护理本科生临床实习期间压力源与应对方式的调查研究

目的调查护理本科生在临床实习过程中的主要压力源和常采用的应对方式,以采取有效的管理措施,并引导学生采取有效的应对方式,减少或有效应对各种压力,以保持身心健康和提高实习效果。方法采用问卷调查方法,对在临床实习的68名护理本科生的压力源及应对方式进行了调查。结果67.64%的学生有中等水平的压力,19.12%有高水平的压力。压力来源依次为对知识技能的需求、工作性质与内容、监督与评价、病人的情况、病房环境与设备及教学安排。其中前10位压力源分别为处理病人紧急情况的能力、出现差错的可能、接触传染性疾病等。常采用的应对方式为接受现实、想办法独自解决、与同学谈论自己的感受等十项。     

实习前夕开展护生岗前培训的方法和体会

目的:在实习前夕进行护生岗前培训,培养护生专业修养,提高护生综合能力。方法:选择三年制护理专科生、四年制护理本科生和五年制护理本科生,采取医院与学校相结合的方式进行培训。结果:经过培训后,巩固了护生理论知识和操作技能。结论:开展岗前培训,是护生由学校进入临床实习的桥梁,有利于护生尽快实现角色转变,更新知识,调动护生学习的主动性和积极性,为提高实习质量,进入临床实习打下坚实的基础。     

以护生为主体的实习指导对其自我效能与临床实践行为的影响

目的：了解不同实习指导方法对实习护生的自我效能和临床实践行为的影响,为提高护生的临床实习水平提供理论依据。方法选取某三级甲等教学医院的2008级和2009级本科实习护生413名为研究对象,2008级护生采用常规实习教学指导方法,2009级护生采用以学生为主体的实习教学指导方法,在实习结束后进行一般自我效能及临床实践行为情况的问卷调查,比较其差异。结果2009级本科护生实习后自我效能得分为（2．79±0．46）分,高于2008级实习护生的（2．58±0．53）分,差异有统计学意义（t＝4．344,P＜0．01）。2009级本科护生实习后临床实践行为总分为（3．84±0．51）分,高于2008级实习护生的（3．69±0．45）分,差异有统计学意义（t＝3．299,P＜0．01）。结论以学生为主体的实习教学指导方法可以有效提高学生的自我效能和临床实践行为水平,可广泛应用于实习护生的教育中。     

护理本科生对临床学习环境评价与其临床实习表现关系的探讨

目的探讨实习初期和中期我国护理本科生对临床学习环境(CLE)评价与其临床实习表现(CPs)的关系。方法从全国142所护理本科高校中,按比例抽取22所高校中毕业实习的护理本科生,实习初期1 249名,中期1 114名,在实习初期和中期结束时调查。学生对CLE评价采用护理临床学习环境评价量表进行,对其CPs评价采用护理本科生毕业实习临床实践行为表现自评量表进行。结果实习初期和中期,学生对CLE评价与其CPs各维度相关系数分别是0.268~0.440(P0.01)和0.295~0.542(P0.01);对CLE评价能解释其CPs总变异分别是20.1%和28.3%,能解释各维度总变异最大的是临床护理,分别是20.6%和28.5%;其次是教学指导,分别是19.6%和31.2%;最小的是专业和自我发展,分别是9.7%和11.7%,所有值均P≤0.000,差异有显著意义。结论在实习初期和中期,我国护理本科生对CLE评价与其CPs各维度均呈中度正相关,相关性在中期增强;对CLE评价是影响学生CPs的重要因素,其中对临床护理、教学指导的影响最大,而对专业和自我发展表现的影响最小,但影响作用在实习中期均增强。     

Contribution of nursing students to clinical settings: A multi center cross sectional study

AimsTo describe the contribution of nursing students to clinical settings based on the perceptions of nurse preceptors and to examine whether certain characteristics of nurses’ professional activity are associated with a positive perception of nursing students.BackgroundMost clinical agencies receive many nursing students each year, who acquire clinical competencies under the guidance of a registered nurse preceptor. However, there is limited evidence of the contributions made by nursing students during clinical placements.MethodsA multi-center cross-sectional study was carried out between June and December 2019. A convenience sample of Registered Nurses (n = 927) was recruited from four public hospitals in Spain. The Nursing Student Contributions to Clinical Settings' questionnaire was used. In addition, sociodemographic, work and teaching activity variables were collected. Multivariable logistic regression was used to determine the variables associated with positive student contributions.ResultsThe nursing student contributions were deemed favorable by 70.7% of the nurse preceptors, mainly because the nursing students are future professionals who know the center, support the development of the nurses' teaching role and constitute a link between the health center and the university. Certain professional characteristics of the Registered Nurses were significantly associated with a positive perception of the contributions of nursing students: having daily coffee breaks (Odds ratio: 2.60; 95% Confidence interval:1.27–5.32), high levels of professional satisfaction (Odds ratio: 2.13; 95% Confidence interval:1.21–3.75) and work in medical-surgical units (Odds ratio: 1.62; 95% Confidence interval: 1.08–2.41). In contrast, nurses with greater work experience (≥ 30 years) (Odds ratio: 0.48; 95% Confidence interval: 0.27–0.85) and who worked at units where 10 or more students perform clinical practice (Odds ratio: 0.57; 95% Confidence interval: 0.36–0.90) were associated with a lower probability of positive perceptions.ConclusionsIn Spain, the contributions made by nursing students to clinical settings are favorable, both for the nursing profession and for healthcare institutions. Their contributions are influenced by the professional characteristics of the Registered Nurses, as well as the environment and the teaching activity within the units.     

