The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessm...The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessment in nursing ten years after its inception. Core nursing courses are based on instructional teaching methods and “hands-on” approach to impact cognitive, psychomotor skills and clinical judgments. Different clinical competency assessment methods are used globally;however, most of them are subjective. A descriptive survey using 16-item five-point likert scale questionnaire was conducted. The study sample consisted of 140 participants: 20 faculty members, 27 graduates of the Bachelor of Science in Nursing (BSN) Degree and 93 graduates of the Associate Degree of Nursing (ADN) programs with OSCE experience during their training. Data collection was carried out between October and November 2015. Eighty percent of faculty members, 74% of BSN and 62.3% of ADN graduates agreed that OSCE represented an objective evaluation method for psychomotor skills. Majority of the graduates perceived their OSCE experience positively although stressful. However, they have suggested the introduction of trial/mock OSCE prior to each exam to minimize the stress associated with it. In conclusion, there appears to be no single “gold-standard” assessment tool for clinical competency. OSCE assesses student nurses’ psychomotor skills in a non-clinical environment, therefore without risks to real patients. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experiences gave new nursing graduates confidence to work as registered nurses in health care settings.展开更多
AIM To extend our previously-published experience in estimating pressure gradients(PG) via physical examination in a large patient cohort. METHODS From January 1, 1997 through December 31, 2009, an attending pediatric...AIM To extend our previously-published experience in estimating pressure gradients(PG) via physical examination in a large patient cohort. METHODS From January 1, 1997 through December 31, 2009, an attending pediatric cardiologist compared clinical examination(EXAM) with Doppler-echo(ECHO), in 1193 patients with pulmonic stenosis(PS, including tetralogy of Fallot), aortic stenosis(AS), and ventricular septal defect(VSD). EXAM PG estimates were based primarily on a murmur's pitch, grade, and length. ECHO peak instantaneous PG was derived from the modified Bernoulli equation. Patients were 0-38.4 years old(median 4.8).RESULTS For all patients, EXAM correlated highly with ECHO: ECHO = 0.99(EXAM) + 3.2 mm Hg; r = +0.89; P < 0.0001. Agreement was excellent(mean difference =-2.9 ± 16.1 mm Hg). In 78% of all patients, agreement between EXAM and ECHO was within 15 mm Hg and within 5 mm Hg in 45%. Clinical estimates of PS PG were more accurate than of AS and VSD. A palpable precordial thrill and increasing loudness of the murmur predicted highergradients(P < 0.0001). Weight did not influence accuracy. A learning curve was evident, such that the most recent quartile of patients showed ECHO = 1.01(EXAM) + 1.9, r = +0.92, P < 0.0001; during this time, the attending pediatric cardiologist had been > 10 years in practice.CONCLUSION Clinical examination can accurately estimate PG in PS, AS, or VSD. Continual correlation of clinical findings with echocardiography can lead to highly accurate diagnostic skills.展开更多
目的观察临床操作技能评估(Direct observation of procedural skills,DOPS)为工具的形成性评价在临床医学学士(Bachelor of Medicine,MBBS)心肺复苏教学中的应用效果。方法选择北华大学附属医院、临床医学院2020届MBBS毕业实习生为对照...目的观察临床操作技能评估(Direct observation of procedural skills,DOPS)为工具的形成性评价在临床医学学士(Bachelor of Medicine,MBBS)心肺复苏教学中的应用效果。方法选择北华大学附属医院、临床医学院2020届MBBS毕业实习生为对照组,2021届MBBS毕业实习生为试验组。对照组心肺复苏教学采用客观结构化临床考试(objective structured clini‐cal examination,OSCE)模式,试验组采用OSCE+DOPS模式。观察两组理论知识与技能考核成绩。问卷调查试验组对DOPS为工具的形成性评价体系应用满意度。结果对照组技能考核成绩(88.6±5.6)分,明显低于试验组的(98.0±3.2)分(P<0.05)。试验组学生认为DOPS形成性评价的运用可提高临床急救能力和临床思维能力、激发学习兴趣、巩固理论知识的学习,提高学生开展急救的信心,提高临床分析、解决问题的能力。结论应用DOPS为工具的形成性评价可以提高在MBBS心肺复苏教学效果。展开更多
目的探讨行为阶段转变理论模型(the transtheoretical model and stages of change,TTM)与客观结构化临床考核(objective structured clinical examination,OSCE)模式对于新入职产科护士实践技能培训的指导价值。方法选取2020年1月—202...目的探讨行为阶段转变理论模型(the transtheoretical model and stages of change,TTM)与客观结构化临床考核(objective structured clinical examination,OSCE)模式对于新入职产科护士实践技能培训的指导价值。方法选取2020年1月—2021年3月南京医科大学附属妇产医院接收的新入职产科护士78名作为对照组,选取2021年4月—2022年9月南京医科大学附属妇产医院接收的新入职产科护士78名为作观察组。对照组采取常规的集中培训方法,观察组采取TTM与OSCE考核培训方法。对比2组新入职产科护士的实践技能考核评分情况、经培训后综合能力以及满意度情况。结果观察组培训后的实践技能考核得分高于对照组[(93.33±2.42)分vs.(88.52±2.71)分],差异有统计学意义(P<0.001);观察组产科护士经培训后在护理评估、临床思维、沟通技能、人文关怀、整体评价各个方面综合能力得分高于对照组,差异有统计学意义(P<0.001);观察组产科护士总满意率(94.87%)高于对照组(83.33%),差异有统计学意义(P<0.05)。结论针对新入职产科护士,实施TTM与OSCE考核培训方式可以提高护士实践技能及综合能力,并提高满意度。展开更多
文摘The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessment in nursing ten years after its inception. Core nursing courses are based on instructional teaching methods and “hands-on” approach to impact cognitive, psychomotor skills and clinical judgments. Different clinical competency assessment methods are used globally;however, most of them are subjective. A descriptive survey using 16-item five-point likert scale questionnaire was conducted. The study sample consisted of 140 participants: 20 faculty members, 27 graduates of the Bachelor of Science in Nursing (BSN) Degree and 93 graduates of the Associate Degree of Nursing (ADN) programs with OSCE experience during their training. Data collection was carried out between October and November 2015. Eighty percent of faculty members, 74% of BSN and 62.3% of ADN graduates agreed that OSCE represented an objective evaluation method for psychomotor skills. Majority of the graduates perceived their OSCE experience positively although stressful. However, they have suggested the introduction of trial/mock OSCE prior to each exam to minimize the stress associated with it. In conclusion, there appears to be no single “gold-standard” assessment tool for clinical competency. OSCE assesses student nurses’ psychomotor skills in a non-clinical environment, therefore without risks to real patients. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experiences gave new nursing graduates confidence to work as registered nurses in health care settings.
