提高中等职业学校学生护士执业资格考试通过率的教学改革实践

该文对中等职业学校学生护士执业资格考试通过率不高的原因进行分析。针对各原因采取相应干预措施,如通过分析护理岗位职业能力和典型工作任务确定学习内容,基于此设计学习领域,并编写学习领域的主干专业课程;改革教学方法,通过情境教学、案例教学、角色扮演提高学生的学习效果和综合能力;加强师资队伍建设和实训基地建设,强化技能训练,提高专业实践能力;改革考核评价方式和加强考前培训,提高考试通过率。     

基于体验式学习的护理人员科研能力培训新模式

分析目前护理人员科研能力培训中存在的不足、体验式学习模式的内涵及与传统培训模式的区别，提出在护理人员科研培训中引入体验式学习的观点，指出体验式学习的引入在护理人员科研道路行进中的必要性。在此基础上，构建基于体验式学习的护理人员科研能力培训新模式，并对该模式的具体实施进行详细阐述。     

以问题为基础式学习与病例讨论式学习在临床营养风险筛查培训教学中的应用

目的评价以问题为基础式学习与病例讨论式学习在＂临床风险筛查＂培训教学过程中的应用效果。方法 2010年6月2011年7月,联合应用两种教学方法对参训医学生进行培训,然后进行临床资料采集、资料整理等实践活动。最后,对学生培训效果进行总结。结果共培训医学生50人,并对398例患者进行营养风险筛查。45人（90%）参与者认为此教学方式能激发自身主动学习兴趣,40人（80%）认为通过此次培训能够使学生逐步建立科学研究的思维方式,但有20人（40%）认为短期内采用两种教学方式能够对论文写作、统计学理论和实践等方面能力的提高有促进作用。影响医学生科研能力培训效果的主要因素集中体现在学习任务量的加重、对新教学方法不适应、自学能力三方面。结论联合应用问题为基础式学习与病例讨论式学习教学模式,在提高医学生学习主动性、积极性、团队合作及人际沟通能力等方面有优势,但尚存部分问题需要进一步解决。     

Effectiveness of an interprofessional workshop on pain management for medical and nursing students

Interprofessional (IP) care is critical for effective pain management, but evidence is lacking about the best way to teach pain management skills to medical and nursing students using IP strategies. In 2013 and 2014, 307 medical and 169 nursing students participated in an IP case-based pain management workshop. The aims of this study were to determine (1) if students who participate in IP case-based learning groups will have improved pain management skills compared to students who participate in uniprofessional case-based learning groups, and (2) if students mentored by faculty with IP training will have improved pain management skills compared to students who are not mentored by IP-trained faculty. Student learning was assessed and compared using scored checklists for each group’s pain management plans. Findings show that IP mentorship and IP group participation improved medical students’ pain management skills but did not have the same effect on nursing student performance. Continued work is needed to develop, refine, and integrate innovative and tailored IP strategies into the curricula of medical and nursing schools to advance the pain management competencies of students before they enter clinical practice.     

Using problem-based learning to redesign nursing administration masters programs

Problem-based learning (PBL) is offered as an appropriate pedagogy to prepare nurse managers for the uncertainties of future administrative practice. It is a student-centered, experiential learning strategy aimed at developing clinical reasoning, structuring knowledge in real-life contexts, motivating learning, and developing self-learning skills. Health professions and business schools report positive feedback from their stakeholders after adopting this new learning paradigm.     

Impact of experiential dementia care learning on knowledge,skills and attitudes of nursing students: A systematic literature review

AimThe aim of this systematic review was to synthesize evidence on the effect of clinical experiential learning approaches on pre-licensure nursing students' competence in dementia care and to identify associated challenges.BackgroundAs the prevalence of dementia increases, nurse educators must proactively prepare pre-licensure nursing students to care for people living with dementia. The limited number of physical clinical learning settings, especially during the current COVID-19 pandemic, has caused many nursing programs to use alternative experiential learning approaches.DesignSystematic Literature ReviewMethodsIn accordance with PRISMA guidelines, we conducted a systematic search for the literature in Cumulative Index to Nursing and Allied Health Literature, MEDLINE and ProQuest for relevant peer-reviewed studies published between 2010 and 2021. Using the Boolean operator search approach, the keyword "dementia care" was combined with "AND/OR" and other search terms. In addition, a descendent and an ascendent search were conducted to find other relevant studies.ResultsA total of 17 retrieved articles met the inclusion criteria. Five themes emerged, with the main findings being that face-to-face (in person), virtual and simulated experiential learning approaches increased pre-licensure nursing students' dementia care knowledge. However, the face-to-face experiential learning approach that provides physical contact with people living with dementia and clinical staff had more impact on their skills and attitudes.ConclusionThe evidence in this review could inform curriculum development, teaching methods, experiential learning experiences and clinical placements of pre-licensure nursing students with regards to dementia care. More research is needed to explore further the impact of virtual and simulated experiential learning approaches on pre-licensure nursing students' dementia care skills.Tweetable abstractThis systematic literature review synthesizes evidence of clinical experiential learning on prelicensure nursing students' competence in dementia care per PRISMA guidelines. Five themes emerged #dementia #experientiallearning #prelicensurenursingstudents #clinicalsducation     