支架式教学对专科实习护生临床沟通能力影响的研究

目的 探讨神经内科运用支架式教学在实习护生临床沟通能力中的应用效果。 方法采用方便抽样法选取淄博市某医学院校在A医院神经内科实习的20名护生为干预组,实习期间在传统带教基础上采用支架式教学开展沟通技能培训,同时选取同校在B医院神经内科实习的20名护生为对照组,采用传统带教模式,实习时间为2个月。在干预前后同时进行沟通能力测评和沟通技能自信问卷调查。 结果 实习2个月后,干预组临床沟通能力明显好于对照组(t=4.763,P<0.01)。干预组沟通自信得分高于对照组(t=2.184,P<0.05)。 结论 支架式教学模式能有效提高实习护生的临床沟通能力和沟通自信心。     

Practices of caring for nursing students: A clinical learning environment

ObjectiveThe purpose of this study was to explore, describe and illuminate nursing students’ best encounters of caring in the clinical learning environment. Caring for nursing students was emphasized and recommendations provided to enhance caring for nursing students within their clinical learning environment.MethodsQualitative data was collected by the researcher using semi-structured individual interviews and an Appreciative Inquiry (AI) methodology. Ten second year nursing students undertaking the bridging course leading to registration as general nurses in terms of Regulation 683 of the South African Nursing Council (SANC) were purposively sampled from 3 private hospitals within the Western Cape. Data was analysed using Giorgi’s method.ResultsThe main theme included the best and ‘least best’ caring practices embedded in the centrality of the heart. The subthemes comprised of the nursing students’ experiences of caring literacy and caring illiteracy. The second theme included the creation of best caring practices within a conducive clinical learning environment. Within this theme, the subthemes comprised of the caring attributes required in reflecting best caring practices, as well the creation of a clinical learning environment to optimise caring.ConclusionsThe significance and necessity of caring for the nursing student were clearly illustrated and confirmed by participants. Caring was equated to the heart as the core to the nursing students’ being. Recommendations for nursing education, management, practice and research were therefore specifically formulated to enhance caring towards nursing students.     

组织护理实习生进行操作技能竞赛的实践与效果

目的通过每年举办护理操作技能竞赛,激发护理专业实习生的学习热情,提高实习生操作的规范性,以更快地适应临床工作。方法在每年临床实习的中后期开展护理操作技能竞赛,并评出名次给予奖励。结果各届实习生操作技能竞赛成绩均在90分以上;参加过操作技能竞赛的新护士岗前操作考核成绩高于未参加过操作技能竞赛的新护士(P<0.01)。结论实习期间举办操作技能竞赛可调动实习生的积极性,加强操作的规范性,为新护士适应临床护理工作打下良好基础。     

Best practice in clinical facilitation of undergraduate nursing students

Clinical facilitation is critical to successful student clinical experience. The research reported in this paper used an interpretive case study to explore perspectives of clinical facilitators on what constitutes best practice in clinical facilitation of undergraduate nursing students.Eleven clinical facilitators from South East Queensland, Australia, participated in focus groups, interviews and a concept mapping exercise to gather their perspectives on best practice. The data gathered information regarding their prior and current experiences as registered nurses and facilitators, considering reasons they became clinical facilitators, their educational background and self-perceived adequacy of their knowledge for clinical facilitation. Analysis was through constant comparison.Findings of the study provided in-depth insight into the role of clinical facilitators, with best practice conceptualised via three main themes; ‘assessing’, ‘learning to facilitate’ and ‘facilitating effectively’. While they felt there was some autonomy in the role, the clinical facilitators sought a closer liaison with academic staff and feedback about their performance, in particular their assessment of the students. Key strategies identified for improving best practice included educational support for the clinical facilitators, networking, and mentoring from more experienced clinical facilitators. When implemented, these strategies will help develop the clinical facilitators' skills and ensure quality clinical experiences for undergraduate nursing students.     

