护理迷你临床演练评估量表在本科护生临床实习教学中的应用研究

发布时间：2018-07-03 10:16

本文选题：Nursing-Mini-CEX + 师资培训　；参考：《大连医科大学》2017年硕士论文

【摘要】：研究目的探讨护理迷你临床演练评估量表在本科护生临床实习阶段的应用效果,验证Nursing-Mini-CEX量表的科学性和有效性;构建基于Nursing-Mini-CEX量表的临床教学模式并实施,完善Nursing-Mini-CEX量表教学与评估一体化功能。研究方法第一阶段,便利抽样法选取大连市某三级甲等医院的本科实习护生及临床护理教师,应用参照系培训法对32名临床护理教师进行护理迷你临床演练评估评分培训,培训前制作示范录像并获得标准分;培训中通过播放两组录像,调动教师多感官融入培训;培训后获得临床护理教师的培训效果。随后,在每月出科考核中应用Nursing-Mini-CEX量表评估146名本科护生的临床护理能力;实习期间每名护生平均接受3.3次测评,共收回436份Nursing-Mini-CEX量表,并对量表得分进行考核成绩分析和考核成绩质量分析。第二阶段,便利抽样法选取在大连市某三级甲等医院临床实习的2012级本科护生42人为对照组,2013级本科护生47人为实验组。对照组采用传统实习带教方法带教,实验组在传统实习带教计划的基础上应用基于Nursing-Mini-CEX量表的教学模式带教。实习结束后采用Nursing-Mini-CEX量表、实习出科考核成绩、教师教学效能感量表分别评价临床教师及两组护生。采用SPSS 20.0软件对数据进行双人核对录入,应用正态性检验、重复测量方差分析、信效度、难度、区分度以及t检验等对数据进行统计分析。研究结果1.师资培训后,录像2 Kendall’s W值为0.818,加权Kappa系数为0.872,总体一致性均高于录像1;评分与标准分比较,差异无统计学意义(P0.05)。2.考核成绩分析:(1)实习期间本科护生Nursing-Mini-CEX量表得分呈正态分布;量表考核时间平均为(19.91±6.87)分钟,反馈时间平均(9.60±4.39)分钟;临床教师及护生对Nursing-Mini-CEX满意度得分分别为(7.22±0.92)分、(7.66±0.97)分,考核满意度较高。(2)护生实习前、中、后期各考核项目得分由中等水平逐步增加到中高等水平,方差分析差异显著(P0.05)。其中实习末期护理查体项目平均得分为(6.92±0.89)分,护理查体能力相对薄弱;护理问诊、护理诊断、护理措施、健康咨询、人文关怀、组织效能、整体评价项目得分依次为(7.47±0.82)、(7.47±0.96)、(7.39±0.96)、(7.43±0.73)、(7.63±0.95)、(7.45±0.74)、(7.40±0.80)分,均处于相对较高水平。实习期间护生成绩由合格逐渐达到优秀,知识、技能、素质各方面能力稳步提升。3.考核成绩质量分析:(1)本研究中Nursing-Mini-CEX量表考核得分总Cronbach'sα系数为0.862,各项目相关系数介于0.411~0.802,信度良好。(2)Nursing-Mini-CEX量表得分与护士资格考试成绩的效标关联效度r=0.428(P0.05),拟合度R2=0.301,呈中度正相关,在一定程度上表明Nursing-Mini-CEX量表对护生临床护理能力评价结果的一致性和有效性。(3)Nursing-Mini-CEX考核的难度在0.70~0.82之间,平均难度为0.79,难度是可以接受的。(4)Nursing-Mini-CEX考核的区分度介于0.35~0.75之间,表明考核区分度较好,能体现出不合格、合格、优秀各等级成绩的护生水平。4.实验性研究结果显示,实验组Nursing-Mini-CEX量表护理问诊、护理查体、护理诊断、人文关怀、组织效能、整体评价各维度得分显著高于对照组(P0.05);实验组实习平时考核成绩、出科操作成绩、教师教学效能感得分显著高于对照组,且差异显著(P0.05)。研究结论1.参照系培训法提高了护理迷你临床演练评估培训教师的评分一致性、准确性。2.Nursing-Mini-CEX量表具有较高的信度、效标关联效度、合理的难度及区分度,是可靠的新型临床能力考评工具。同时,揭示了护生临床能力的薄弱环节,全面客观、科学有效的评估并提升了护生的临床综合能力,为临床教学改革提供理论依据。3.基于Nursing-Mini-CEX量表的教学模式使临床教学更加制度化、规范化,可完善Nursing-Mini-CEX的教学与评估一体化功能,实现教学相长,保证并提升临床护理教学质量,值得在临床护理教学中推广应用。
[Abstract]:Objective to explore the application effect of nursing Mini clinical practice assessment scale in the clinical practice stage of undergraduate nursing students, to verify the scientific and effective of the Nursing-Mini-CEX scale, to construct the clinical teaching model based on the Nursing-Mini-CEX scale and to implement the integrated function of the teaching and evaluation of the Nursing-Mini-CEX scale. Stage, the convenience sampling method was used to select the undergraduate nursing students and clinical nursing teachers in a class three grade a hospital in Dalian, and the training method of reference department was applied to 32 clinical nursing teachers to train the evaluation of nursing Mini clinical training, and the demonstration video was made before training and the standard scores were obtained. The training of two groups of videos was played in the training. After the training, the training effect of the clinical nursing teachers was obtained after the training. Then, the Nursing-Mini-CEX scale was used to evaluate the clinical nursing ability of 146 undergraduate nursing students. During the practice period, each nurse received an average of 3.3 tests, a total of 436 Nursing-Mini-CEX scales were recovered, and the scores of the scale were analyzed. The second stage, the second stage, the convenience sampling method selected 42 people as the control group of 2012 grade undergraduate nursing students in a three grade hospital in Dalian, and 47 of the 2013 grade undergraduate nursing students. The control group adopted the traditional practice teaching method, and the experimental group was based on the traditional practice teaching plan based on the Nursing-M. The teaching mode of the ini-CEX scale was taught. After the end of the practice, the Nursing-Mini-CEX scale was used and the results of the examination were evaluated. The teachers' teaching efficacy scale was used to evaluate the clinical teachers and the two groups of nursing students respectively. The data were checked by the SPSS 20 software, the normal test, the