情景模拟联合清单式教学在烧伤科护理实习生临床决策能力培训中的应用效果

Application effects of scenario simulation combined with checklist-based teaching in clinical decision-making ability training of nursing interns in burn department

目的探讨情景模拟联合清单式教学在烧伤科护理实习生(以下简称护生)临床决策能力培训中的应用效果。方法该研究为随机对照研究。将2023年7月—2024年3月在陆军军医大学(第三军医大学)第一附属医院(以下简称本院)全军烧伤研究所实习的53名符合入选标准的护生,采用信封法随机分为常规组[25名,男5名、女20名,年龄(21.6±0.8)岁]和联合组[28名,男6名、女22名,年龄(21.2±1.3)岁]。对常规组、联合组护生分别采用常规教学、常规教学基础上的情景模拟联合清单式教学进行临床决策能力培训。培训前后对护生进行理论考试和技能考核、采用护理专业本科生临床决策能力测量问卷测评护生临床决策能力。培训后,采用本院的带教老师满意度调查问卷、护生满意度调查问卷,分别调查带教老师对护生学习情况的满意度和护生对带教老师教学情况的满意度。结果培训后,联合组护生理论考试和技能考核得分均明显高于常规组(Z值分别为-5.73、-6.26,P<0.05);常规组、联合组护生培训后理论考试(Z值分别为-6.07、-6.45,P<0.05)和技能考核得分(Z值分别为-6.08、-6.48,P<0.05)均明显高于培训前。培训后,联合组护生临床决策能力总得分及临床环境适应性、临床思维、护患沟通能力、综合基础素质得分[97.00(95.42,98.02)、18.00(17.00,19.00)、25.00(24.10,27.00)、19.00(18.00,20.75)、20.00(19.00,21.75)分]均明显高于常规组[87.90(86.30,90.30)、16.00(14.50,17.00)、24.00(22.35,25.00)、17.00(15.00,18.00)、17.50(16.00,20.00)分,Z值分别为-6.24、-3.45、-2.90、-3.68、-3.27,P<0.05]。联合组护生培训后临床决策能力总得分及临床环境适应性、临床思维、知识结构、护患沟通能力、综合基础素质得分均明显高于培训前(Z值分别为-6.43、-5.21、-5.44、-4.31、-5.02、-6.32,P<0.05);常规组护生培训后除护患沟通能力得分(P>0.05)外,临床决策能力总得分及临床环境适应性、临床思维、知识结构、综合基础素质得分均明显高于培训前(Z值分别为-6.06、-5.06、-5.71、-3.76、-5.90,P<0.05)。培训后,带教老师对联合组护生学习情况的满意度总评分及学习能力、专业能力评分均明显高于常规组(Z值分别为-4.55、-5.45、-3.21,P<0.05),联合组护生对带教老师教学情况的满意度总评分及教学能力、专业能力评分均明显高于常规组(Z值分别为-5.95、-5.99、-5.34,P<0.05)。结论情景模拟联合清单式教学可有效提高烧伤科护生的理论和技能水平、临床思维、护患沟通能力,并提升教学满意度。

ObjectiveTo explore the application effects of scenario simulation combined with checklist-based teaching in clinical decision-making ability training of nursing interns in burn department.MethodsThis study was a randomized controlled study.A total of 53 nursing interns who met the inclusion criteria and underwent internships at Institute of Burn Research of the First Affiliated Hospital of Army Medical University(the Third Military Medical University),which was hereinafter referred to as the hospital,from July 2023 to March 2024 were randomly assigned to convention group(n=25,5 males and 20 females,aged(21.6±0.8)years)and joint group(n=28,6 males and 22 females,aged(21.2±1.3)years)using the envelope method.The nursing interns in convention group and joint group respectively received conventional teaching and scenario simulation combined with checklist-based teaching based on conventional teaching for clinical decision-making training.Before and after the training,the theoretical examination and skill assessment were performed on nursing interns,the clinical decision-making ability of nursing interns was evaluated with a clinical decision-making ability measurement questionnaire designed for undergraduate nursing students.After training,the satisfaction of the instructors on nursing interns'learning and the satisfaction of the nursing interns on the instructors'teaching were investigated by the instructors'satisfaction questionnaire and nursing interns'satisfaction questionnaire in the hospital,respectively.ResultsAfter training,the theoretical examination and skill assessment scores of nursing interns in joint group were significantly higher than those in convention group(with Z values of-5.73 and-6.26,respectively,P<0.05).The theoretical examination(with Z values of-6.07 and-6.45,respectively,P<0.05)and skill assessment(with Z values of-6.08 and-6.48,respectively,P<0.05)scores of nursing interns in joint group and convention group after training were significantly higher than those before training.After training,the total scores of clinical decision-making ability and the scores of adaptability to clinical environment,clinical thinking,nurse-patient communication skills,and comprehensive basic quality of nursing interns in joint group(97.00(95.42,98.02),18.00(17.00,19.00),25.00(24.10,27.00),19.00(18.00,20.75),and 20.00(19.00,21.75),respectively)were significantly higher than those in convention group(87.90(86.30,90.30),16.00(14.50,17.00),24.00(22.35,25.00),17.00(15.00,18.00),and 17.50(16.00,20.00),with Z values of-6.24,-3.45,-2.90,-3.68,and-3.27,respectively,P<0.05).The total scores of clinical decision-making ability and the scores of adaptability to clinical environment,clinical thinking,knowledge structure,nurse-patient communication skills,and comprehensive basic quality of nursing interns in joint group after training were significantly higher than those before training(with Z values of-6.43,-5.21,-5.44,-4.31,-5.02,and-6.32,respectively,P<0.05).Except for the scores of nurse-patient communication skills,the total scores of clinical decision-making ability and the scores of adaptability to clinical environment,clinical thinking,knowledge structure,and comprehensive basic quality of nursing interns in convention group after training were significantly higher than those before training(with Z values of-6.06,-5.06,-5.71,-3.76,and-5.90,respectively,P<0.05).After training,the total scores of satisfaction of the instructors on nursing interns'learning and the scores of learning ability and professional competence in joint group were significantly higher than those in convention group(with Z values of-4.55,-5.45,and-3.21,respectively,P<0.05);the total scores of satisfaction of the nursing interns on the instructors'teaching and the scores of teaching ability and professional competence in joint group were significantly higher than those in convention group(with Z values of-5.95,-5.99,and-5.34,respectively,P<0.05).ConclusionsScenario simulation combined with checklist-based teaching can effectively enhance the theoretical and skill levels,clinical thinking,and nurse-patient communication skills of nursing interns in burn department,as well as improve teaching and learning satisfaction.