高级护理实践工作坊的建立及实践

目的 建立高级护理实践工作坊,并探讨其在教学中的实践效果。方法 对某高校2016级—2018级88名护理硕士专业学位研究生采用工作坊教学法开展高级护理实践课程,并采用高级护理实践课程成绩、学生反思日记及对18名护理硕士的质性访谈进行效果评价。结果 工作坊教学后,护理硕士专业学位研究生综合能力考核的总分为（87.19±4.61）分。对学生反思日记和访谈结果进行分析,提取出工作坊培养了学生的综合素质、工作坊促进了学生的自我反思、工作坊的教学模式还需要进一步探索三大主题。结论 工作坊不仅提高了护理专业硕士的综合能力,而且有利于学生的职业成长,学生普遍反馈较好。     

我国高等护理教育中人文社会科学课程改革的进展

目前,大多数护理院校仍沿用医学教育的课程体系,没有摆脱生物医学模式的影响。加强高等护理教育中人文社会科学课程的教学,是培养护生关爱生命和病人的必修课程,是提高护生人文素质的重要手段。结合国内外医学与护理学人文社会科学课程改革的现状,提出新世纪高等护理教育中提高人文社会科学课程的地位,重视师资培养,营造学校人文环境等人文社会科学课程改革的进展。     

The spirit of humanism should be cultivated in the nursing profession

As nursing is an art that emphasizes the nature of caring it should have humanistic attributes. Humanistic education of a nursing professional should emphasize a person-centered perspective in order to foster cultivation of the humanities and infuse the spirit of humane care into medical practice. Cultivation of humanism refers to the emotional level of personal-affective experience that blends humanistic science and aesthetic experience to enhance nurse observational abilities. The ability generated by self-awareness and reflection can trigger deep empathy and empathetic performance, which is ideal humanistic-nursing behavior in nursing staff. Traditional nursing education focuses on acquiring professional knowledge and largely ignores the cultivation of a humanist spirit. To help nurses adjust to the rapidly changing environment of nursing care and demonstrate a professional and humane character, in addition to advocating for a humane medical environment, the six Es of humanistic-nursing education (Example, Explanation, Exhortation, Environment, Experience, Expectation) should be promoted. The six Es are essential to building a framework to cultivate humanistic education strategies and strengthen humanist content in nursing education. In order to instill deeply the spirit of humanistic care in nursing and make the nursing-care process more humane, these ideals must be emphasized in nursing education to raise the level of humanism.     

我国本科护理教育社会人文课程设置现状的研究

目的探讨中国本科护理教育社会人文课程设置的现状及发展趋势。方法采用文献调查法比较本科护理教育1998年和2006年社会入文课程设置的情况。结果1998年19所护理本科院校设置社会人文课程的科目和学科范围狭窄,只有14门必修课,无任意选修课;政治、英语以外所有社会人文课程的学时之和仅占总理论学时的4．08％。2006年47所院校设置社会人文课程数量达到了70余门,有76．6％的学校开设了任意选修课,涉及文学、艺术、历史、地理、东西方哲学与文化等多类课程;政治、英语以外所有社会人文课程的学时之和占总理论学时的7．37％。结论2006年本科护理教育社会入文课程设置的状况较1998年发生了较大变化,必修课和选修课的科目范围和学时比例都有所增加。     

Medical humanities in nursing: thought provoking?

Medical humanities is an innovative way of learning. Discussing literary texts of nursing practice has been used to help students analyse attitudes, values and ethics; it has also been used to help practitioners review and reflect on their own experience and philosophy of nursing. In nursing education, it has been used to explore difficult issues in a safe environment. The value of this approach in nursing education and practice is that it can encourage reflection, promote self-awareness and stimulate debate on difficult issues: for example, death and dying, power and institutionalization (of patients and staff) and pain. This paper gives a detailed worked example of how a literary text can be used in this way, the aim being to provide a resource which readers can then use with a group of students or colleagues. Finally, the authors explore the question of where medical humanities might have a place in the curriculum: as a lecture/tutorial in a course (e.g. Ethics), as a module in the curriculum, as a method of teaching nursing subjects (e.g. communication skills), as a discussion group (outside the curriculum), as a study guide, using literary texts alongside nursing text books. Any of these strategies can be a powerful vehicle for preserving the 'human factor' in both nursing education and continuing professional development.     

