高仿真模拟教学对护理本科生临床能力影响的研究

目的探讨高仿真模拟教学对护理本科生临床能力的影响。方法将实习前的60名护理本科生随机分为试验组和对照组,各30名,试验组采用高仿真模拟教学,对照组采用普通教学(案例讨论与护理技能操作训练),各培训20学时,并利用客观结构化临床考试(objective structured clinical examination,OSCE)分别在培训前后对学生进行考核。结果培训后,试验组的11项成绩比培训前均有提高(P<0.05);培训后,试验组在小组综合能力、护理问诊、护理体检、健康教育口试、职业态度考核成绩上高于对照组(P<0.05)。结论高仿真模拟教学可显著提高学生的临床能力,比普通教学具有优势。     

Debriefing approaches for high-fidelity simulations and outcomes related to clinical judgment in baccalaureate nursing students

Simulation followed by debriefing is increasingly common in clinical nursing education. Yet, limited studies have compared approaches to debriefing—the portion of simulations where participants re-examine and make sense of their experience. In this study, 120 baccalaureate nursing students in Quebec were randomized to receive one of two types of debriefing (self-assessment with Plus-Delta vs. guided reflection using a structured tool with REsPoND) after each of four simulations (a hemorrhage scenario, two sepsis scenarios, and a trauma simulation) during which their situation awareness was measured as a proxy for their clinical judgment. Unexpectedly, situation awareness scores showed little to no consistency across students or simulations and no clear improvements over time were noted, which rendered the comparison of the debriefing approaches across scenarios problematic. However, when comparing the two iterations of the sepsis scenario, students who participated in a reflective debriefing showed greater improvement in their recognition of abnormalities in patient vital signs and level of consciousness than students whose debriefing involved self-assessment.     

高仿真模拟教学对护生实习影响的质性研究

目的：探讨高仿真模拟教学的远期效果并为教改提供依据.方法：采用质性研究方法,对参与过模拟教学培训且完成实习任务的15名学生进行访谈,并运用现象学分析程序分析.结果：该教学对护生实习工作适应快,提高实习积极性及团队合作意识,培养谨慎的工作作风.结论：高仿真模拟教学对学生影响深远,不断改进教学方案能提高学生的团队合作意识和实习积极性.     

高仿真模拟教学法对护生自我效能感影响的Meta分析

[目的]评价高仿真模拟教学法对于护生自我效能感的影响。[方法]通过检索the Cochrane Library、PubMed、Web of Science、Science Direct、Nurimedia、万方、中国知网数据库,收集自建库至2019年6月1日发表的关于高仿真模拟教学法(试验组)和传统教学法(对照组)对护生自我效能感影响的随机对照试验研究以及类实验研究,用RevMan 5.3软件对所纳入的文献进行Meta分析。[结果]共纳入相关文献6篇,Meta分析结果显示,试验组护生的自我效能感高于对照组[SMD=0.29,95%CI(0.16,0.42),P<0.0001];亚组分析显示,无论是在亚洲还是欧美,高仿真模拟教学法均可提高护生的自我效能感[亚洲:SMD=0.32,95%CI(0.12,0.52),P<0.001;欧美:SMD=0.27,95%CI(0.09,0.44),P=0.003]。高仿真模拟教学法对护生的学业自我效能感的影响结果差异无统计学意义[SMD=0.09,95%CI(-0.13,0.32),P=0.42],对一般自我效能感的影响结果差异有统计学意义[SMD=0.39,95%CI(0.23,0.55),P<0.00001]。[结论]现有证据表明,高仿真模拟教学法可以提高护生的自我效能感,其中对护生的一般自我效能感影响更加显著。本研究纳入文献较少,未来仍需更多高质量的研究加以证实。     

护理本科生高仿真模拟教学学习体验的现象学研究

目的 了解和探讨护理本科生在高仿真模拟教学中的真实学习感受及体验,为护理教育者改革教学方法和指导教学实践提供借鉴.方法 采用质性研究中的现象学研究法,深入访谈了4个焦点小组的28名护理本科生,了解其对高仿真模拟教学学习的体验,并对访谈结果进行归纳分析.结果 运用Colaizzi分析法,得到5个主题:分工合作明确,理论与实践紧密联系,护理决策能力得到提高,病情观察能力得到提高,自信心增强.结论 高仿真模拟教学有利于理论联系实践,培养学生的综合能力,增加临床实践机会.

