管理和培训体系,提高临床带教能力,确保护理实习生(以下简称护生)的实习效果,培养优秀的护理人才。方法明确建立师资管理和培训体系的目标,同时建立及制定师资管理和培训制度,采用严格的临床带教资格认证,建立全院临床护理带教老师管理档案,实行导师制带教,建立实习带教老师考评表,完善带教老师的激励机制,通过集中培训的方法对临床带教老师进行短期培训。比较建立师资管理和培训体系前后的教学质量。结果建立师资管理和培训体系后带教老师综合考评、护生对带教老师的满意度测评及护生综合成绩均较之前明显提高(P<0.05)。结论临床护理师资管理和培训体系的构建,拓宽了带教老师的知识结构,提升了带教能力,日常工作也更加规范化和标准化,从而促进护生的满意度提高。     

形成性评价在临床护理教学中的开展对护生就业竞争力的影响

目的 探讨在临床护理教学中采用形成性评价对护生就业竞争力的影响.方法 选取2014届护理本科实习生160人 ,分为A、B班 ,各80人.A班为观察组 ,采用形成性评价法 ,B班为对照组 ,采用终结性评价法.每季度实习结束后 ,比较两个班理论成绩、操作成绩、综合能力考评结果 .实习结束后 ,对2个班护生的就业能力自我评估进行统计分析.结果 实习期间下阶段观察组护生理论成绩、操作成绩、综合能力考评分值均显著高于对照组 ,实习结束后观察组护生就业能力自我评估 ,其中专业能力、分析能力等5方面分值明显高于对照组(P均<0 .05 ).结论 在临床护理教学中开展形成性评价 ,可以增强护生就业竞争力.     

追踪管理方法在外科临床护理教学中的应用

目的分析追踪管理方法在外科临床护理教学中的应用与效果,提高临床护理教学水平。方法在参考企业追踪管理理论的基础上,成立追踪管理小组,对114名本科护生进行实习教学追踪管理,对护生的实习目标、临床护理能力、工作服务态度、护理文件书写等结果进行反馈追踪。结果护生出科综合考评成绩达标率达97.37%,对临床护理教学满意度达100%。结论应用追踪管理法,强化了外科临床护理教学过程中的细节管理,有针对性地解决临床护理问题,提高了护生的实习质量及其对教学的满意度,提高了外科临床护理教学水平,达到了教、学双赢的目的。     

实施临床护理实习总带教老师的效果及评价

目的提高临床护生的实习效果，寻求规范化、系统化的实习管理方法，保证实习教学质量。方法实施聘任临床实习总带教老师，并采取科学的管理方法对总带教老师进行审查、培训、考核、聘任，制定工作职责，使其完成护理实习总带教工作。结果实施总带教老师制度后，护生以及护理部对总带教老师评价满意，护生的临床实习成绩提高。结论实施临床护理实习总带教老师制度，规范了实习教学工作，促进了教学质量的提高，值得推广。     

加强高职护生毕业实习期间隐性护理知识管理的探究

[目的]探索加强高职护生毕业临床实习期间护理隐性知识管理的策略及对临床实习护生实习质量的影响。[方法]以中国医科大学高职学院2010年7月—2011年6月临床生产实习护生为实验教学对象,通过强化师生隐性知识培训、增加深度会谈教学策略、撰写实习笔记和日志,促进隐性知识的生成、提高师德和带教水平、改革出科考评方法等举措对现有的临床带教措施进行重新设计和补充,利于护理隐性知识更充分地共享。采用实习医院带教教师评价量表对护生的实习质量进行问卷调查。[结果]加强护理隐性知识管理,能提高护生临床实习质量。[结论]建议加强护生毕业临床实习护理隐性知识管理,促进护生职业能力的养成和提高。     

护理本科生实习综合能力测评办法探讨

目的 探讨一种较为全面评价本科护生毕业临床实习的考评办法。方法 根据历年带教大、中专护理毕业生实践的经验,结合实习大纲要求制订出详细的综合能力测评系统,对99级本科护生的实习情况进行综合测评、计分。结果护生通过10个月的临床实习,综合考评结果基本符合正态分布,成绩与每一位护生的综合表现相符。达到了公正、全面、综合、量化考评学生的目的,提高了临床教学质量,也为用人单位选择人才提供了依据。结论 全面综合考评系统是一个评价本科实习生实习效果较为理想的方法,有利于提高临床护理教学质量。     

全程双导师责任制整体护理实习模式的构建及应用研究

目的 :基于责任制整体护理理念,建立全程双导师护理实习模式,并探究其应用效果。方法 :采用便利抽样,纳入2014年度于某三级甲等医院进行临床毕业实习的182名护生为实验组,2013年度在同一医院实习的165名护生为对照组,学历均为本科。实验组采用全程双导师责任制整体护理实习模式,具体包括完整的三级监管体系、双导师带教制度、持续改进的PDCA责任制整体护理实习路径及多渠道师生互动平台;对照组采用传统护理实习模式。实习结束时,对两组护生进行综合考评,调查护生职业认同、对实习模式评价和患者护理服务满意度。结果 :实验组护生的综合考评结果、职业认同(除组织影响感维度外)、实习模式评价均高于对照组,差异有统计学意义(P0.05),患者对实验组护生的护理服务满意度优于对照组(P0.05)。结论 :全程双导师责任制整体护理实习模式顺应现阶段高等护理教育培养目标,应用效果显著,值得进一步推广。     