Kaleidoscope: a 5-year action research project to develop nursing confidence in caring for patients with HIV disease in west India

As the national epidemic of human immunodeficiency virus (HIV) infection and the acquired immune deficiency syndrome (AIDS) epidemic rapidly unfolds in India, nurses have to acquire new competencies in order to provide appropriate care to an increasing number of affected persons. In response, an Indo-British action research collaboration was initiated to build clinical confidence and facilitate relevant changes in nursing practice. During a 10-day educational programme, a change intervention was applied, culminating in the development of individual and partnership action plans focused on bringing about changes in nursing practice within well-defined fields of action. Following implementation of their action plans, participants were reassembled 12 months later for a follow-up workshop to discuss their progress and describe those factors that either helped or hindered them in achieving their objectives. They then developed new action plans for the next 12-month period. This article reports on the results from six cohorts (n = 160) in India who participated in this project between 1995 and 1999. Action plans were frequently focused on infection control, primary prevention, curriculum development in preregistration nursing programmes and in-service nursing education. The majority of participants reported significant achievements in realizing their action-plan objectives. Data analysis revealed that the change intervention itself, together with multidisciplinary support from colleagues, the senior status of the participant, and anticipating and attending the follow-up workshop, were all positively correlated with achievement. The lack of personal authority and resistance from managers were the two major factors negatively correlated with achievement. This method for facilitating changes in nursing practice has been successfully adapted and replicated by our group in other countries.     

The humanities interface of nursing and medicine.

In the 1970s, the field of medical humanities developed and included ethics, literature, history, integrative medicine, and other topics, most often described from a physician's perspective. During this same period of revolutionary changes in health care, nursing curricula did not seek to emphasize content in humanities, perhaps because stereotypical views of nursing as the "caring profession" made such coursework seem redundant. In 2001, as a result of the Institute of Medicine's call for all health professionals to be educated in interdisciplinary teams, there was a new focus on the importance of interdisciplinary education. Collaborative experiences in the humanities can foster professional relationships that lead to professional growth, promote collaboration, and enhance patient-centered care. The purpose of this article is to describe the relevance of humanities to the interdisciplinary education and practice of health care providers. This article extends the thinking about the value of interdisciplinary education beyond the traditional dimensions of evidence-based practice, quality improvement, and informatics to humanities. Ways to provide nurses and physicians with interdisciplinary humanistic experiences are illustrated through an overview of projects jointly developed by the School of Nursing and the College of Medicine at The Pennsylvania State University.     

护生人文关怀精神培养方法的研究

现代医学模式的转变要求充分实践社会人文医学,护理人文关怀是其中的一个重要组成部分,人文关怀精神的培养是护理教育改革的重要内容。本文重点论述在护理学基础教学中培养学生人文关怀精神的方法研究,包括人文关怀精神在教学内容的渗透、情景教学法、实体训练法、小组讨论法、记学习日记法、安排学生早接触临床等。用以上方法在护理学基础教学中培养学生人文关怀精神是有效的。     

护理人文素质教育模式的构建

根据现代护理的需求,对护理本科人才培养方案、课程体系、教学内容、教学方法及实践教学进行改革．提出三、三、三护理人文素质教育模式。该教育模式突出学生护理人文知识、能力、素质的培养,融传授人文知识、培养人文能力及人文素质为一体。     

An integrative review of humanities-based activities in baccalaureate nursing education

