临床学习环境及择业动机对实习护生生涯适应力的影响

目的调查实习护生的生涯适应力现状,并探讨临床学习环境和择业动机对其生涯适应力的影响,为提高实习护生的生涯适应力提供参考。方法采用中文版生涯适应力量表、护理临床学习环境评价量表及自行设计的护理择业动机问卷,对山东省6所护理院校的431名实习护生进行问卷调查。结果实习护生的生涯适应力总均分（3.93±0.52）分,处于中等偏上水平。临床学习环境、择业动机与生涯适应力呈正相关（均P〈0.01）。多元回归分析表明,临床学习环境、择业期望和担任学生干部经历对实习护生的生涯适应力有显著影响（P〈0.05,P〈0.01）,能解释实习护生生涯适应力21.1%的变异。结论实习护生的生涯适应力有待进一步提高,护理教育者可通过提供积极、支持性的临床学习环境,增强实习护生择业信心,激发其择业动机等措施,来提高他们的生涯适应力。     

三甲医院护生临床学习环境评价及影响因素研究

目的调查三甲医院护生临床学习环境评价现状并分析其影响因素。方法采用一般资料问卷、临床学习环境评价量表、职业期望量表对长沙市10所三甲医院450名实习护生进行调查。结果三甲医院实习护生临床学习环境评价得分为126.28±22.76,处于中等水平。职业期望与临床学习环境评价呈正相关(r=0.197,P0.01),对就业前景的看法、临床实习满意程度、职业期望是临床学习环境评价的主要影响因素(R~2=0.108,F=6.916,P0.01)。结论三甲医院实习护生临床学习环境评价处于中等水平,职业期望越高的个体,临床学习环境评价越好。实习护生应合理自我定位,制定科学的职业期望。护理管理者应针对不同特征的实习护生提供适宜的临床带教,提高实习护生临床学习环境评价,从而提高临床教学质量。     

临床学习环境对护理本科生临床实习表现的影响

目的探讨临床学习环境(CLE)对护理本科生(护生)临床实习表现(CPs)的影响。方法按比例分层从全国142所医药高校中抽取22所的毕业实习护生923名,采用护理临床学习环境评价量表、护理本科生毕业实习临床实践行为表现自评量表进行问卷调查。结果护生CLE总评分为3.39±0.62,CPs总评分为3.68±0.47;护生对CLE评价与其CPs相关系数是0.520(P<0.01);个性化、学生参与性、任务定位是影响护生CPs的主要因素(均P<0.01)。结论 CLE可影响护生的CPs。在临床实习中,护理管理者和临床带教老师应给护生一定的自主性,并进行因人而异的个性化施教,为护生创造更多的动手机会,对护生的实习活动指示明确,让护生清楚自己的实习角色和实习任务,以提高临床实习质量。     

实习护生患者安全感知现状及与共情及临床实习环境的关系

目的探讨实习护生患者安全感知现状及与共情、临床实习环境的关系,为实习护生患者安全感知管理提供依据。方法运用方便抽样法选取320名临床实习护生作为研究对象,采用共情量表、临床实习环境量表和卫生职业教育患者安全感知量表进行调查。结果实习护生患者安全感知总分为(57.75±10.34)分,临床实习环境及各维度、共情及各维度与实习护生患者安全感知呈正相关(P0.05,P0.01);多元线性回归结果显示教师素质、学习机会、教学方法、观点采择和工作氛围是实习护生患者安全感知的主要影响因素(P0.05,P0.01),能解释总变异的32.6%;结构方程模型分析显示临床实习环境通过共情的部分中介效应作用于患者安全感知,总效应为0.21;间接效应为0.04,效应有统计学意义(均P0.05)。结论实习护生患者安全感知水平有待提高,临床实习环境可以通过共情的中介效应影响实习护生患者安全感知。临床护理教育者和管理者应采取多种措施优化临床实习环境,提高实习护生共情水平,旨在促进其对患者安全感知的水平。     

临床学习环境对实习护生关爱能力影响的研究

目的探讨临床学习环境对实习护生关爱能力的影响,为营造良好的临床学习环境、提高护生关爱能力提供依据。方法以方便整群抽样方法抽取合肥市6所综合性教学医院的346名临床实习护生,采用实习护生一般情况调查表、关爱能力评价量表和护理临床学习环境评价量表进行调查。结果实习护生关爱能力总分为(203.40±14.25)分,各维度得分为理解(78.88±8.37)分、勇气(66.43±5.75)分、耐心(58.09±4.37)分。实习护生关爱能力各维度及总分与临床学习环境各维度及总分呈正相关(均P0.01),工作氛围和团队文化、人际关系、创新性、个性化及任务定位对关爱能力总分有积极影响(P0.05,P0.01)。结论实习护生关爱能力较以往有进步,但仍需进一步提升。良好的临床学习环境有利于提高实习护生的关爱能力。     

