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目的 汉化护生临床实践反思问卷,检验其在实习护生中的信度和效度。 方法 基于Brislin模型对英文版临床实践反思问卷进行翻译。采用一般资料调查表、中文版护生临床实践反思问卷和反思功能问卷对550名实习护生进行调查,以检验其信效度。 结果 中文版护生临床实践反思问卷包括专业能力、内部动机来源、基于反思的自我管理、具有挑战性的临床情境、动态的组织氛围和动态的职业发展6个维度,共36个条目。探索性因子分析共提取6个公因子,累计方差贡献率为70.099%;验证性因子分析结果显示,χ2/df=1.292,RMSEA=0.033,CFI=0.977,TLI=0.974。量表Cronbach′s α系数为0.961,各维度Cronbach′s α系数为0.870~0.949,量表水平的平均内容效度为0.983,折半信度为0.853,重测信度为0.934。 结论 中文版护生临床实践反思问卷具有较好的信度和效度,可用于评估我国实习护生在临床实践中的反思能力。  相似文献   
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Reflective practice is encouraged in medical education in general and in teaching communication skills in particular to develop into a reflective practitioner. However, the term is complex to understand and multidimensional thus challenging to grasp, describe and teach. Furthermore, though used frequently little guidance exists on how to promote reflective ability in teaching communication skills. This paper builds on a keynote address delivered at the International Conference of Communication in Healthcare (ICCH 2019) and is based on the vast literature on reflection and the author’s personal experience as a researcher and educator. It discusses the components of reflective practice as well as exemplifies the importance of reflective practice to student’s capability to learn communication skills.  相似文献   
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Reflective practice strategies can enable healthcare practitioners to draw on previous experiences to render more effective judgment in clinical situations. The central argument presented in this commentary is that education programs and structures for continuing professional development (CPD) and revalidation of professionals sharpen their focus regarding self-assessment to identify gaps in skills and attitudes rather than merely as a means of on-going monitoring. Pharmacy undergraduate and professional education need to promote reflective practice strategies that foster self-evaluation to promote pharmacists’ readiness for practice change and advance patient care within rapidly expanding roles and scope of practice.  相似文献   
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BackgroundDespite reported benefits of transition support programmes for other healthcare professionals, no evidence-based support interventions exist to ease newly-registered novice community pharmacists' (NCPs) transition into practice.ObjectivesTo develop an intervention to provide psychosocial support, support the development of professional behaviours and skills of novice pharmacists in community pharmacy and conduct an evaluation.MethodsThe Medical Research Council (MRC) guidance for developing complex interventions was applied to develop a 17-week, pharmacist coach-led intervention, using a social media group, a face-to-face introductory workshop, two webinars, weekly case studies, portfolios (reflective logs and development plans) and a handbook. Twelve newly-registered NCPs participated. A coach log and semi-structured interviews collected data on feasibility, acceptability and perceived impact.ResultsFindings suggest the intervention was feasible and highly acceptable to NCPs, who perceived the coach and social media group to be the most valuable components. The coach was described as non-judgemental, approachable and collaborative. Provision of guided one-to-one reflection was viewed as useful for debriefing, feedback and meaningful reflection, and supported development of reflection-in-action. The face-to-face workshop was considered important for establishing rapport and trust. The social media group was most valued for providing an accessible, confidential and responsive support network, in which NCPs felt psychologically safe to learn. This component was reported to present opportunities for developmental discourse and shared reflection with peers, thus reducing the sense of professional isolation. NCPs reported that the intervention led to increases in meaningful learning, confidence, critical reasoning, self-awareness and self-reflection. The webinars and handbook were identified as the least valuable components.ConclusionsA transition-support intervention using an experienced pharmacist coach, delivered within a safe, supportive, albeit online facilitated learning environment, appeared feasible and valuable in supporting guided reflection and developmental discourse. This facilitates transformative learning, and supports NCPs to gain proficiency and become independent reflective practitioners.  相似文献   
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Background and aimsConsuming pulses (dry beans, dry peas, chickpeas, lentils) over several weeks can improve vascular function and decrease cardiovascular disease risk; however, it is unknown whether pulses can modulate postprandial vascular responses. The objective of this study was to compare different bean varieties (black, navy, pinto, red kidney) and white rice for their acute postprandial effects on vascular and metabolic responses in healthy individuals.Methods and resultsThe study was designed as a single-blinded, randomized crossover trial with a minimum 6 days between consumption of the food articles. Vascular tone (primary endpoint), haemodynamics and serum biochemistry (secondary endpoints) were measured in 8 healthy adults before and at 1, 2, and 6 h after eating ¾ cup of beans or rice. Blood pressure and pulse wave velocity (PWV) were lower at 2 h following red kidney bean and pinto bean consumption compared to rice and navy bean, respectively (p < 0.05). There was greater vasorelaxation 6 h following consumption of darker-coloured beans, as shown by decreased vascular tone: PWV was lower after consuming black bean compared to pinto bean, augmentation pressure was lower after consuming black bean compared to rice and pinto bean, and wave reflection magnitude was lower after consuming red kidney bean and black bean compared to rice, navy bean, and pinto bean (p < 0.05). LDL-cholesterol concentrations were lower 6 h after black bean consumption compared to rice (p < 0.05).ConclusionOverall, red kidney and black beans, the darker-coloured beans, elicited a positive effect on the tensile properties of blood vessels, and this acute response may provide insight for how pulses modify vascular function.  相似文献   
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《Australian critical care》2016,29(2):104-109
Effective team decision making has the potential to improve the quality of health care outcomes. Medical Emergency Teams (METs), a specific type of team led by either critical care nurses or physicians, must respond to and improve the outcomes of deteriorating patients. METs routinely make decisions under conditions of uncertainty and suboptimal care outcomes still occur. In response, the development and use of Shared Mental Models (SMMs), which have been shown to promote higher team performance under stress, may enhance patient outcomes. This discussion paper specifically focuses on the development and use of SMMs in the context of METs. Within this process, the psychological mechanisms promoting enhanced team performance are examined and the utility of this model is discussed through the narrative of six habits applied to MET interactions.A two stage, reciprocal model of both nonanalytic decision making within the acute care environment and analytic decision making during reflective action learning was developed. These habits are explored within the context of a MET, illustrating how applying SMMs and action learning processes may enhance team-based problem solving under stress. Based on this model, we make recommendations to enhance MET decision making under stress. It is suggested that the corresponding habits embedded within this model could be imparted to MET members and tested by health care researchers to assess the efficacy of this integrated decision making approach in respect to enhanced team performance and patient outcomes.  相似文献   
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从医院伦理委员会存在的价值出发,指出目前医院伦理委员会名不副实的几大因素主要为制度缺陷、机构设置不科学、人员组成不合理,当然文化差异以及人文科学相对落后于自然科学的大背景等环境影响,也是其中的原因之一。因此,要通过大力健全制度,完善机制,在保证伦理审查的正义性、客观性和公正性的基础上不断提升伦理审查实践运用能力,使得医院伦理委员会名副其实。  相似文献   
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