repeated measurement of variance analysis, the reliability and validity, the difficulty and the distinction The data were statistically analyzed by t test. After 1. teacher training, the video 2 Kendall 's W value was 0.818, the weighted Kappa coefficient was 0.872, the overall consistency was higher than the video 1; the score and the standard score were compared, the difference was not statistically significant (1) the Nursing-Mini-CEX scale score of the undergraduate nursing students during the internship. The average assessment time was (19.91 + 6.87) minutes and the feedback time was (9.60 + 4.39) minutes. The satisfaction scores of clinical teachers and nursing students were (7.22 + 0.92), (7.66 + 0.97), and (2) (2). (2) in the middle and later period, the scores of the assessment items were gradually increased from the middle level to the middle level. In the middle and higher levels, the difference of variance analysis was significant (P0.05). The average score of the nursing checkup item at the end of the internship was (6.92 + 0.89), and the ability of nursing checkup was relatively weak; the scores of nursing inquiry, nursing diagnosis, nursing measure, health consultation, humanistic care and organizational effectiveness were (7.47 + 0.82), (7.47 + 0.96), (7.39 + 0.96), (7.. 0.96), (7.. 0.96), (7.. 43 + 0.73), (7.63 + 0.95), (7.45 + 0.74), (7.40 + 0.80), all at a relatively high level. During the internship, the performance of the nursing students gradually reached excellent, knowledge, skills and quality improved the quality of.3. assessment steadily. (1) the total Cronbach's alpha coefficient of the Nursing-Mini-CEX scale assessment score of this study was 0.862, each item The relationship was between 0.411~0.802 and good reliability. (2) the correlation validity of the Nursing-Mini-CEX scale score and the score of nurse qualification examination was r=0.428 (P0.05), and the fitting degree was R2=0.301, which showed moderate positive correlation. To a certain extent, the consistency and effectiveness of the evaluation result of the clinical nursing ability of the nurse students was shown by the Nursing-Mini-CEX scale. (3) Nursing-Mini-CE The difficulty of X assessment is between 0.70~0.82, the average difficulty is 0.79, the difficulty is acceptable. (4) the division of the Nursing-Mini-CEX assessment is between 0.35~0.75, which indicates that the degree of assessment is better, and the result of the unqualified, qualified and excellent grades of the nursing students shows that the experimental group is protected by the Nursing-Mini-CEX scale. The score of each dimension was significantly higher than that of the control group (P0.05). The scores of the experimental group were significantly higher than the control group, and the teachers' teaching efficacy score was significantly higher than the control group, and the difference was significant (P0.05). The 1. reference training method improved the nursing Mini clinic. The bed rehearsal evaluates the consistency of the training teachers. The accuracy.2.Nursing-Mini-CEX scale has high reliability, the validity of the correlation validity, the reasonable difficulty and the division of the area. It is a reliable new clinical ability evaluation tool. At the same time, it reveals the weak link of the clinical ability of the nursing students, comprehensively and objectively, scientifically and effectively appraise and enhance the nursing students. The clinical comprehensive ability provides a theoretical basis for clinical teaching reform. The teaching mode based on the Nursing-Mini-CEX scale based on.3. makes clinical teaching more institutionalized and standardized. It can improve the function of integration of teaching and evaluation of Nursing-Mini-CEX, realize teaching and learning, guarantee and improve the quality of clinical nursing teaching, and deserve to be popularized in clinical nursing teaching. Application.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47-4;G642

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