高仿真模拟教学联合护理整合课程教学模式对护理本科生临床实践能力的影响

Effects of high-fidelity simulation combined with nursing integrated curriculum on undergraduate Nursing students′clinical practical ability

目的探讨高仿真模拟教学联合护理整合课程教学模式对护理本科生临床实践能力的影响。方法选取武汉大学护理学院大二、大三及大四的护理本科生为研究对象,分别对应高仿真模拟教学联合护理整合课程教学前、两学期教学后、全部三学期教学结束后的护理本科生。临床实践能力采用中文版评判性思维倾向量表和中文版Lasater临床判断评分进行评估。结果108人有效完成问卷调查。大二、大三、大四年级评判性思维得分依次逐步提高,其中分析能力(42.16±5.58,44.94±4.60,45.31±4.64,P=0.023)、系统化能力(35.94±7.49,39.82±6.57,42.69±7.02,P=0.001)、自信心(38.59±7.23,41.23±7.16,43.91±5.48,P=0.008)三个维度和总分(276.66±30.70,291.43±32.47,301.78±27.62,P=0.005)差异有统计学意义。三年级[30(27~32)]和四年级学生[31(29~34)]的临床判断总分高于二年级[21(17~23)]学生,差异具有统计学意义(P<0.05);四年级学生高于三年级,但差异无统计学意义(P=0.103)。根据临床判断总分得分分级,在三年级和四年级学生中达到熟练或专家水平逐渐增多(P<0.001)。结论高仿真模拟教学联合护理整合课程教学模式可以有效提高护理本科生临床实践能力,该联合教学模式教学时长是临床实践能力的影响因素。

Objective To explore the teaching effect of high-fidelity simulation(HFS)combined with nursing integrated curriculum on undergraduate Nursing students′clinical practical ability.Methods Grade 2,grade 3 and grade 4 students from School of Nursing of Wuhan University were selected and acted as Nursing undergraduates before the high-fidelity simulation combined with nursing integrated curriculum teaching,after two semesters′teaching of the high-fidelity simulation combined with nursing integrated curriculum teaching and after all three semesters′teaching of the high-fidelity simulation combined with nursing integrated curriculum teaching respectively.Clinical practical ability was assessed using the Chinese Critical Thinking Disposition(CTDI-CV)and Chinese Lasater Clinical Judgment Rubric(C-LCJR).Results 108 students completed the questionnaire effectively.Scores of critical thinking increased sequentially among grade 2,grade 3 and grade 4 students,and the scores of analytical ability(42.16±5.58,44.94±4.60,45.31±4.64,P=0.023),systematic ability(35.94±7.49,39.82±6.57,42.69±7.02,P=0.001)and confidence(38.59±7.23,41.23±7.16,43.91±5.48,P=0.008)and the total score(276.66±30.70,291.43±32.47,301.78±27.62,P=0.005)were statistically significant.Grade 3 students[30(27-32)]and grade 4 students[31(29-34)]were scored on a significant higher level of clinical judgement compared to grade 2 students[21(17-23)],and their difference was of statistical significance(P<0.05);seniors have higher scores than juniors,but the difference was not statistically significant(P=0.103).More grade 3 and grade 4 students reached an accomplished or expert level of clinical judgement according to the total clinical scores(P<0.001).Conclusion High-fidelity simulation combined with nursing integrated curriculum can effectively improve Nursing undergraduates′clinical practical ability,and the teaching time of this mode is the influence factor of clinical practical ability.