Model of practical skill performance as an instrument for supervision and formative assessment

There are still weaknesses in the practical skills of newly graduated nurses. There is also an escalating pressure on existing clinical placements due to increasing student numbers and structural changes in health services. Innovative educational practices and the use of tools that might support learning are sparsely researched in the field of clinical education for nursing students.This paper reports on an action research study that promoted and investigated use of The Model of Practical Skill Performance as a learning tool during nursing students' clinical placement. Clinical supervisors and two cohorts of nursing students placed in a hospital setting shared their experiences on the use of the model in six focus group interviews. Data was also generated through the supervisors' reflective logs.The model was viewed as highly applicable in the planning of learning situations as well as during practice, performance and formative assessment of practical skills learning. It provided a common language about practical skills and enhanced the participants' understanding of professionalism in practical nursing skill. In conclusion, the model helped to highlight the complexity in mastering practical skills, afforded help in sequencing a learning process that supported the novice, and contributed to a more nuanced feedback by supervisors.     

An explorative study of experiences of healthcare providers posing as simulated care receivers in a 'care-ethical' lab

In recent approaches to ethics, the personal involvement of health care providers and their empathy are perceived as important elements of an overall ethical ability. Experiential working methods are used in ethics education to foster, inter alia, empathy. In 2008, the care-ethics lab 'sTimul' was founded in Flanders, Belgium, to provide training that focuses on improving care providers' ethical abilities through experiential working simulations. The curriculum of sTimul focuses on empathy sessions, aimed at care providers' empathic skills. The present study provides better insight into how experiential learning specifically targets the empathic abilities of care providers. Providing contrasting experiences that affect the care providers' self-reflection seems a crucial element in this study. Further research is needed to provide more insight into how empathy leads to long-term changes in behaviour.     

CBL与TBL联合教学法在急诊规培学员教学中的应用效果

目的探讨病例教学法(CBL)与以团队为基础的学习法(TBL)联合教学法在急诊规培学员教学培训中的应用效果。方法将2018年1月至2018年8月于我院急诊进行规范化培训的60例学员随机分为对照组与观察组,各30例。对照组采用传统教学法(LBL),观察组采用CBL与TBL联合教学法。比较两组的综合能力考核、教学方法评价结果。结果观察组的理论成绩、操作成绩及总成绩均显著高于对照组(P<0.05)。观察组的教学方法评价结果显著优于对照组(P<0.05)。结论采用CBL与TBL联合教学法能明显提高教学效果,提高规培学员的学习积极性和临床技能,值得进一步的改进和推广。     

The use of simulation as a learning approach to non-technical skills awareness in final year student nurses

Understanding what non-technical skills are and their relevance for healthcare practitioners has become a new area of exploration. Although recent literature has highlighted the necessity of introducing non-technical skills training and assessment within medical education, nursing education has still to fully embrace this skills training. The purpose of this paper is to explore the use of simulated practice as a learning approach to demonstrate and assess non-technical skills for final year nursing students. An established ward simulation exercise was refocused to incorporate opportunities for these nursing students to be assessed on their ability to demonstrate application of non-technical skills. Opinions on whether this was a successful strategy were sought from the students by means of module evaluation questionnaires. Analysis of this data revealed that the majority of the students agreed that it was an effective learning approach, allowing them to demonstrate their non-technical skills, be assessed and subsequently identify further learning needs.     

Could simulated emergency procedures practised in a static environment improve the clinical performance of a Critical Care Air Support Team (CCAST)? A literature review.