影响护生动手能力的因素分析

目的 探讨影响实习护生在临床实习中动手能力的因素。 方法 对2007年4月-2009年4月来我科实习的护生共211人采用调查、观察、考试相结合的综合测评,调查实习护生动手能力的现状。 结果 动手能力考评差的护生占总人数的42.2%;影响护生动手能力的原因包括护生自身原因、心理因素、实习环境、临床教师及患者因素等。结论 应从加强护生的理论知识学习、岗前培训,提高带教水平,培养护生的沟通技巧等方面入手,提高护生在临床工作中的实际动手能力。     

临床人文环境对实习护生影响的调查分析

目的了解临床人文环境对实习护生的影响,为创造良好教学人文环境提供努力方向。方法采用自行设计的调查问卷对实习护生进行调查。结果临床人文环境对护生的影响主要有实习效果、工作态度、专业思想和心理压力;专科护生在实习效果、工作态度、专业思想、求知欲4个方面受临床人文环境的影响高于本科生（P〈0．05,P〈0．01）。结论护理管理者应科学地建立临床教学基地和完善临床人文环境管理;临床科室应注重自身建设,为做好临床护理教学工作奠定基础。     

A clinical experience with foster families

A structured, preceptored community clinical experience was established in foster care to help nursing students better understand the health problems of foster children and the nurse's role in interdisciplinary teamwork. The public health nurse preceptor identified specific opportunities for student involvement including intake, health record review, home visiting, and case management. The student was able to blend physical assessment skills, knowledge of child development and parenting, and psychosocial evaluations to have a rewarding service learning experience.     

基于 Benner 模式的护士岗位竞聘管理效果评价

目的：探讨优化护理人力资源管理的有效策略。方法按照护士岗位管理要求,基于Benner模式分层设置护理岗位,制定护士岗位竞聘条件,编写《护理岗位管理》手册,比较竞聘前后护士岗位管理质量情况。结果竞聘后N1、N2级护士的专业素养、危急重症护理技能、危急重症护理与监护、责任制整体护理、医院感染预防与控制、案例分析与情景演练等指标评分均高于竞聘前（ P＜0.01）,N3、N4级护士除危急重症护理技能评分外,其余几项评分均高于竞聘前,差异有统计学意义（ P＜0.01）。结论基于Benner模式的岗位竞聘管理有利于发展护士职业生涯规划,提升护士岗位胜任力,优化护理人力资源管理。     

目标设置理论在门诊换药室实习护生管理中的应用

目的:探讨目标设置理论在门诊换药室实习护生管理中的应用效果。方法:选择2007年2月～2008年12月来我科的58名实习护生应用目标设置理论进行管理,通过设置目标(强调目标的明确度和难度),保证护生能接受并承担目标,同时为护生提供支持(包括相信护生、获取信息并及时作出反馈)。结果:提高了护生对带教老师的满意度;提高了患者对护生操作的满意度;实习护生的出科理论和操作考核平均成绩均在92.5分以上。结论:目标设置理论在门诊换药室实习护生的管理中起到了很好的作用,它使教学中各个环节的质量始终得到有效控制,减少了实习过程中的随意性和盲目性,使实习护生的管理更加科学化,提高了临床教学质量。     

军队医院专科护士的培养与管理

目的探讨军队医院专科护士培养模式与管理方法。方法分析专科护士的发展现状,结合军队医院专科护士的特点提出其培养模式和管理方法。结果军队医院专科护士的培养和管理方法包括拓宽培训渠道,利用军队文职人员政策引进地方专科护士的培养方法和途径,以及建立管理架构、工作评价制度和个人档案,设立岗位津贴和专项奖励制度等。结论加强专科护士的使用与管理,可有效提升军队专科护士的质量,发挥专科护士作用,进一步提高军队医院护理队伍的人才建设。     

专科护士的培养和使用现状

综述国内外专科护士的发展、培养模式、资格认证和使用情况,比较国内外专科护士的培养和使用差异。指出我国可以借鉴国外的成熟经验,加强国内专科护士的培养和使用,构建规范的专科护士培养体系,加强专科护士培训基地建设,完善资格考核认证系统。对专科护士的岗位设置、工作内容、工作职责等方面形成完善体系和标准。     

