加涅教学理论配合场景教学在呼吸与重症医学科护生实习带教中的应用

目的 探讨加涅教学理论配合场景教学用于呼吸与重症医学科护生实习带教对核心胜任力的影响。方法 将在北京积水潭医院参与呼吸与重症医学科护理实习的42名实习生作为研究对象，采用随机数字表法分为观察组（21名）和对照组（21名）。对照组采用传统带教，观察组采用加涅教学理论配合场景教学。教学结束后，考查两组护生理论知识及实操能力；并采用护生核心胜任力评价表评估核心胜任力，采用护理专业学生自主学习能力测评工具评估两组护生自主学习能力；同时比较两组护生对带教的自评情况。采用SPSS 22.0进行t检验或卡方检验。结果 观察组护生的理论知识和实践操作技能考核成绩得分分别为（88.10±7.52）、（90.81±4.88），高于对照组的（83.62±6.58）、（72.57±8.94），差异有统计学意义（t=2.06、8.21，均P<0.05）；观察组护生的核心胜任力、自主学习能力评分总分分别为（185.53±20.19）、（129.09±16.14），高于对照组的（170.52±20.32）、（105.86±12.23），差异有统计学意义（t=2.40、5.10，均P<0.05）；观察组护生对教学模式自评效果评分得分为[28（25，29）]，高于对照组的[21（20，22）]（Z=5.39，P<0.05）。结论 加涅教学理论配合场景教学应用于呼吸与重症医学科护生实习带教中，有利于提高护生理论知识及实践操作技能的掌握程度，能够提升护生的自主学习能力及核心胜任力，有效提高护理教学效果，值得推广应用。

Application of Gagne's teaching theory combined with scene teaching method in practice teaching of nursing students in department of respiratory and critical care medicine

Objective To explore the effects of practice teaching based on Gagne''s teaching theory combined with scene teaching method on core competency of nursing students in department of respiratory and critical care medicine.Methods A total of 42 nursing students from the Respiratory and Critical Care Medicine Department of Beijing Jishuitan Hospital were enrolled and divided into observation group (21 cases) and control group (21 cases) using a random number table. Traditional teaching method was used in the control group, while Gagne''s teaching theory combined with scene teaching method was used for teaching the observation group. After teaching, theoretical knowledge and actual operation ability of nursing students were assessed. The core competency of nursing students was evaluated by core competency assessment scale. The independent learning ability of nursing students was evaluated using an assessment tool. The self-evaluation of teaching effect in the two groups was compared. The t test or chi-square test was performed in SPSS 22.0.Results The scores of theoretical knowledge and actual operation ability in the observation group were (88.10±7.52) and (90.81±4.88), respectively. These scores were significantly higher than those in the control group [(83.62±6.58) and (72.57±8.94), t=2.06, 8.21, P<0.05]. The scores of core competency and independent learning ability were significantly higher in the observation group than in the control group [(185.53±20.19) and (129.09±16.14) vs. (170.52±20.32) and (105.86±12.23), t=2.40, 5.10, P<0.05]. The score of self-evaluation on teaching effect was significantly higher in the observation group than in the control group [28 (25, 29) vs. 21 (20, 22), Z=5.39, P<0.05].Conclusion Gagne''s teaching theory combined with scene teaching method in practice teaching of nursing students in the department of respiratory and critical care medicine should be promoted because this combined method improves the mastery of theoretical knowledge and actual operation skills, the independent learning ability and core competency of nursing students, and the effect of nursing teaching.