OSCE在ICU专科护生临床能力评价中的应用研究

【作者】 张艳；

【导师】 于兰贞；

【作者基本信息】 青岛大学 ， 护理学， 2012， 硕士

【摘要】 目的：了解ICU专科护生临床能力现况,据此提出教学对策,在实习前的综合实训课程中运用OSCE教学模式并对其效果进行评价,以探讨ICU专科护生临床能力培训及考核的有效策略,推进护理教学改革。方法：第一部分采用文献法、德尔菲调查法,构建ICU专科护生的OSCE考站和考核模式。将某高等专科学校180名ICU专科护生分为实验组和对照组,对实验组90名ICU专科护生实施OSCE考核,了解ICU专科护生临床能力现状。第二部分采用传统教学和OSCE模式教学进行干预,在综合实训课程中实验组运用OSCE模式教学,而对照组运用传统教学法。在干预前、后,对学生进行笔试考核,并应用中文版评判性思维能力测量表测评学生的评判性思维能力。干预后对实验组再次实施OSCE考核,并对参与OSCE教学和考核的师生进行问卷调查和座谈。利用SPSS19.0统计软件包,采用统计描述、t检验、x2检验等方法对考核成绩和问卷调查结果进行统计分析。结果：确定了适用于ICU专科护生的OSCE考核的10个考核站点、考核具体内容、各考站的评分标准。干预前,实验组和对照组学生的笔试成绩和评判性思维能力测评得分差异无统计学意义(P>0.05)。干预后,实验组的笔试成绩和评判性思维能力测评得分高于对照组,差异有统计学意义(P<0.05)。对实验组学生OSCE教学前后的OSCE成绩进行比较,学生在入院护理考站、护理问诊考站、护理体格检查考站、护理文书书写考站、阅读实验检查结果考站、健康教育考站、监护技能考站、团队合作急危重病人救护技能考站、笔试考核和评判性思维能力的测评得分都有提高,差异有统计学意义(p<0.05),但基础护理技能考站和专科护理技能考站的成绩差异无统计学意义(p>0.05)。实验组2次OSCE考核成绩显示考生技能操作方面的得分率较高,护理问诊、护理体格检查、团队合作急危重病人救护等考站的得分率较低,这方面的能力还需进一步提高。问卷调查结果显示,考生、标准化病人和教师一致认为有必要推广OSCE这一考核和教学模式。结论：OSCE客观评价了ICU专科护生临床能力的实际水平,可以作为评价ICU专科护生临床能力的有效工具。OSCE可以发现教学过程中的不足之处,对教学具有指导作用。应用OSCE教学模式可以促进ICU专业学生临床能力的培养,可在护理考核和教学中进一步应用。更多还原

【Abstract】 Objective:To investigate junior ICU nursing students’clinical ability.Based on this to put forward the teaching countermeasures,to explore the application and effects of OSCE teaching method, study a suitable training and evaluation system for junior ICU nursing students and promote nursing reform and cultivate students’clinical ability.Method:Part1:Literature comparing, Delphi methods were performed in the research to set the junior ICU nursing students’clinical competence OSCE examination stations and exam framework.180ICU nursing students were divided into two groups:the experimental group and the control group. OSCE was applied to the experimental group, to investigate junior ICU nursing students’clinical ability. Part2:OSCE teaching method was applied to the experimental group while traditional method was applied to the control group. All the students fulfilled the written examination, CTDI-CV before and after the course. OSCE was applied to the experimental group again; conducted a questionnaire survey to all the students and teachers participated in the OSCE.The spssl9.0statistical software was adopted to analysis test scores and questionnaire survey results with the methods including statistical description, t-test, Person Chi-square test and so on.Result:10examination stations applied to junior ICU nursing students are designed, the test specific content and marking criterion is set in details.There were no significant differences between the two groups’sores of written examination and CTDI-CV (p>0.05) before the intervention.After the intervention, there were significant differences in written examination sores and CTDI-CV sores among the experimental group and the control group. The comparison on the OSCE results of OSCE teaching group before and after training, there were significant differences (p<0.05). After training, the OSCE results including the admission nursing, nursing inquiry, nursing body examination, read the experimental test results, health education, the group rescue capacity, the sores of written examination and critical thinking were improved. But there were no significant differences in the sores of fundamental nursing techniques and specialist nursing techniques.In the average grades of the OSCE, the score of skills operations is higher, the score of assessment, physical examination, rescuing urgent critical patients in cooperation is lower, so more progress should be done in these ability. The results of questionnaires show that the students and teachers agreed that it is necessary to promote the OSCE assessment and teaching model.Conclusion:OSCE can objectively and truly evaluate the clinical competence of the junior ICU nurses students and can be used as an effective evaluation tools in the field of nursing education.OSCE teaching mode can promote the cultivation of the junior ICU nurses students’clinical ability.更多还原