客观结构化临床考试在护理本科毕业生实践技能考评中应用体会

目的探讨客观结构化临床考试在护理本科毕业生实践技能考评中的应用。方法通过撰写标准化患者病例,设置客观结构化临床考试考站,对41名护理本科毕业生进行实践技能考评。结果多站式考核总分为100分,考生成绩平均(81.02±4.59)分。结论客观结构化临床考试能够较全面的考评护理本科毕业生的实践技能,建议在专业课程教学、临床带教及考评过程中应用客观结构化临床考试。     

OSCE在高职涉外护理方向学生核心能力评价中的应用

目的探讨客观结构化临床考试(objective structure clinical examination,OSCE)用于高职涉外护理学生核心能力评价的设计方法与效果。方法以涉外护理核心能力为评价维度,临床护理工作过程为主线,护理病例库为依托,构建OSCE方案,共包括护理评估、护理诊断与计划、急救护理、基础护理、专科护理、健康教育6个考站。对105名高职涉外护理方向三年级学生进行考核,评价考核成绩、难度和区分度,并调查学生与教师对考核的评价。结果OSCE平均成绩为(72.52±9.50)分,呈正态分布。各考站试题的难度系数为0.62～0.79,区分度系数为0.41～0.74。师生对该考核方式的总体认可度较高。结论客观结构化临床考试能够较为全面地评价高职涉外护理方向学生的核心能力,具有较好的可行性和有效性。     

《中医护理学基础》客观结构化临床考试质量分析

目的研究客观结构化临床考试在基础课程《中医护理学基础》中的应用效果。方法以我院2011级的1个护理大专班护生作为实验对象,用客观结构化临床考试模式作为其教学、考核方法,客观结构化临床考试结束后进行考试质量分析。结果 (1)客观结构化临床考试总成绩服从正态分布(P0.10),偏度系数为0.87,峰度系数为0.80,得分率较高的考站为中医护理技能的2个考站,得分率较低的考站为健康教育站、护理评估站。(2)本次客观结构化临床考试平均难度为0.78,平均区分度为0.26,内容效度比平均数为0.95,各站考核成绩与课程的总评成绩(平时成绩占15%+实验成绩占15%+期末操作考核占35%+期末理论笔试占35%)的相关系数为0.39(P0.01);评分者之间的信度系数为0.51~0.94。结论客观结构化临床考试模式运用于《中医护理学基础》课程有较好的有效性和应用价值,可考虑在其他基础课程、临床课程中运用,以培养和锻炼护生的临床能力。     

应用客观结构化临床考试评价护理本科毕业生的临床能力

目的 采用客观结构化临床考试(objective structured clinical examination,OSCE)评价护理本科毕业生的临床能力.方法 设置OSCE考站,对2010届护理本科145名毕业生进行考核和成绩分析.结果 在本次考试中毕业生成绩分布均匀,分数在合理范围内,考试的信度及效度较好.结论 OSCE能够客观地反映毕业生的临床能力,但其考站的设置有待于进一步完善.     

以客观结构化临床考试和团队为基础的基础护理学 技能考试模式的设计与评价

目的 分析在护理本科生的基础护理学技能考试中,设计以客观结构化临床考试和团队为基础的考试模式的效果,以及学生对该考试模式的评价和认同情况,探讨基础护理学技能考试模式的改革.方法 选取本校2013级148名护理本科生分为30个团队,以客观结构化临床考试和团队合作为基础,同时融入临床病例贯穿始终,实施基础护理学技能考试.分析各个考站的成绩,并调查学生对该考试模式的评价和认同情况.结果 30个团队的平均成绩为(86.30±6.15)分,操作前评估与准备考站平均成绩为(13.47±0.78)分,得分最高.多数学生对该考试模式的设计、感受、效能方面有较好的评价和认同感.结论 该考试模式有助于客观评价和提高学生多方面的临床能力,如团队协作、护患沟通交流、健康教育、临床思维、技能操作等.学生对该考试模式普遍认同.     