实习护生临床学习环境与职业认同感相关性研究

目的探讨实习护生临床学习环境与职业认同感的现状,分析二者之间的关系,为护理教育工作提供实证依据。方法采用学习环境量表和职业认同感量表对在某医院实习后期的278名护生进行问卷调查。结果实习护生临床学习环境得分148.36±13.51;职业认同感总条目均分3.56±0.47;临床学习环境与职业认同感呈正相关(P0.01)。结论实习护生的临床学习环境及职业认同感均处于中等水平,临床学习环境对护生的职业认同感有显著影响,护理管理者应结合实习护生的特点,提供良好的临床学习环境,从而提升护生职业认同感。     

临床学习环境对实习护生关爱能力影响的研究

目的 探讨临床学习环境对实习护生关爱能力的影响,为营造良好的临床学习环境、提高护生关爱能力提供依据.方法 以方便整群抽样方法抽取合肥市6所综合性教学医院的346名临床实习护生,采用实习护生一般情况调查表、关爱能力评价量表和护理临床学习环境评价量表进行调查.结果 实习护生关爱能力总分为（203.40±14.25）分,各维度得分为理解（78.88±8.37）分、勇气（66.43±5.75）分、耐心（58.09±4.37）分.实习护生关爱能力各维度及总分与临床学习环境各维度及总分呈正相关（均P＜0.01）,工作氛围和团队文化、人际关系、创新性、个性化及任务定位对关爱能力总分有积极影响（P＜0.05,P＜0.01）.结论 实习护生关爱能力较以往有进步,但仍需进一步提升.良好的临床学习环境有利于提高实习护生的关爱能力.     

实习护生对临床学习环境的评价与其职业态度关系探讨

目的探讨本科实习护生对临床学习环境(CLE)的评价与其职业态度的关系。方法选取2所医学院校本科实习护生219名,采用护理专业自我概念量表及护理临床学习环境评价量表进行调查。结果护生CLE总评分为137.84±20.81,职业态度总评分为85.89±10.32;护生对CLE评价与其职业态度呈正相关(P<0.01);学生参与性、人际关系、工作氛围和团队精神对护生职业态度有显著影响(均P<0.01)。结论CLE可影响护生职业态度,护生对CLE评价与其职业态度显著相关,学生参与性、人际关系、工作氛围和团队精神是影响护生职业态度的主要因素。     

实习护生工作沉浸体验的潜在类别与生涯适应力的关系

目的 探讨实习护生工作沉浸体验的潜在类别及其与生涯适应力的关系，为护理临床教学提供参考。 方法 使用一般资料问卷、工作沉浸体验量表和大学生生涯适应力量表，以武汉市10所三级甲等综合教学医院的169名实习护生为研究对象进行问卷调查，进行潜在剖面分析。 结果 实习护生工作沉浸体验可分为低水平沉浸组（12.3%）、中低水平沉浸组（55.6%）、中高水平沉浸组（28.4%）与高水平沉浸组（3.6%）4种潜在类别。不同护理专业喜爱程度、月生活费的实习护生在4种不同工作沉浸体验潜在类别上的分布比较，差异有统计学意义（均P＜0.05）；不同工作沉浸体验剖面的实习护生生涯适应力及其各维度得分差异有统计学意义（均P＜0.05）。 结论 实习护生的工作沉浸体验存在4种潜在类别，且具有人口学差异，实习护生工作沉浸体验的高低影响护理职业生涯适应能力。应针对工作沉浸体验的异质性采取针对性干预措施，帮助实习护生提高工作沉浸体验从而增强生涯适应力。     

基于护理迷你临床演练评估量表的临床教学模式的设计与实施

目的构建护理迷你临床演练评估临床教学模式,并探讨其实施效果。方法以2011级本科护生35人为对照组,2012级本科护生42人为实验组。对照组采用传统实习带教方法带教,实验组采用护理迷你临床演练评估教学模式带教。采用护理迷你临床演练评估量表、实习出科考核成绩、教师教学效能感量表分别对护生与教师进行评价。结果实验组护理迷你临床演练评估量表护理问诊、护理查体、护理诊断、健康咨询、组织效能、整体评价得分显著高于对照组(P0.05,P0.01);实习平时考核成绩、出科操作成绩、教师教学效能感得分显著高于对照组(P0.05,P0.01)。结论护理迷你临床演练评估教学模式可提高临床护理教学质量,实现教学相长。     

