简易客观结构化临床考核在围术期临床综合能力评估中的应用

Application of simple objective structured clinical examination in evaluation of clinical comprehensive ability of perioperative nursing

目的探讨简化客观结构化临床考核在围术期护理临床综合能力评估中的应用效果。方法航天中心医院于2016年11月至2017年1月期间,根据临床实际情况,制定相应的考核方案及考核标准,编写病例,选择并培训标准化患者(SP)。对在职的57名外科护士实施考核,由SP和临床教师分别对外科护士进行考核,并进行最终考核结果分析。结果术前评估、技能操作、健康教育三站的平均分分别为:(90.39±3.12)、(88.23±8.01)、(93.60±2.91),三站考核难度指数分别为0.10、0.12、0.07,区分度指数分别为0.17、0.18、0.10,内部一致性系数分别为0.660、0.681、0.652。外科护士围术期护理OSCE考核调查问卷统计中,考生认为该考核的疲劳度适中(70.18%),总时长合理度适中(96.49%),难易程度适中(91.23%),该考核的病例符合临床实际(82.46%),SP能够真实的模拟临床患者的真实性(85.96%),该考核能够评价护士的综合能力(66.67%),能够促进临床护士职业能力的形成(63.16%)。结论简易客观结构化临床考核(s OSCE)模式能对新入职护士进行客观的评估,减少考官的主观性评价,且测试手段与临床实际情景密切结合,更贴近于临床实际,是值得推荐应用的考核方法之一。

Objective To study the application effect of simplified objective structured clinical examination（ s OSCE） in perioperative comprehensive evaluation of clinical nursing ability. Methods Examination plan and examination standard were formulated, cases were compiled, standardized patients were selected and trained in November 2016 to January 2017, The 57 new surgical nurses were evaluated by SP and clinical teachers, the examination results were analysed ultimately. Results The scores of preoperative evaluation, skill operation, health education were（90.39±3.12）,（88.23±8.01）,（93.60±2.91）, difficulty index and Discrimination index were low. Candidates scored high on the assessment. Conclusions Our hospital has achieved the desired results by using s OSCE for surgical nurses perioperative nursing comprehensive clinical ability assessment, has tested and trained the clinical comprehensive ability of clinical evaluation, analysis decision, skill operation, humanistic care and health education. However, the assessment and SP training should be further optimized and perfected.