文摘AIM To extend our previously-published experience in estimating pressure gradients(PG) via physical examination in a large patient cohort. METHODS From January 1, 1997 through December 31, 2009, an attending pediatric cardiologist compared clinical examination(EXAM) with Doppler-echo(ECHO), in 1193 patients with pulmonic stenosis(PS, including tetralogy of Fallot), aortic stenosis(AS), and ventricular septal defect(VSD). EXAM PG estimates were based primarily on a murmur's pitch, grade, and length. ECHO peak instantaneous PG was derived from the modified Bernoulli equation. Patients were 0-38.4 years old(median 4.8).RESULTS For all patients, EXAM correlated highly with ECHO: ECHO = 0.99(EXAM) + 3.2 mm Hg; r = +0.89; P < 0.0001. Agreement was excellent(mean difference =-2.9 ± 16.1 mm Hg). In 78% of all patients, agreement between EXAM and ECHO was within 15 mm Hg and within 5 mm Hg in 45%. Clinical estimates of PS PG were more accurate than of AS and VSD. A palpable precordial thrill and increasing loudness of the murmur predicted highergradients(P < 0.0001). Weight did not influence accuracy. A learning curve was evident, such that the most recent quartile of patients showed ECHO = 1.01(EXAM) + 1.9, r = +0.92, P < 0.0001; during this time, the attending pediatric cardiologist had been > 10 years in practice.CONCLUSION Clinical examination can accurately estimate PG in PS, AS, or VSD. Continual correlation of clinical findings with echocardiography can lead to highly accurate diagnostic skills.
文摘目的观察临床操作技能评估(Direct observation of procedural skills,DOPS)为工具的形成性评价在临床医学学士(Bachelor of Medicine,MBBS)心肺复苏教学中的应用效果。方法选择北华大学附属医院、临床医学院2020届MBBS毕业实习生为对照组,2021届MBBS毕业实习生为试验组。对照组心肺复苏教学采用客观结构化临床考试(objective structured clini‐cal examination,OSCE)模式,试验组采用OSCE+DOPS模式。观察两组理论知识与技能考核成绩。问卷调查试验组对DOPS为工具的形成性评价体系应用满意度。结果对照组技能考核成绩(88.6±5.6)分,明显低于试验组的(98.0±3.2)分(P<0.05)。试验组学生认为DOPS形成性评价的运用可提高临床急救能力和临床思维能力、激发学习兴趣、巩固理论知识的学习,提高学生开展急救的信心,提高临床分析、解决问题的能力。结论应用DOPS为工具的形成性评价可以提高在MBBS心肺复苏教学效果。
文摘目的探讨行为阶段转变理论模型(the transtheoretical model and stages of change,TTM)与客观结构化临床考核(objective structured clinical examination,OSCE)模式对于新入职产科护士实践技能培训的指导价值。方法选取2020年1月—2021年3月南京医科大学附属妇产医院接收的新入职产科护士78名作为对照组,选取2021年4月—2022年9月南京医科大学附属妇产医院接收的新入职产科护士78名为作观察组。对照组采取常规的集中培训方法,观察组采取TTM与OSCE考核培训方法。对比2组新入职产科护士的实践技能考核评分情况、经培训后综合能力以及满意度情况。结果观察组培训后的实践技能考核得分高于对照组[(93.33±2.42)分vs.(88.52±2.71)分],差异有统计学意义(P<0.001);观察组产科护士经培训后在护理评估、临床思维、沟通技能、人文关怀、整体评价各个方面综合能力得分高于对照组,差异有统计学意义(P<0.001);观察组产科护士总满意率(94.87%)高于对照组(83.33%),差异有统计学意义(P<0.05)。结论针对新入职产科护士,实施TTM与OSCE考核培训方式可以提高护士实践技能及综合能力,并提高满意度。