PurposeThe American Association of the Colleges of Nursing has stressed the importance of the liberal arts as a foundation of nursing education that supports the development of clinical reasoning and judgments in their recently updated essentials for professional nursing education. The purpose of this research was to conduct an integrative review of the literature to explore the use of the humanities in baccalaureate nursing programs.Research questionAmong undergraduate nursing programs, what types of humanities interventions were used in nursing courses and what were the outcomes of these interventions?Theoretical frameworkThis research was guided by the Aesthetic Knowing and Knowledge conceptual model by Chinn and Kramer, which is based on the Fundamental Patterns of Knowing in Nursing by Carper.MethodsAn integrative review method, as outlined by Whittemore and Knafl, was used for this research.ResultsAfter analysis of 227 titles, 19 studies were selected. Studies used art, literature, music and dance-based interventions. A key theme in examining the use of humanities in nursing education is its connection to aesthetic knowing in nursing. This included moral/ethical comportment, therapeutic use of self and scientific competence, as outlined in the Aesthetic Knowing and Knowledge conceptual model by Chinn and Kramer. Additionally, several other common themes emerged across the studies as nursing students reflected on the impact of the inclusion of humanities in their nursing curricula. Nursing student-recognized benefits included enhanced learning, emotional development, communication and new insights into best nursing practices.ConclusionsHumanities-based interventions are a useful addition to undergraduate nursing education. Future research should use randomized controlled designs to strengthen the body of literature regarding this topic.     

Windows and mirrors: reflections of a module team teaching the arts in nurse education

The five-year experience of a group of nursing lecturers teaching the expressive arts within a Scottish degree programme is outlined and discussed. The place of the arts is contextualised within curriculum developments and module content, sequencing, thematic development, mode of delivery, assessment, student evaluation and pedagogical approaches are all addressed. Relationship to practice is discussed in terms of the art of nursing, reflection, ethics and spirituality. Future developments are discussed in terms of drawing upon the wider resources of the humanities, rather than merely expressivist sources of art. The paper concludes by encouraging the teaching of the arts in nurse education to remain responsive to practice issues and to consideration of students' learning needs.     

Teaching the skills of assessment through the use of an experiential workshop.

Assessment is a key element of the nursing process, yet the skills required to perform a nursing assessment are poorly defined in the literature. Related to this, nurse education does not adequately address how it might be possible to develop in students the skills required to plan individualised care. As a contribution to this important area of nurse education, this paper describes the first term of an assessment course, an important component of which is an experiential workshop. This workshop introduces students to the skills of observation, measurement and testing as used when assessing physiological indicators of health status. The workshop was designed to facilitate an understanding of the connection between the students' knowledge of biological sciences and nursing practice.     

Geriatric nursing assessment

Gerontological nursing is a unique area of nursing. The cornerstone of the gerontological nursing process is assessment. In some traditional education models, nurses are taught assessments in general areas, such as cardiology, neurology, urology, and orthopedics. Little emphasis is placed on integrating these systems. A one-day workshop was developed with the objective to further develop the assessment skills of the registered nurse (RN) in continuing care by demonstrating a holistic approach to assessment and care planning. For this workshop, the "giants of geriatric medicine," namely falls, incontinence, confusion, iatrogenic illness, and impaired homeostasis (Cape, 1978) were further developed into a geriatric nursing model to include the psychosocial issues. This model demonstrates a way of assessing and integrating the information known about the resident. To ensure the workshop content was practical for the nurse, existing resident care documentation within the sponsoring organization, The Capital Care Group, was used. Through the education provided in the workshop, the RNs recognized that individualized care is based on full assessment of the resident, integration of the information gathered, and complete documentation.     

Mature age students access, entry and success in nurse education: an action research study

This action research study involved an 'expert group' that was convened to consider issues for mature age nursing students in the Australian context and develop recommendations that could be used to strengthen mature age entry, access and success in nursing programs. Consistent with action research, the group worked through phases of planning, action, observation, evaluation and critical reflection. In developing recommendations that could be used for future planning, the group met regularly, reviewed extensive literature, and conducted two data collection activities, a questionnaire and focus group with education providers. From the action research activities, five major recommendations were generated. These focused on the value of mature age students, the need for specific information, transparent and clear processes for students entering nurse education, study support and finally, the provision of financial assistance.     