OBJECTIVE: The Royal Air Force Critical Care Air Support Teams (CCASTs) have a philosophy to undertake transfers of critically ill patients from anywhere in the world back to a UK medical facility in a stable or improved clinical condition. The training they receive is primarily taught by traditional didactic methods, with no standardisation of education between teams that are expected to deliver care to the same standard. Notwithstanding there being no current compromise to patient care during air transfer, it was important to consider the benefits of an alternative experiential teaching modality. Experiential learning utilised in the static environment could potentially improve the current CCAST training curriculum and, therefore, improve clinical performance during air transfer. METHOD: In the absence of primary research evidence investigating beneficial teaching modalities for medical flight crews, a review of recent literature was undertaken to observe any potential relevance to the aeromedical specialty. This critical review examined recent quantitative research on various modalities of experiential learning and their influence on the critical thinking, higher cognitive and psychomotor skill acquisition by healthcare professionals in a static hospital environment. The main databases were interrogated using the following inclusion criteria: patient simulation, clinical competence, aeromedical, education, computer simulation, critical thinking and problem-based learning. The number of articles obtained was 13; these were coded on methodological strength to reduce the potential for inclusion bias. Nine studies were finally selected for review. RESULTS: Many small studies have been undertaken, primarily observing benefits of experiential learning to medical students and doctors. No studies show conclusively that simulated learning improves patient outcome, but the body of evidence suggests human patient simulators to be advantageous over other modalities because of their realistic recreation of critical events. They have proven to be at least as effective as traditional teaching by didactic methods. CONCLUSION: For CCASTs to have a standardised training curriculum, they should undertake real-time missions in a flight simulator, supported by a human patient simulator programmed to respond to the physiological changes associated with altitude. Real scenarios could then be practised, on demand, in a safe environment as an augmentation to the current training programme. Consequently, those acquired skills could then be carried out with improved proficiency during real missions with a concomitant potential for improvement in the standard of patient care.     

Effects of communication training on real practice performance: a role-play module versus a standardized patient module

This study investigated the effectiveness of modules involving standardized patients and role-plays on training communication skills. The first module involved standardized patients and an Objective Structured Clinical Examination (OSCE); the second module consisted of peer role-plays and a written examination. A randomized posttest-only control group design with first-year nursing students was used. The intervention group received one-to-one communication training with direct oral feedback from the standardized patient. The control group had training with peer role-playing and mutual feedback. The posttest involved students' rating their self-efficacy, and real patients and clinical supervisors evaluated their communication skills. No significant differences were found between self-efficacy and patient ratings. However, the clinical supervisors rated the intervention group's communication skills to be significantly (p < 0.0001) superior. Assessments by clinical supervisors indicate that communication training modules including standardized patients and an OSCE are superior to communication training modules with peer role-playing.     

Learning to be a ward sister

Initially, this article argues that although general nurse training usually produces a competent and caring staff nurse, it contains little to develop the variety of skills needed by a ward sister. General nurse training concentrates on the theoretical and practical concept of nursing and places little emphasis on the teaching of interpersonal skills, particularly in relation to the management role of the ward sister.The ways in which these interpersonal skills are learnt and can best be taught are briefly discussed. The concept of experiential learning is described and the problems of its application highlighted. The question is then posed, can experiential learning methods be used in a two-dimensional setting, creating the drama within the student's mind, using only the written word? In an attempt to illustrate this, there is an experiential problem-solving ‘game’. The reader is asked to participate in the exercise and judge for him/herself the sort of learning it has fostered.     

Objectives to direct the training of emergency medicine residents on off-service rotations: orthopedics

In this third article in a continuing series on objectives for emergency medicine training, orthopedic objectives are presented. Orthopedic complaints are common in emergency medicine. Direction in mastering evaluative, cognitive, and procedural skills are provided utilizing behaviorally based objectives and references. These objectives provide a structure for systematically learning the content of orthopedics through enlightened patient care, questioning of attending physicians and supervisors, and directed reading.     

Experiential learning in nursing and allied health education: Do we need a national framework to guide ethical practice?

Experiential learning is widely used in health courses to develop students' clinical skills. Students act as models for demonstrations of practical techniques and work in small groups to practise clinical skills. These classes present a number of ethical challenges including removing clothing, physical touch and disclosing personal information. The aim of this study was to ascertain the views of nursing and allied health regulators and professional associations regarding the need for a national framework to facilitate ethical experiential learning in health courses. Ten semi-structured interviews were conducted either face-to-face or by phone and their audio-recordings transcribed verbatim for thematic analysis. Students' willingness to participate as models was taken-for-granted by educators. Risks to students' wellbeing were considered minor and outweighed by the benefits of experiential learning. The increasing diversity of students enrolled in health courses has increased awareness of students' rights, including choosing not to participate in some learning activities. Ongoing cycles of curriculum review provided an opportunity to respond to changing social values, including increased collective awareness and respect for, students' rights, cultural diversity, professional standards, and risk/benefit analysis of all student activities. There is a need for a national framework to guide ethical experiential learning in practical classes.     

