高职护理人才不同培养模式的效果比较

发布时间：2018-05-01 22:14

本文选题：高职护理 + 培养模式　；参考：《福建医科大学》2015年硕士论文

【摘要】：目的:1.评价高职护理校院合作“1+1+1”培养模式的近期效果。2.通过质性研究,了解临床护士在校期间接受校院合作“1+1+1”培养模式的内心真实体验。3.了解高职护理人才不同培养模式下临床护士能力及一般自我效能感的现状。方法:采用量性研究与质性研究相结合的研究方法。①量性研究:采用目的抽样法,选取福建卫生职业技术学院3年制普通护理专业2013届毕业且从事临床工作的护士76名。实验组(36名)在校期间接受校院合作“1+1+1”培养模式,对照组(40名)则接受传统的“2+1”培养模式。运用一般情况调查表、一般自我效能感量表和中文版护理行为六维度量表进行调查研究。由76名护士本人及其相应的140名同事和145名管理者共同参与评价。采用2x检验分析研究对象一般资料的可比性。采用独立样本t检验、Mann-Whitney U秩和检验分析护士能力自评及他评得分的组间差异。采用Spearman秩相关分析和Pearson相关分析一般自我效能感与护士能力的关系。②质性研究:通过查阅文献制定访谈提纲,采用现象学研究法分别对8名在校期间接受过校院合作“1+1+1”培养模式的护士进行面对面、深度的半结构式访谈,并将收集的资料用Colaizzi现象学分析法进行整理与主题分析。结果:1不同培养模式下临床护士能力现状1.1自评结果实验组在计划/评估能力、人际/沟通能力2个维度的得分和总分均大于对照组,差异有统计学意义(分别为t=-2.015,P=0.048;Z=-2.330,P=0.020;t=-2.259,P=0.027)。其余护士能力维度的得分组间比较差异无统计学意义(P0.05)。两组护士能力各维度自评得分水平从高到低的排序大多不一致,其中两组护士的人际/沟通能力维度均排在首位,而教学/合作能力维度均排在末位。1.2同事评价结果实验组在重症监护能力、计划/评估能力、人际/沟通能力3个维度的得分和总分均大于对照组,差异有统计学意义(分别为t=-3.139,P=0.002;t=-2.764,P=0.006;t=-4.607,P=0.000;Z=-3.474,P=0.001)。其余护士能力维度的得分组间比较差异无统计学意义(P0.05)。两组同事评价护士能力各维度得分水平中,人际/沟通能力维度和教学/合作能力维度分别排在首位和末位。1.3管理者评价结果实验组在重症监护能力、计划/评估能力、人际/沟通能力3个维度的得分和总分均大于对照组,差异有统计学意义(分别为t=-2.778,P=0.005;t=-3.833,P=0.000;t=-3.842,P=0.000;Z=-3.151,P=0.002)。其余护士能力维度的得分组间比较差异无统计学意义(P0.05)。两组管理者评价护士能力各维度得分水平中,人际/沟通能力维度和教学/合作能力维度分别排在首位和末位。2.在大专学历护士优势项目评价方面,评价者均认为两种培养模式培养的护士共同具备较好的临床实践能力和人际沟通能力优势,且实验组认为校院合作“1+1+1”培养模式培养的护士在问题解决能力、评判性思维能力等方面的优势较为明显。在培养优秀高职护理人才的建议方面,对照组自评者认为要侧重加强专业理论知识、操作技能和伦理/法律知识。实验组自评者认为要侧重加强组织管理能力、伦理/法律知识和专业理论知识;而他评者均认为要侧重加强组织管理能力、护理科研及伦理/法律知识。3.在一般自我效能感得分方面,实验组、对照组的一般自我效能感得分分别为27.56±4.21、25.10±4.58,两组比较差异有统计学意义(t=-2.423,P=0.018);且实验组、对照组的一般自我效能感与护士能力各维度和总分均呈正相关(分别为r=0.304~0.521;r=0.316~0.504,P0.05)。4.在综合考评成绩方面,省立医院班、普通教学班的顶岗实习成绩分别为90.40±1.75、91.13±0.94,两组比较差异有统计学意义(t=2.308,P=0.024);省立医院班、普通教学班的毕业考试成绩分别为72.53±4.43、75.00±5.90,两组比较差异有统计学意义(t=2.122,P=0.037)。5.质性访谈结果显示,校院合作“1+1+1”培养模式真正实现了理论教学与临床实践的紧密结合,具有较为显著的教学成效,增强了护生的临床实习适应能力,促进了理论知识和操作技能水平的提高,提升了人际沟通交流能力和专业认同感;同时,该人才培养模式存在着课程设置欠佳、学生负荷重、自我压力大、学习生活单调和组织管理能力薄弱等不足之处。结论:1.两种不同培养模式培养的高职护理毕业生基本达到高等职业教育护理专业的培养目标,能较好地胜任临床护理工作。尤其以接受过校院合作“1+1+1”培养模式的毕业生质量较好,其临床护士能力更强,达到中上水平。2.相比传统的“2+1”培养模式,校院合作“1+1+1”培养模式培养高职护理人才的近期效果较好,特别是对毕业生的综合考评成绩、一般自我效能感、重症监护能力、计划/评估能力和人际/沟通能力等均有较大的促进作用。3.校院合作“1+1+1”培养模式培养的护士一般自我效能感与临床护士能力呈正相关,一般自我效能感程度越高,临床护士能力越强。4.校院合作“1+1+1”培养模式存在着学生负荷偏重、自我压力大、校园活动严重匮乏等不足之处,需采取针对性的措施加以改善,并注重加强培养教学/合作能力、组织管理能力、护理科研及伦理/法律知识等。
[Abstract]:Objective: 1. to evaluate the short-term effect of the "1+1+1" training mode in the college nursing school cooperation.2. through qualitative research to understand the inner real experience of the "1+1+1" training mode of the clinical nurses in school, and to understand the current situation of the clinical nurses' ability and the general self-efficacy under different training modes of higher vocational nursing talents. Using the method of quantitative study and qualitative research. (1) quantitative study: using the method of target sampling, 76 nurses who graduated from the 3 year general nursing specialty of Fujian health Career Technical College and the nurses who were engaged in clinical work were selected. The experimental group (36) received the "1+1+1" training mode in the school and the control group (40). In the traditional "2+1" training model, the general situation questionnaire, the general self-efficacy scale and the Chinese version of the six dimension nursing behavior scale were investigated. 