客观结构化临床考试在护理本科生临床综合能力评价中的应用研究

[目的]了解应用客观结构化临床考试(OSCE)评价护理本科生临床综合能力的可行性.[方法]以教育学经典测量理论为指导,分析山西医科大学护理本科生OSCE成绩及考试难度、区分度、信度和效度.[结果]除护理操作3个考站外,其他10个考站成绩在不同学制和年级间的差异均具有统计学意义;本次OSCE考试难度较低,区分度指数较高,各部分考站考试内容信度较高,效度较好.[结论]OSCE是护生临床综合能力客观、有效和可操作性强的评价方法,为OSCE在护理教育领域的实践提供了客观依据.     

某院校护理本科生客观结构化临床考试效果分析

[目的]对我院护理本科生客观结构化临床考试(OSCE)成绩进行分析,了解学生的能力水平,为临床教学改革提供依据.[方法]2006级护理本科生110人实施OSCE考试,对考试成绩进行分析.[结果]OSCE考试平均成绩为72.8分±6.8分,成绩在总体上基本服从正态分布.[结论]对护理本科生开展OSCE考试,能够客观、真实的考查学生的总体水平及临床综合能力.     

客观结构化临床考试在护理本科生临床综合能力评价中的应用研究

[目的]了解应用客观结构化临床考试（OSCE）评价护理本科生临床综合能力的可行性。[方法]以教育学经典测量理论为指导，分析山西医科大学护理本科生OSCE成绩及考试难度、区分度、信度和效度。[结果]除护理操作3个考站外，其他10个考站成绩在不同学制和年级间的差异均具有统计学意义；本次OSCE考试难度较低，区分度指数较高．各部分考站考试内容信度较高，效度较好。[结论]OSCE是护生临床综合能力客观、有效和可操作性强的评价方法，为OSCE在护理教育领域的实践提供了客观依据。     

中医院校护理本科生客观结构化临床考试设计及效果评价

[目的]了解中医院校护理本科生对客观结构化临床考试(OSCE)的评价。[方法]随机选择70名学生参加有6个考站组成的OSCE考核,对其成绩及有关OSCE考试的设计与组织、质量和效能进行调查。[结果]本次OSCE考试成绩为78.17分±10.49分,考核总难度系数为0.78,总体区分度为0.35。62.9%学生认为各考站设计合理,75.7%学生认为有必要推广OSCE考试模式。[结论]将OSCE应用于中医院校本科护生的考核中,能够科学、客观地评价考生的综合能力,有助于考生临床运用能力的提高,考生对此新型考核模式较为认可。     

OSCE在涉外护理专业护生技能考核中的应用

[目的]探讨客观结构化临床考试(OSCE)在涉外护理专业技能考核中的应用。[方法]按照临床护理工作设置6个考站,对136名涉外护理本科生进行OSCE考核,分析内容包括描述性统计了解OSCE成绩分布及考试质量,采用问卷调查的方式调查学生对考核的评价。[结果]OSCE考试成绩为(75.35±6.23)分,成绩在总体上基本服从正态分布,校标关联效度系数为0.72(P0.05),考试难度系数(P)=0.68,区分度系数(D)=0.39;涉外护理本科生对OSCE考核方式的总体评价满意度近90%。[结论]OSCE考核能够客观评价涉外护理本科生专业能力的真实水平,可以作为评价涉外护理本科生专业技能的有效工具。     