护理操作风险量化表在护生临床带教中的应用

目的 探讨护理操作风险量化表在护生临床带教中应用的效果.方法 设计护理操作风险量化表,将2008年6月至2009年4月进入我院实习的106名护生作为对照组,实施原有护理操作风险管理办法;将2009年6月至2010年4月进入我院实习的105名护生作为观察组,应用量化表,对护理风险实施量化的管理办法.比较2组护生的风险意识、护理缺陷发生情况等指标.结果 观察组护生在风险意识、操作考核、护理缺陷及血源性暴露发生例数等方面显著优于对照组.结论 量化表的应用有利于提高护生的风险意识,提高教学质量,保障护理安全.     

Association between cultural intelligence and cultural sensitivity in nursing students: A cross-sectional descriptive study

BackgroundBecause of the multicultural composition of the Turkish population, healthcare providers encounter and serve individuals from various cultural backgrounds.AimTo determine the relationship between cultural sensitivity and cultural intelligence levels among nursing students.MethodsThis study was performed with 336 students attending the Nursing Department of a state university in Turkey. Data were collected using a sociodemographic data form, the Intercultural Sensitivity Scale, and the Cultural Intelligence Scale.ResultsMean age of the Nursing Department students was 20 ± 1.76 years. Mean total scores on the Intercultural Sensitivity Scale and Cultural Intelligence Scale were 90.49 ± 12.68 (maximum 120) and 95 ± 15.8 (maximum 140), respectively. Total scores in both the Intercultural Sensitivity Scale and the Cultural Intelligence Scale were higher among those nursing students who had encounters with people with different cultural backgrounds for any reason and those who wanted to work abroad. The nursing students’ Intercultural Sensitivity Scale and Cultural Intelligence Scale total scores were positively correlated (p < .001).ConclusionIntercultural sensitivity increased with higher cultural intelligence. Enhancing nursing education with programs that improve the students’ cultural sensitivity and cultural intelligence will help them to successfully manage cultural differences and provide culturally appropriate care in their nursing practice.     

Improvement of learning domains of nursing students with the use of authentic assessment pedagogy in clinical practice

With evolving healthcare demands, nursing educators need to constantly review their teaching methodologies in order to enhance learners’ knowledge and competency of skills in the clinical settings. Learning is an active process in which meaning is accomplished on the basis of experience and that authentic assessment pedagogy will enable nursing students to play an active part in their learning.The study was conducted with an aim to examine nursing students’ learning domains through the introduction of the authentic assessment pedagogy during their clinical practice. A quasi-experimental study (n = 54) was conducted over a period of 10 weeks at a local tertiary hospital. The experimental group was exposed to the authentic assessment pedagogy and were taught to use the assessment rubrics as an instrument to help enhance their learning. Students were assessed and scored according to the assessment rubrics, which were categorized into four domains; cognitive, psychomotor, affective and critical thinking abilities.The findings indicated that an overall score for the four domains between the experimental and control groups were significant, with p value of <0.05. Critical thinking scores were indicative of consistent improvement within the experimental group. The findings confirmed that learning outcomes of the nursing students were enhanced through the early introduction of the authentic assessment pedagogy in the clinical setting.     

Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions

Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements.Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool.     

实习护生对护理应急预案认知的调查

目的了解护生临床实习后对护理应急预案知识掌握的情况,为临床带教中增加应急预案知识的教学内容及其必要性提供依据。方法采用自行设计的护理应急预案知识测试量表,以北京市某三级医院75名实习护生作为调查研究对象进行问卷测试调查,对问卷得分进行分析,运用独立样本t检验,比较不同学历实习护生问卷得分情况。结果问卷回收率为100％,有效率为96％,100％的实习护生认为有进行护理应急预案学习的必要性;中专生应急预案知识总分为（39．00±2．716）分,大专生应急预案知识总分为（38．67±2．474）分,且间比较差异无统计学意义（t=0．545,P=0．588）。结论实习护生普遍缺乏医院护理应急预案的知识,l临床教学中应加强护生对护理应急预案知识的教育和危机意识、应对能力的培养。     

构建护理临床实习三级教学管理模式的探讨

目的探讨临床实习教学管理模式,提高护生临床实习的教学质量。方法在传统临床实习管理模式的基础上,创新护理学院与教学基地的护理部共同构建三级教学管理模式。结果通过4年实践,临床实习三级教学管理模式不断改进与提高,临床实习的管理水平、老师的带教质量、护生理论联系实际的综合能力均得到提升。结论护理学院与护理部共同构建临床实习三级教学管理模式,符合国家卫生部、教育部《医学教育临床实践管理暂行规定》的要求,提高了护理教学质量,达到教学目的。