基于岗位胜任力的OSCE教学在护理实习带教中的效果评价

Effect evaluation of OSCE teaching based on post competence in nursing practice teaching

目的探讨客观结构化临床考试(OSCE)教学考核模式对实习护士岗位胜任力的应用效果。方法选取蚌埠医学院第一附属医院2019年7月—2021年7月骨科实习护士108人,按随机数字表法分为对照组和观察组各54人。对照组采用目前传统教学模式进行带教和考核;观察组在传统教学模式的基础上,实施标准化病人(SP)培训和OSCE考核模式的带教。选取骨科真实的典型病例腰椎间盘突出症,建立标准化病人和OSCE案例库,设置相关考核站点,实行骨科5个病区的同质化带教和考核模式。实习结束前1周,根据6个站点针对性地进行操作和理论知识考核。完成教学计划后,比较2组护生理论、技能、评估和干预、沟通、评判性思维、应激处理及人文护理得分,评价2组护生岗位胜任力情况;同时评价2组护生对教学效果的满意度。结果观察组带教总满意率为90.74%(49/54),高于对照组的66.67%(36/54),χ^(2)=9.336,P=0.002;培训结束后,观察组理论及技能考核成绩高于对照组(均P<0.05);在其他5个维度的岗位核心胜任力方面:评估和干预、沟通、评判性思维、应激处理及人文护理得分亦高于对照组,差异有统计学意义(均P<0.05)。结论OSCE培训考核模式能提高护理带教满意度,并提升实习护士的岗位核心胜任力。

Objective To explore the application effect of objective structured clinical examination(OSCE)teaching assessment model on the post competence of practice nurses.Methods A total of 108 orthopaedic practice nurses from July 2019 to July 2021 in the First Affiliated Hospital of Bengbu Medical College were selected and divided into control and observation groups in accordance with the random-number table method,with 54 cases in each group.The control group adopted the current traditional teaching mode for teaching and learning.For the observation group,on the basis of the traditional teaching mode,standardised patient(SP)training and teaching of OSCE assessment mode were implemented.Real typical cases of lumbar intervertebral disc herniation in orthopaedics were selected,SP and OSCE case databases were established,relevant assessment sites were set up,and a homogeneous teaching and assessment mode was implemented in five orthopaedics wards.One week before the end of nursing practice,the operation and theoretical knowledge assessment were conducted based on six sites.After completing the teaching plan,the scores of theory,skills,assessment and intervention,communication,critical thinking,stress handling and humanistic nursing were compared between the two groups of nursing students,and the competency of their positions was evaluated.Satisfaction of nurses of two groups with teaching effect was evaluated.Results The total satisfaction rate of teaching in the observation group was 90.74%(49/50),which was higher than that in the control group(66.67%,χ^(2)=9.336,P=0.002).After the training,the theoretical and skills assessment scores of the observation group were higher than those of the control group(both P<0.05).The scores in other five dimensions of post core competencies,namely,assessment and intervention,communication,critical thinking,stress handling and humanistic nursing,were also higher than those of the control group,and the differences were statistically significant(all P<0.05).Conclusion OSCE training and assessment model can improve satisfaction in nursing teaching and improve the core competencies of practice nurses.