Art and health care: A dialog about interdisciplinary collaboration

Tell Well is an innovative creative writing and storytelling workshop developed by a public health nursing scholar and educator and a writer and educator. The demonstration project was a writing workshop designed especially for nurses. While the overall objective of Tell Well is to teach writing and storytelling as self‐care tools for health care workers to address professional quality of life, the interdisciplinary collaboration has proven to be a vital component of the program's development. After an exploration of the importance of bringing the arts and humanities to nurses and their nursing practice, the writer and the nurse engage in a dialog about the collaboration, its origins, the challenges faced, and the value of such interdisciplinary endeavors.     

Reflective process in action: the uncovering of the ritual of washing in clinical nursing practice

• ? Reflection can be utilized to reveal aspects of clinical practice which remain shrouded in ritualistic origin.
• ? The underlying themes surrounding the action of washing patients can be traced to Victorian legacies and the nurse education process.
• ? The nurse-patient relationship serves as a template for the deliverance of nursing interventions.
• ? An incomplete awareness of the nurse-patient relationship persists as to its initiation, continuation and usefulness in clinical nursing.
• ? Following reflection, there has been an increased awareness of feelings and attitudes surrounding the activity of washing a patient.

     

安徽省4所医学院校护理学专业人文社会科学课程设置的调查分析

目的了解医学院校护理学专业人文社会科学课程设置情况,以期对护理学专业的人文教育提供参考。方法收集了安徽省4所医学院校五年制护理学专业的培养方案,对培养方案中人文社会科学课程及学时、专业课程及学时、总学时进行分析。结果 4所医学院校人文社会科学课程学时分别占总学时的30.1%、32.0%、31.3%、38.2%。结论护理学专业人文社会科学课程设置的门类较多,人文社会科学课程设置的课时比例达到1/3,但各学校人文社会科学课程设置不平衡,有待进一步优化。     

基于就业能力的高职护生人文素质现状的实证研究

目的 对高职护生人文素质现状进行描述,为高职护理专业人文教育改革提供实证依据。方法 采用问卷调查法分别对用人单位和高职护生实施调查。结果 大多数学生有正确的人生观、价值观;专业思想稳定;具有良好的护理礼仪和与人合作的能力;有一定的人文关怀意识。不足之处主要表现为心理素质问题突出;工作中缺乏责任感、慎独精神及法律意识;沟通能力与发现、解决问题能力欠佳;没有良好的阅读习惯,人文知识贫乏,写作能力较差;对职业规划的认识较为肤浅。结论 更新教育理念、明确高职护理专业人文教育的目标、加强心理素质教育、强化责任意识、培养敬业精神、实施全程式职业生涯设计指导,可以提升护生的人文素质和就业能力。     

在护理学专业开设医学人文课程的实践与体会

目的为提高护生的护理软技能,在护理学专业开设《医学文化概论》和《医学沟通学》两门医学人文课程。方法2010-2011年对成都医学院435名护理本科生进行了《医学文化概论》和《医学沟通学》的课程教学,均为专业必修课,课程总学时均为36学时,教学目标包括知识、能力、素质三个方面,采用同事评价、教师自我评价、专家评价以及学生评价等4种方式对两门课程的教学质量进行综合评估。结果护生对两门课程的教学内容设计、教学案例选择与应用、教学内容实用性、思考题与讨论题及教学方法的满意度较高(满意率与基本满意率达到96%以上),但是对教材规范性与教学目标一致性及实践实训内容安排的满意度较低(不满意率超过20%)。结论对护理专业学生开设医学人文课程,是提高护生护理软技能的有效途径,而周密设计、注重过程及专业导向并不断反馈是保证教学效果的重要环节。