Abstract：

Objective To understand and explore the lived study feeling and experience of nursing undergraduate students during high- fidelity simulation training so as to provide the evidence of reforming teaching methods and performing the teaching practice of nursing educators. Methods Phenomenological study of qualitative research was used. In- depth interviews were conducted among 4 focus groups. 28 nursing undergraduate students were interviewed to understand their lived study feeling. Results 5 themes were emerged using Colaizzi's phenomenologic method, including cooperating explicitly, integrating theory with practice closely, promoting disease observation ability and nursing decision making, enhancing self-confidence. Conclusions High- fidelity simulation training was beneficial to integrate theory with practice, cultivate students' comprehensive ability and increase clinical practical opportunities.     

护理实习学生学习动机和师生关系的研究

目的 调查护理实习学生的学习动机和师生关系状况,探讨其影响因素,并分析两者的关系.方法 采用方便抽样法,抽取江西省3家三级甲等医院的护理实习学生489名为对象,应用一般情况调查表、师生关系问卷、学习动机量表对其进行问卷调查.结果 学习动机各维度评分为:深层动机(3.52±0.55)分,成就动机(3.33±0.57)分,表层动机(3.10±0.49)分;亲密性为深层动机、学习动机最强影响因子;支持性为成就动机最强影响因子;择业意向对深层动机、成就动机有预测作用.师生关系各维度评分为;支持性(3.68:±0.75)分,满意性(3.62±0.66)分,亲密性(3.21±0.69)分,冲突性(1.63±0.52)分;表层动机对师生关系有负向预测作用,是支持性、冲突性的重要预测因子;成就动机、深层动机对师生关系有较强的正向预测作用,其中,深层动机是支持性、满意度、亲密性和冲突性的重要预测因子,成就动机是支持性的重要预测因子;择业意向、亲属从医情况、医院性质、年龄、学历对师生关系也有较强的预测作用.结论 护理实习学生的师生关系和学习动机受多种因素影响,师生关系和学习动机是相互促进的,培养护理学生学习兴趣和构建融洽师生关系是必要的.     

The effects of high-fidelity simulation training on empathy and attitudes toward older people among undergraduate nursing students: A quasi-experimental study

AimTo evaluate the effects of high-fidelity simulation training on attitudes towards older people and empathy among undergraduate nursing students.BackgroundPeople worldwide are living longer and, consequently, the number of older people is increasing globally. Geriatric syndromes are highly prevalent and associated with increased morbidity and mortality in this population. Positive attitudes towards older people and high levels of empathy are necessary for the provision of high-quality nursing care, which will contribute towards improving the quality of life of older patients affected by these syndromes.MethodsA quasi-experimental study was conducted using a longitudinal design with a single group and a pre- and post-intervention evaluation. The development of attitudes towards older people and empathy skills were evaluated using high-fidelity simulation-based training, comparing the levels obtained in these skills at baseline and after the simulation experience. The simulated scenarios recreated the great geriatric syndromes in older patients: instability, immobility, intellectual impairment and incontinence.ResultsAfter the simulation sessions, nursing students significantly improved their total scores for both attitudes toward older people and empathy, moreover, improvements were found in the three subscales of empathy. The effect size was large for the total scores of both the attitudes towards older people and the empathy scales and the ‘perspective taking’ subscale. The obtained effect size was small for the ‘compassionate care’ subscale, whereas for the ‘standing in the patient’s shoes’ subscale, the obtained effect size was medium.ConclusionsOur high-fidelity simulation-based training allows undergraduate nursing students to improve their empathy levels and positive attitudes toward older people. The development of these skills may provide benefits directly related to high-quality care for older patients. Therefore, the inclusion of simulation training programs in geriatric nursing study plans is necessary to train nursing students in the care of older people and to prepare them for real clinical practice.     

