互动沟通模式配合问题导向教学在本科实习护生临床带教中的应用研究

Application of interactive communication mode combined with problem-based learning in clinical teaching of undergraduate nursing students

目的探讨互动沟通模式配合问题导向教学在本科实习护生临床带教中的应用, 为护理教学改革提供依据。方法选择北京积水潭医院本科实习护生62名, 其中2018年9-11月采用传统教学方法的32名纳入对照组, 2019年9—11月采用互动沟通模式配合问题导向教学的30名纳入观察组, 比较2组考核成绩、综合能力、临床沟通能力、科研能力、教学质量反馈情况。结果干预后观察组考核综合成绩为(90.62 ± 4.75)分, 高于对照组的(83.84 ± 5.01)分, 差异有统计学意义(t=5.46, P<0.05);干预后观察组综合能力中观察能力、操作能力、团队协作能力评分分别为(3.51 ± 0.59)、(3.75 ± 0.50)、(4.30 ± 0.77)分, 高于对照组的(3.18 ± 0.44)、(3.22 ± 0.46)、(3.53 ± 0.81)分, 差异有统计学意义(t=2.51、4.35、3.83, 均P<0.05);干预后观察组临床沟通能力中敏锐倾听、明确患者问题、共同参与、传递有效信息、建立和谐医患关系、验证感受评分分别为(83.61 ± 10.18)、(81.66 ± 8.92)、(84.01 ± 9.17)、(83.25 ± 9.73)、(80.90 ± 9.99)、(84.15 ± 8.08)分, 高于对照组的(73.91 ± 9.73)、(74.95 ± 8.05)、(76.02 ± 8.22)、(73.16 ± 8.02)、(74.61 ± 8.54)、(76.08 ± 8.25)分, 差异有统计学意义(t值为2.67 ~ 4.47, 均P<0.05);干预后观察组科研能力中文献查阅能力、资料处理能力、论文写作能力评分分别为(14.29 ± 1.54)、(13.02 ± 1.29)、(14.91 ± 1.50)分, 高于对照组(13.08 ± 1.43)、(11.44 ± 1.24)、(12.36 ± 1.28)分, 差异有统计学意义(t=3.21、4.92、7.22, 均P<0.05);观察组对教学提高护理人文素养、提高职业认同感、提高学习兴趣、提高沟通能力、提高临床思维能力、提高创新能力的反馈评分分别为(4.26 ± 0.75)、(4.43 ± 0.81)、(4.25 ± 0.77)、(4.18 ± 0.66)、(4.44 ± 0.90)、(4.38 ± 0.94)分, 高于对照组的(3.51 ± 0.64)、(3.79 ± 0.70)、(3.48 ± 0.84)、(3.40 ± 0.76)、(3.83 ± 0.89)、(3.60 ± 0.89)分, 差异有统计学意义(t值为2.68 ~ 4.30, 均P<0.05)。结论互动沟通模式配合问题导向教学有效提高了本科实习护生考核成绩, 促进护理本科生综合素质的提升, 有利于护理本科生临床沟通能力、科研能力的提高。

Objective To explore the application of interactive communication mode combined with problem-based learning in clinical teaching of undergraduate nursing students so as to provide basis for nursing teaching reform.Methods A total of 62 undergraduate nursing students in Beijing Jishuitan Hospital were selected.Among them,32 cases from September to November 2018 received traditional teaching(the control group),and 30 cases from September to November 2019 were given interactive communication mode combined with problem-based learning(the observation group).The assessment results,comprehensive ability,clinical communication ability,scientific research ability,and feedback results of teaching quality were compared between the two groups.Results After intervention,the total score of assessment in the observation group was(90.62±4.75)points,higher than that in the control group(83.84±5.01)points,there was significant difference(t=5.46,P<0.05).After intervention,the scores of observation ability,operation ability and teamwork ability in the observation group were(3.51±0.59),(3.75±0.50),(4.30±0.77)points,higher than those in the control group(3.18±0.44),(3.22±0.46),(3.53±0.81)points,there were significant differences(t=2.51,4.35,3.83,all P<0.05).After intervention,the scores of clinical communication and keen listening,determining patients′problems,participating together,sending effective information,establishing harmonious doctor-patient relationship,and verifying perception ability in the observation group were(83.61±10.18),(81.66±8.92),(84.01±9.17),(83.25±9.73),(80.90±9.99),(84.15±8.08)points,higher than those in the control group(73.91±9.73),(74.95±8.05),(76.02±8.22),(73.16±8.02),(74.61±8.54),(76.08±8.25)points,there were significant differences(t values were 2.67-4.47,all P<0.05).After intervention,the scores of literature reading ability,data processing ability and paper writing ability in the observation group were(14.29±1.54),(13.02±1.29),(14.91±1.50)points,higher than those in the control group(13.08±1.43),(11.44±1.24),(12.36±1.28)points,there were significant differences(t=3.21,4.92,7.22,all P<0.05).The feedback scores of students about improving nursing humanistic quality,professional self-identity,learning interest,communication ability,clinical thinking ability and innovation ability in the observation group were(4.26±0.75),(4.43±0.81),(4.25±0.77),(4.18±0.66),(4.44±0.90),(4.38±0.94)points,higher than those in the control group(3.51±0.64),(3.79±0.70),(3.48±0.84),(3.40±0.76),(3.83±0.89),(3.60±0.89)points,there were significant differences(t values were 2.68-4.30,all P<0.05).Conclusions The interactive communication mode combined with problem-based learning can effectively improve assessment results of undergraduate nursing students,and promote the improvement of their comprehensive quality,which is conducive to the improvement of clinical communication ability and scientific research ability in nursing students.