客观结构化临床考试在护理教学中应用效果的Meta分析

目的 用Meta分析评价在护理教学中应用客观结构化临床考试的效果。方法 检索Cochrane Library、PubMed、Embase、Medline、Science Direct、CNKI、VIP等资源,收集在护理教学中应用客观结构化临床考试的随机对照试验,检索时限均为建库至2017年10月,数据分析处理采用RevMan 5.3软件。结果 最终纳入11篇文献。结果显示,客观结构化临床考试对比传统教学法,能够提高护生生的综合成绩SMD=1.54,95%CI(0.78,2.31),P＜0.001]、理论知识成绩SMD=2.83,95%CI(1.75,3.91),P＜0.001]、操作成绩SMD=1.06,95%CI(0.54,1.58),P＜0.001]、评判性思维 SMD=3.37,95%CI(1.49,5.25),P=0.0005]和沟通能力SMD=3.15,95%CI(1.40,4.90),P=0.0004];但在体格检查和健康宣教考站评分的比较中,差异不具有统计学意义(P＞0.05)。结论 在护理教学中应用客观结构化临床考试模式能够促进护生对知识的掌握和运用,培养批判性思维能力和沟通能力。但因纳入研究的质量不一,未来仍需要更多严谨的RCTs来验证其应用效果。

Effects of objective structured clinical examinationin nursing teaching:a meta-analysis

Objective To evaluate the effects of objective structured clinical examination(OSCE)in nursing teaching.Methods We searched databases such as Cochrane Library/PubMed/Embase/Medline/Science Direct/CNKI/VIP for randomized controlled trials.The retrieval time was update to October 2017.Two researchers independently extracted data and evaluated the quality of each article.The Meta-analysis on the data collected was conducted by using RevMan 5.3 software.Results A total of 11 RCTs were included.The results of meta-analysis showed that there were significant differences between OSCE and traditional methods in students’ examination scores SMD=1.54,95%CI(0.78,2.31),P<0.001],theoretical knowledge scores SMD=2.83,95%CI(1.75,3.91),P<0.001],operational scores SMD=1.06,95%CI(0.54,1.58),P<0.001] critical thinking SMD=3.37,95%CI(1.49,5.25),P=0.0005] and communication ability SMD=3.15,95%CI(1.40,4.90),P=0.000 4],but there was no significant difference between physical examination and health education scores(P>0.05).Conclusion OSCE is a scientific teaching method,which is efficacious in mastering and applying knowledge,training critical thinking and improving the ability of communication for nursing students.However,due to the different quality of the research,more rigorous RCTs will be needed in the future to verify its application effect