76 nurses themselves and their corresponding 140 colleagues and 145 managers were involved in the evaluation. The comparability of the general data of the subjects was analyzed by the 2x test. T test of vertical sample, Mann-Whitney U rank sum test analysis of nurses' self-evaluation and the difference in scoring among the groups. Using Spearman rank correlation analysis and Pearson correlation analysis the relationship between general self-efficacy and nurses' ability. 2. Qualitative research: through consulting literature to make interview outline, and using phenomenological study method to 8 school period respectively. The nurses who had received the "1+1+1" training mode were face to face, deep semi structured interview and collected data by Colaizzi phenomenological analysis. Results: 1 the status of clinical nurse ability under different training modes was 1.1 self-evaluation results in the experiment group in the planning / evaluation ability and interpersonal / communication ability of 2. The score and total score of the dimensions were greater than those in the control group (t=-2.015, P=0.048, Z=-2.330, P=0.020; t=-2.259, P=0.027). There was no statistical difference between the scores of the other nurses' ability dimensions (P0.05). The ranking of the two groups of nurses' abilities in each dimension from high to low was mostly inconsistent, of which two The level of interpersonal and communication ability of the group nurses ranked first, and the teaching / cooperative abilities were all ranked in the last.1.2 colleague evaluation results in the intensive care ability, the score and the total score of the 3 dimensions of interpersonal / communication ability were greater than those of the control group. The difference has the significance of t=-3.139, P=0.002, t=-2.764, P=0., respectively. 006; t=-4.607, P=0.000, Z=-3.474, P=0.001). There was no significant difference between the scores of the other nurses' ability dimensions (P0.05). The two groups of colleagues evaluated the scores of nurses' ability in each dimension, and the interpersonal / communication ability dimension and the teaching / cooperative ability dimension were in the first and last.1.3 manager evaluation results in the severe monitoring group. The score and total score of 3 dimensions of interpersonal and interpersonal skills were greater than those in the control group (t=-2.778, P=0.005; t=-3.833, P=0.000; t=-3.842, P=0.000; Z=-3.151, P=0.002). The difference between the other nurses' ability dimensions was not statistically significant (P0.05). The two groups of managers evaluated the difference (P0.05). In the score level of nurses' abilities, the interpersonal / communication ability dimension and the teaching / cooperative ability dimension were ranked first and last.2. in the evaluation of the superiority project of junior college nurses. The evaluators all thought that the nurses in the two training modes had better clinical practice ability and interpersonal communication ability, and the experimental group recognized them. The nurse trained for the "1+1+1" training mode in the school hospital was more obvious in the problem solving ability and the critical thinking ability. In the field of training excellent vocational nursing talents, the control group self