Perspectives of third-year medical students toward their surgical clerkship and a surgical career

INTRODUCTION: A deficit of surgeons currently exists in the health care workforce. We have designed a study that identifies predictors of students choosing a career in surgery. First, we conducted two feasibility studies, and on the basis of these data, designed a third study for addressing our specific aims. The design and one-year results for the new study are provided here. METHODS: For the feasibility studies, students participating in the third-year surgery clerkship at our institution were asked to complete surveys using two different study designs. For the new study, which began in June 2005, students complete surveys covering domains of interest at the beginning of the clerkship and at weekly intervals throughout the clerkship, and will be providing match results. RESULTS: The feasibility studies offered insight into ways to improve our study design. In the first year of this multi-year study, 93 students participated (response rate = 77%). Forty-five students were women (48%), and the average age was 26.09 (sd 2.85). Proportion of students rating general surgery or a surgery subspecialty in their top three choices for a career increased over the course of the clerkship by 24.7% (n = 32, 34.4% at baseline; n = 55, 59.1% at end of clerkship). Seventy-one students (76.3%) reported having a meaningful experience on the clerkship, and 30 (32.3%) received honors grades. CONCLUSION: Our study design benefitted from the knowledge we gained from our feasibility studies. We look forward to achieving the necessary sample size in the next several years to report the final results of this study.     

硕士研究生学历护士职业发展定位与需求的质性研究

目的了解医院硕士研究生学历护士职业发展定位与需求,为医院管理者对硕士研究生学历护士的培养与职业规划提供依据。方法采用质性研究中的现象学研究方法 ,分析入职1年以上的10名硕士研究生学历护士的职业发展定位与需求的内心希望及感受。结果硕士研究生学历护士渴望得到更多的机会和发展空间;期待获得英语及科研知识培训;期望医院管理者能够建立完善的培养体系对其进行培养并向专科护士或管理岗位发展。结论护理管理者应重视硕士研究生学历护士的培养,尽快建立完善的培养体系,同时开展多种形式的继续教育模式;其使用应实施双向选择制,为硕士研究生学历护士提供更大的职业发展空间。     

急诊科护士自我职业生涯管理及核心自我评价对职业弹性的影响

目的了解三甲综合医院急诊科护士自我职业生涯管理、核心自我评价、职业弹性现状及相关影响因素,为针对性干预提供参考。方法采用自我职业生涯管理量表、核心自我评价量表、职业弹性量表对北京市4所三甲综合医院的164名急诊科护士进行问卷调查。结果急诊科护士自我职业生涯管理总分46.13±7.99,核心自我评价总分38.30±3.99,整体职业弹性总分39.18±5.57;职务、核心自我评价及自我职业生涯管理的继续学习维度是职业弹性的主要影响因素(调整R~2=0.329)。结论急诊科护士自我职业生涯管理、核心自我评价及职业弹性处于中等水平,其中护士长、善于学习者及核心自我评价较高者正向影响职业弹性;护理管理者应给予关注和构建学习机制,促进护士通过不断学习,正确自我评价,提升职业弹性水平。     

职业韧性在临床护士职场友谊与工作绩效间的中介作用

目的 探讨临床护士职场友谊、职业韧性以及工作绩效之间的关系，为提升临床护士工作绩效提供建议。方法 采用职场友谊量表、职业韧性量表、工作绩效量表，对河南省、陕西省、广东省7所三级甲等医院673名临床护士进行调查。结果 临床护士职场友谊得分为(48.17±7.26)分、职业韧性得分为(19.99±3.65)分、工作绩效得分为(42.62±6.44)分；临床护士职场友谊与职业韧性、工作绩效呈正相关(均P<0.05);在控制一般资料变量后，职业韧性在职场友谊与工作绩效间起中介作用，中介效应占总效应的30.68%。结论 职场友谊可直接预测工作绩效，职业韧性在两者间起中介作用。护理管理者可通过营造良好的工作氛围，帮助临床护士建立稳固的职场友谊，进而增强其职业韧性，以提升工作绩效。     