基于问题的高仿真模拟教学对学生护理处置能力的影响

目的评价高仿真模拟教学结合以问题为基础的教学法对护理专业学生临床护理处置能力的效果。方法将180名护理大专二年级学生随机分为两组,试验组采用高仿真模拟教学结合以问题为基础的教学法,对照组采用传统角色扮演法。在护理实务临床处置课程开始和结束时,采用临床处置能力测评表对两组学生进行测评;课程结束后进行临床护理处置能力考核,并采用自设的调查问卷,调查学生对课程效果的评价。结果课程结束后,试验组临床护理处置能力总分及各条目得分(P<0.05或P<0.01)、课程考核成绩均优于对照组(P<0.05);试验组学生对疾病知识、护理操作能力、沟通交流能力、团队合作能力及护理处置能力提高情况自我评价优于对照组(P<0.05)。结论应用高仿真模拟教学结合以问题为基础的教学法有助于培养学生的临床护理处置能力。     

High-fidelity simulation and the development of clinical judgment: students' experiences

Nursing education programs across the country are making major capital investments in alternative learning strategies, such as human patient simulators; yet, little research exists to affirm this new innovation. At the same time, nursing programs must become even more effective in the development of students' clinical judgment to better prepare graduates to take on increasingly complex care management. This qualitative study examined the experiences of students in one nursing program's first term of using high-fidelity simulation as part of its regular curriculum. On the basis of these experiences, it seems that high-fidelity simulation has potential to support and affect the development of clinical judgment in nursing students and to serve as a value-added adjunct to their clinical practica.     

Effects of peer review on communication skills and learning motivation among nursing students

The purpose of this study was to investigate the effects of video-based peer review on communication skills and learning motivation among nursing students. A non-equivalent control with pretest-posttest design was used. The participants were 47 sophomore nursing students taking a fundamentals of nursing course at a nursing college in Korea. Communication with a standardized patient was videotaped for evaluation. The intervention group used peer reviews to evaluate the videotaped performance; a small group of four students watched the videotape of each student and then provided feedback. The control group assessed themselves alone after watching their own videos. Communication skills and learning motivation were measured. The intervention group showed significantly higher communication skills and learning motivation after the intervention than did the control group. The findings suggest that peer review is an effective learning method for nursing students to improve their communication skills and increase their motivation to learn.     

临床见习前护生的学习动机现状

目的 了解临床见习前护生的学习动机,探索有效提高临床见习前护生学习动机的方法.方法 采用大学生学习动机问卷对288名见习前本科、高职本科和大专护生进行调查.结果 临床见习前护生总体学习动机居中等程度,本科和大专护生学习动机均高于高职本科护生(P＜0.05),本科与大专护生之间学习动机差异无统计学意义(P＞0.05);女...     

Effects of high-fidelity simulation on the critical thinking skills of baccalaureate nursing students: A causal-comparative research study

BackgroundCritical thinking has been identified as one of the standards for nursing school accreditation and a long-standing outcome of nursing education and nursing practice. High-fidelity simulation is one method currently used by nursing programs to increase critical thinking in nursing students. Despite these expectations, there is limited empirical evidence which compares the effects of simulation to other teaching strategies.ObjectivesThe purpose of this study was to examine whether statistically significant differences existed in mean critical thinking skill scores within groups (pretest to posttest) and between groups (simulation versus written case studies).DesignA quantitative causal-comparative methodology with a pretest/posttest design.SettingA private university in the midwestern United States which offers a four-year Bachelor of Science Nursing program.ParticipantsBaccalaureate junior nursing students (N = 69) were recruited from a convenience sample and divided into two groups which consisted of a simulation group (n = 36) and a written case studies comparison group (n = 33).MethodsThis research study consisted of a pretest, three weeks of being in either the simulation group or the written case studies group, and a posttest. The Health Science Reasoning Test (HSRT) was the instrument used for the pretest and posttest to measure critical thinking skills of all participants.ResultsA repeated measures mixed analysis of variance (ANOVA) indicated there was no statistically significant difference in participants' mean critical thinking scores within groups (pretest to posttest) or between groups (simulation versus written case studies).ConclusionsThe use of high-fidelity simulation as a teaching strategy versus written case studies to increase critical thinking skills of nursing students was not supported.     