ICU专科护士教学基地准入标准与现存问题的分析

临床教学基地的教学质量,对培训ICU专科护士有着重要的作用。临床教学基地的评审有其认证的原则和评审程序,在通过的16个ICU专科护士教学基地中,其医疗护理水平处于国内领先地位,医疗仪器设备完备先进,教学计划较完整,护理管理比较完善。相对而言,教学基地的医疗和教学环境仍有待改善,临床带教老师的规范化培养和资格认证制度尚处于起步阶段,部分教学基地的科研水平有待进一步提高,需根据学员需要增加护理管理的教学计划。     

Summative assessment of clinical practice of student nurses: A review of the literature

ObjectivesTo provide an overview of summative assessment of student nurses’ practice currently in use.DesignNarrative review and synthesis of qualitative and quantitative studies.Data sourcesWith the support of an information specialist, the data were collected from scientific databases which included CINAHL, PubMed, Medic, ISI Web of Science, Cochrane library and ERIC published from January 2000 to May 2014. Sources used in all of the included studies were also reviewed.Review methods725 articles concerned with student nurse clinical practice assessment were identified. After inclusion and exclusion criteria, 23 articles were selected for critical review.ResultsFindings suggest that the assessment process of student nurses’ clinical practice lacks consistency. It is open to the subjective bias of the assessor, and the quality of assessment varies greatly. Student nurses’ clinical assessment was divided into 3 themes: acts performed before final assessment, the actual final assessment situation and the acts after the final assessment situation. Mentors and students need teachers to provide them with an orientation to the assessment process and the paperwork. Terminology on evaluation forms is sometimes so difficult to grasp that the mentors did not understand what they mean. There is no consensus about written assignments’ ability to describe the students’ skills. Mentors have timing problems to ensure relevant assessment of student nurses. At the final interview students normally self-assess their performance; the mentor assesses by interview and by written assignments whether the student has achieved the criteria, and the role of the teacher is to support the mentor and the student in appropriate assessment. The variety of patient treatment environments in which student nurses perform their clinical practice periods is challenging also for the assessment of student nurses’ expertise.ConclusionsMentors want clinical practice to be a positive experience for student nurses and it might lead mentors to give higher grades than what student nurses in fact deserve. It is very rare that student nurses fail their clinical practice. If the student nurse does not achieve the clinical competencies they are allowed to have extra time in clinical areas until they will be assessed as competent.Further research needs to be carried out to have more knowledge about the final assessment in the end of clinical practice. Through further research it will be possible to have better methods for high quality assessment processes and feedback to student nurses. Quality in assessment improves patient safety.     

PBL教学法在本科护生耳鼻喉科临床护理教学中的应用

目的:探讨PBL教学法在本科护生耳鼻喉科临床护理教学中的应用效果。方法:将82名本科护生随机分为PBL组和对照组各41例,分别采用PBL教学法和传统带教方法进行耳鼻喉科临床护理教学。实习1个月后,对两组护生综合考核成绩和各项能力指标进行测评。结果:PBL组综合考核成绩和各项能力指标均明显高于对照组(P0.05或0.01)。结论:PBL教学法能使本科护生更好地将护理理论知识与临床实践相结合,明显提高护生耳鼻喉科临床护理综合实践能力。     

Assessing nurse practitioner students using a modified objective structured clinical examination (OSCE)

Limitations of applying the traditional final medical examination for the assessment of clinical competence of nurse practitioners are a matter of concern. This paper discusses a modified Objective Structured Clinical Examination (OSCE) to assess physical examination skills of student nurse practitioners at Bournemouth University. This assessment was developed to standardize the evaluation of examining skills by using healthy volunteers from the student body as patients. This modified OSCE can be used as an assessment tool for formative and summative assessment, as a resource for learning, as a basis for abbreviated versions of physical examination assessments and to identify gaps and weaknesses in clinical skills. The emphasis, therefore, is not only on the product but also the process. The Bournemouth experience may be of interest to other organizations that are developing OSCEs for formative and summative purposes in nurse practitioner education.     

What are the criteria that mentors use to make judgements on the clinical performance of student mental health nurses? An exploratory study of the formal written communication at the end of clinical nursing practice modules

Issues concerning the assessment of student nurse performance in clinical practice have pre-occupied nurse educationalists for some time and continue to pose problems. The debate in the nursing literature tends to revolve around two seemingly mutually exclusive positions related to competence vs. learning outcomes. These are views that seem to be held by academics with little reference to clinical nurses who have responsibility for the assessment of student performance in clinical practice. This paper adds to the wider debate on clinical assessment by reporting on a small research study that explored the written comments that 150 mentors made in relation to the performance of student mental health nurses following periods of clinical practice. An extensive literature review is provided in order to place the debate in context, followed by a brief outline of the research study, its findings, discussion and conclusion. This analysis of findings demonstrates that student learning is of major concern to mentors, and that the assessment of student performance in clinical practice is not restricted by pre-determined behavioural learning outcomes. Personal characteristics of students exert a great influence on judgements about clinical performance. This paper does not offer solutions to the search for the perfect clinical assessment, but it does call for an increased dialogue between educationalists and mentors to discuss the implications of this research for the development of an appropriate clinical assessment tool.