Rofecoxib: clinical pharmacology and clinical experience

BACKGROUND: Rofecoxib is a member of a subgroup of nonsteroidal anti-inflammatory drugs (NSAIDs) known as cyclooxygenase-2 (COX-2)-selective inhibitors. It has been studied in adult and elderly patients in a number of painful conditions (primary dysmenorrhea, acute pain after dental and orthopedic surgery, osteoarthritis [OA], and rheumatoid arthritis). OBJECTIVE: This review discusses the clinical pharmacology of and clinical experience with rofecoxib, and the role of COX-2-selective inhibitors in clinical practice. METHODS: Pertinent studies were identified through searches of MEDLINE and EMBASE, as well as the Web sites and proceedings of relevant scientific meetings. RESULTS: Although the published literature is limited, the data indicate that rofecoxib is an effective analgesic agent for the painful conditions in which it has been studied. As a COX-2-selective inhibitor, rofecoxib offers safety advantages over traditional NSAIDs. In clinical trials, gastrointestinal (GI) toxicity, including mucosal damage, perforation, ulcers, and bleeding, occurred significantly less often in healthy volunteers and patients treated with rofecoxib than in those who received NSAIDs such as ibuprofen, naproxen, or diclofenac (all comparisons, P < 0.001). In terms of renal toxicity, rofecoxib does not appear to offer a safety advantage over traditional NSAIDs. Rofecoxib has not been shown to affect platelets (bleeding time and platelet aggregation), unlike traditional NSAIDs. CONCLUSIONS: Rofecoxib is an appropriate choice for patients who do not obtain adequate analgesia with acetaminophen and those who have not obtained adequate analgesia from, cannot tolerate, or are at risk for GI toxicity with traditional NSAIDs. Patients who require chronic analgesic medication (ie, those with OA), including those who take other medications daily for comorbid conditions, may also benefit from the once-daily dosing regimen of rofecoxib.     

Enhancing clinical effectiveness among clinical nurse specialists

This article describes the findings of an exploratory study which aimed to discover how clinically effective nursing care is fostered among clinical nurse specialists (CNSs) and nurse practitioners (NPs) in an NHS trust in East London. The study was funded by the Central and East London Education Consortium in January 1999. Qualitative approaches included non-participant observation of practice, interviews during observaton and focus group meetings, Findings from the research identify areas that both foster and hinder the ability of the CNSs and NPs to engage in and provide clinically effective nursing care.     

Laboratory clinical effectiveness: pathologists improving clinical outcomes

This article calls on pathologists to take a larger role in improving the performance of the American health care system. To improve outcomes for populations and individuals require that pathologists increase their activities outside of the traditional laboratory in interdisciplinary collaborations, outcomes research, health care systems development, and clinical care.     

Adherence in clinical trials and in clinical practice

The degree of patient adherence is increasingly recognized to be a key factor in the success of highly active antiretroviral therapy (HAART). HAART regimens are also among the most complex ever prescribed and low adherence is directly related to treatment complexity. Physicians prescribing HAART need to make adherence a priority both in clinical practice and in the design and interpretation of clinical trials if HAART really is to succeed in the long term.     

The clinical imperative in clinical nursing research.

Conducting preliminary clinical fieldwork to update clinical knowledge in preparation to plan and perform relevant, meaningful, credible and feasible clinical research is imperative. Clinical nurse investigators cannot generate relevant questions to study a current phenomenon with which they are not experienced. The nurse researcher's early involvement in the clinical world of health care as a prerequisite of proposal development not only contributes to the design of a study that has rigor and significance, but it also augments his or her competence and commitment to the improvement of patient outcomes.     

临床路径在临床护理带教工作中的应用

临床实习是护理教育的最后阶段,护生临床实习是理论联系实际,巩固和提高已学知识的有效途径,是一种锻炼服务思想,培养专业素质,提高技术水平,培养工作能力的综合性教学环节[1]。临床路径(clinical pathways,CP)是美国20世纪80年代以后逐步发展起来的质量效益型的管理模式[2]。它是一种包括了多专业的协调合作、预期结果的制定、服务的时限性、服务的连续性、持续的服务品质改进等特殊内涵的,设计精密的临床服务计划[3]。我科将临床路径严格的时间管理与质量控制引入到护理临床教学中,取得了较好的效果。现报告如下。1临床资料1.1一般资料20…