临床护理教学中师生满意度现状调查

目的 了解临床护理教学中师生双方的满意度。方法采用自制满意度调查表,调查60名临床护理带教老师和180名实习护生双方的满意度。结果护生对带教老师不满意主要集中在教学方法、尊重护生、民主平等、沟通交流方面;带教老师对护生不满意主要集中在热爱专业、学生态度、基础知识方面。结论临床带教老师应发挥主导作用,尊重护生,建立平等、和谐的师生关系;护生应发挥主体作用,树立牢固的专业思想,端正学习态度,主动参与教学。     

对44名本科实习护生临床能力现状的研究

目的评价本科实习护生毕业时所具备的实际临床能力。方法根据自行研制的本科实习护生临床能力评价指标体系,编制本科实习护生临床能力评价表,采用自评与他评相结合的方式对44名本科实习护生进行评价。结果44名本科实习护生的临床能力大部分处于良好和中等水平,少数处于优秀或及格水平,不及格人数为零;临床处置能力、护理沟通能力、健康教育能力、职业心理素质相对较强,而临床科研能力、临床管理能力和临床教学能力相对较弱。结论被选取的本科实习护生临床能力现状与预期期望相吻合。     

Comparing the effectiveness of video-assisted oral debriefing and oral debriefing alone on behaviors by undergraduate nursing students during high-fidelity simulation

Complex healthcare, less resources, high-level medical equipment, and fewer available clinical settings have led many health professionals to use simulation as a method to further augment educational experiences for nursing students. While debriefing is recommended in the literature as a key component of simulation, the optimal format in which to conduct debriefing is unknown. This pre- and posttest two-group randomized quasi-experimental design compared the effectiveness of video-assisted oral debriefing (VAOD) and oral debriefing alone (ODA) on behaviors of 48 undergraduate nursing students during high-fidelity simulation. Further, this study examined whether roles (e.g., team leader, medication nurse), type of scenarios (i.e., pulmonary and cardiac scenarios), and student simulation team membership (i.e., VAOD and ODA groups) influenced these behaviors. Behaviors observed in this study related to patient safety, communication among team members, basic- and problem-focused assessment, prioritization of care, appropriate interventions, and delegation to healthcare team members. Both human patient simulator practice and guidance using video-assisted oral debriefing and oral debriefing alone appeared to be comparable regarding behaviors, regardless of roles, type of scenarios, and student simulation team membership. These findings suggest that nurse educators may use either video-assisted oral debriefing or oral debriefing alone to debrief undergraduate nursing students during high-fidelity simulation.     

微课结合高仿真模拟人对外科实习护生临床技能影响的研究

目的 探讨微课结合高仿真模拟人在外科实习护生临床技能教学中的应用效果.方法 选取我院北院2019年9-12月外科轮转的护理实习生30名为对照组,采用教师集中授课演示的传统培训方式,选取同时期我院南院外科轮转的护理实习生30名为观察组,在对照组的基础上采用微课结合高仿真模拟人的培训方式.比较2组实习护生临床技能成绩和护生...     

Satisfaction and gains perceived by nursing students with medium and high-fidelity simulation: A randomized controlled trial

BackgroundThe use of simulation to reproduce the experience of health care settings and its use as a strategy in the teaching of nurses has grown at an unprecedented rate. There is little scientific evidence to examine the differences in satisfaction and gains perceived by the students with the use of medium and high fidelity.ObjectivesTo analyse and benchmark gains and satisfaction perceived by nursing students, according to their participation in medium- and high-fidelity simulated practice.DesignRandomized control trial post-test only design with control group.Setting and ParticipantsStudents of the 4th year of the Bachelor's Degree in Nursing who performed medium and high-fidelity simulated practice in a Simulation Centre environment.MethodsA satisfaction scale and a scale of perceived gains from the simulation were applied to the students who underwent simulated practice in a medium-fidelity environment (control group) and high-fidelity environment (experimental group). Statistical analysis was performed and a significance level of p < 0.05 was established.ResultsOf the 85 students who participated in the study, the majority were female (92.94%), with an average age of 21.89 years (SD = 2.81 years). Satisfaction is statistically significant in the realism dimension and overall satisfaction. In the gains perceived with the simulation there is a statistically significant difference in the dimension recognition/decision.ConclusionStudents are very satisfied with the realism of high-fidelity simulated practice and consider that this helps them more with recognition and decision compared with the medium-fidelity simulation.