Making the move: from traditional neonatal education to simulation-based training

Resuscitating neonates is a critical skill set for obstetric and neonatal care providers. The principles, knowledge, and skills of neonatal resuscitation as developed by the Neonatal Resuscitation Program are taught in a variety of ways to enhance learning including didactic, CD-ROM, hands-on-task training, and mock codes. Despite this variety of educational methods, studies have called into question the ability of the care provider to adequately perform neonatal resuscitation. Simulation-based training is gaining more recognition in healthcare as a method of training that incorporates adult learning theory, real-time clinical situations, and video debriefing of the scenario to allow a healthcare team an opportunity to practice skills and evaluate their performance. The Neonatal Resuscitation Program is including simulation-based training as an educational methodology to promote skill acquisition and performance enhancement in its providers.     

Using a phenomenological research technique to examine student nurses' understandings of experiential teaching and learning: a critical review of methodological issues

This paper provides a report of the usage of a phenomenological research methodology to investigate the influence on clinical practice of pre- and post-registration nurse education which makes explicit use of experiential teaching and learning approaches. The primary aim of the research was to explore the use of a phenomenological research methodology to examine the students'understanding of experiential teaching and learning. The claims made for the use of experiential teaching and learning approaches in both pre- and post-registration nurse courses and how clinical practice is influenced by the experiential learning elements of pre- and post-registration nurse education were also examined. The first stage of the enquiry involved focused non-directive interviews with members of BSc Nursing Studies and MSc Mental Health Branch programmes. Both programmes claim to make use of experiential teaching and learning. The data were analysed using a technique developed by Giorgi. Previous experiences of experiential teaching and learning were probed, student interpretations differentiated, and the relationship between course-based learning using experiential approaches and the implications for it's influence on practice were examined. The second stage of the enquiry has followed up the initial findings, exploring the students'experience of experiential approaches on their courses both in the classroom and in work-based learning situations. The findings are presented and discussed in the context of other studies from both nurse and higher education. Throughout the paper methodological concerns arising are discussed. The paper concludes with the identification of methodological problems arising from the research strategy: the implications of the power nexus created when teachers research students, and issues relating to the use of a phenomenological methodology in a longitudinal study.     

联合训练法在护理人员操作技能培训中的应用研究

目的探讨提高护理人员操作技能水平的培训方法。方法对护理人员应用微格教学法、典型案例教学、标准工作流程再造、相关理论知识拓展等联合训练法进行每月的操作技能培训,比较应用前后护理人员理论、操作考核成绩、综合素质与应变能力。结果联合训练法应用后,护理人员各项操作技能考核成绩、理论考核成绩高于应用前(P<0.05,P<0.01),综合素质与应变能力显著提高(P<0.01)。结论联合训练法是一种有效提高护理人员操作技能水平的培训方法。     

The role of ultrasound simulators in education: an investigation into sonography student experiences and clinical mentor perceptions

Simulation as an effective pedagogy is gaining momentum at all levels of health care education. Limited research has been undertaken on the role of simulated learning in health care and further evaluation is needed to explore the quality of learning opportunities offered, and their effectiveness in the preparation of students for clinical practice. This study was undertaken to explore ways of integrating simulation-based learning into sonography training to enhance clinical preparation. A qualitative study was undertaken, using interviews to investigate the experiences of a group of sonography students after interacting with an ultrasound simulator. The perceptions of their clinical mentors on the effectiveness of this equipment to support the education and development of sonographers were also explored. The findings confirm that ultrasound simulators provide learning opportunities in an unpressurised environment, which reduces stress for the student and potential harm to patients. Busy clinical departments acknowledge the advantages of opportunities for students to acquire basic psychomotor skills in a classroom setting, thereby avoiding the inevitable reduction in patient throughput which results from clinical training. The limitations of simulation equipment to support the development of the full range of clinical skills required by sonographers were highlighted and suggestions made for more effective integration of simulation into the teaching and learning process. Ultrasound simulators have a role in sonography education, but continued research needs to be undertaken in order to develop appropriate strategies to support students, educators and mentors to effectively integrate this methodology.     

微课结合案例教学法对中医外科本科临床实践技能教学的影响

目的探讨微课结合案例教学法在中医外科本科临床实践技能教学中的应用价值。方法选取2018年7月至2019年12月在我院临床技能中心接受培训的78名中医外科学专业本科学生作为研究对象,按照随机数字表法将其分为对照组和观察组,各39名。对照组给予传统的中医外科技能教学,观察组在对照组基础上给予微课结合案例教学法。比较两组的考核成绩、能力提升自我评价情况以及对教学的满意度。结果观察组学生的基础理论、病例分析、病历书写及技能操作成绩均高于对照组(P<0.05)。观察组学生的自我训练、思维、沟通、协作能力、兴趣提升占比均高于对照组(P<0.05)。观察组学生对教学的满意度高于对照组(P<0.05)。结论微课结合案例教学法应用于中医外科临床实践技能教学中能够明显提升教学质量及学生对教学的满意度。