commentators thought to focus on strengthening professional theoretical knowledge, operation skills and ethical / legal knowledge. To strengthen organizational management ability, ethics / legal knowledge and professional theoretical knowledge, and his commentators all think to focus on strengthening organizational management ability, nursing scientific research and ethical / legal knowledge.3. in the general self-efficacy score, the experimental group and the control group are 27.56 + 4.21,25.10 + 4.58, respectively, the two groups are different. There were statistical significance (t=-2.423, P=0.018), and in the experimental group, the general self-efficacy of the control group was positively correlated with the dimensions and total scores of the nurses' ability (r=0.304~0.521; r=0.316~0.504, P0.05).4. in the comprehensive evaluation results, the provincial hospital class and the general teaching class were 90.40 + 1.75,91.13 + 0.94, respectively, two groups. The difference was statistically significant (t=2.308, P=0.024); the grade of graduation examination in the provincial hospital class was 72.53 + 4.43,75.00 + 5.90 respectively. The difference between the two groups was statistically significant (t=2.122, P=0.037).5. qualitative interview results showed that the school cooperative "1+1+1" training model really realized the tight theory teaching and clinical practice. Close combination, with more remarkable teaching results, enhanced the ability to adapt to clinical practice of nursing students, promoted the improvement of theoretical knowledge and operation skills, improved interpersonal communication ability and professional identity. At the same time, the training mode had a poor curriculum setting, heavy load of students, heavy self pressure, and monotonous study and life. Conclusion: 1. the higher vocational nursing graduates in two different training modes basically reach the training goal of higher vocational education nursing specialty, and can be better qualified for clinical nursing work. The quality of the graduates with the "1+1+1" training mode is better, and the clinical nurses are able to work well. Compared with the traditional "2+1" training mode, the middle and upper level.2. is better than the traditional "1+1+1" training mode, and the school hospital cooperation "1+1+1" training mode is good for the training of higher vocational nursing talents, especially for the graduates' comprehensive evaluation results, the general self-efficacy, the intensive care ability, the planning / evaluation ability, and the interpersonal / communication ability. The general self-efficacy of nurses in the training mode of "1+1+1" training in.3. school is positively related to the ability of clinical nurses. The higher the general self-efficacy is, the stronger the ability of the clinical nurses, the.4. school cooperation "1+1+1" training mode has some shortcomings, such as the students' heavy load, the big self pressure, the serious lack of campus activities and so on. Targeted measures should be taken to improve and focus on strengthening teaching / cooperation capabilities, organizational management capabilities, nursing research and ethical / legal knowledge.

【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R47-4;G712

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