目标管理在护士职业生涯规划中的应用

目的探讨目标管理在护士职业生涯规划中的作用及其效果。方法首先制定病区的工作目标,并将目标有效传达至每位护士,再与护士面对面地交谈,协助其制定个人目标,通过激励、沟通、授权、帮助等方法推动目标实施并进行绩效评价,从而实现组织和个人目标。结果每位护士的目标和病区目标基调一致,创建了优质护理服务示范病房,未发生压疮、跌倒、投诉、差错等不良事件;获得多项奖励;获市科研立项1项,撰写论文6篇等。结论目标管理能促进护士及早地规划职业生涯,并在护理工作中实行自我管理,以目标为导向,以人为中心,以成果为标准,而使组织和个人取得最佳绩效。     

Brief intervention by surgeons can influence students toward a career in surgery

BACKGROUND: General surgery training programs are experiencing an alarming decrease in applicants. The purpose of the current study was to determine whether exposing students to surgery through a brief intervention early in their medical education could influence perceptions toward surgery as a career choice. METHODS: First-year medical students were asked to rank 19 items coded on a Likert-type scale from 1 (not important) to 8 (very important) regarding their beliefs about surgery as a career both before and after a brief 1-h intervention with a panel of surgeons. Each panelist spoke about his or her professional and personal lives, followed by a question and answer period. Survey data were analyzed by Wilcoxon sign-rank and Spearman rank correlation. RESULTS: Of 210 first year students, 121 (58%) students voluntarily attended and completed the presurvey and 94 (45%) the post, of which 82 were matched responses. Preintervention responses revealed that career opportunities, intellectual challenge, and the ability to obtain a residency position were positively correlated with surgery (P < 0.007) whereas length of training, lifestyle during residency, lifestyle after training, and work hours during residency were negatively correlated (P < 0.01). The following factors were significantly influenced by the intervention: academic opportunities, patient relationships, prestige, and gender distribution became more important whereas concern about debt and length of training became less important. CONCLUSIONS: Positive encounters with surgeons can favorably influence the perceptions of first-year medical students toward a career in surgery. In addition to addressing lifestyle issues, surgeons can and must make a concerted effort to interact with medical students early in their education and foster their interest throughout their career.     

护士个人职业目标现状及影响因素研究

目的了解护士的个人职业目标现状并分析影响因素,为引导护士个人职业目标管理提供依据。方法在KRIF绩效考核模式的基础上设计护士个人职业目标调查工具,对726名护士进行调查。结果除学习本专业知识目标(74.8%)外,其他23个目标的选择率为0~36.1%。不同学历、科室、编制、职称、年龄、工龄护士的部分个人职业目标存在差异(P0.05,P0.01)。结论护士对个人职业目标的认识尚需提高,护理管理者应指导护士建立科学、合理的个人职业目标,关注护士的职业发展,促进护士成长和医院科室健康发展。     

Evaluating the Women's Empowerment and Leadership Initiative: Supporting mentorship,career satisfaction,and well-being among pediatric anesthesiologists

The Society for Pediatric Anesthesia launched the Women's Empowerment and Leadership Initiative (WELI) in 2018 to empower highly productive women pediatric anesthesiologists to achieve equity, promotion, and leadership. WELI is focused on six career development domains: promotion and leadership, networking, conceptualization and completion of projects, mentoring, career satisfaction, and sense of well-being. We sought feedback about whether WELI supported members' career development by surveys emailed in November 2020 (baseline), May 2021 (6 months), and January 2022 (14 months). Program feedback was quantitatively evaluated by the Likert scale questions and qualitatively evaluated by extracting themes from free-text question responses. The response rates were 60.5% (92 of 152) for the baseline, 51% (82 of 161) for the 6-month, and 52% (96 of 185) for the 14-month surveys. Five main themes were identified from the free-text responses in the 6- and 14-month surveys. Members reported that WELI helped them create meaningful connections through networking, obtain new career opportunities, find tools and projects that supported their career advancement and promotion, build the confidence to try new things beyond their comfort zone, and achieve better work–life integration. Frustration with the inability to connect in-person during the coronavirus-19 pandemic was highlighted. Advisors further stated that WELI helped them improve their mentorship skills and gave them insight into early career faculty issues. Relative to the baseline survey, protégés reported greater contributions from WELI at 6 months in helping them clarify their priorities, increase their sense of achievement, and get promoted. These benefits persisted through 14 months. Advisors reported a steady increase in forming new meaningful relationships and finding new collaborators through WELI over time. All the members reported that their self-rated mentoring abilities improved at 6 months with sustained improvement at 14 months. Thus, programs such as WELI can assist women anesthesiologists and foster gender equity in career development, promotion, and leadership.