本文選題：Nursing-Mini-CEX + 師資培訓(xùn)��； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究目的探討護(hù)理迷你臨床演練評(píng)估量表在本科護(hù)生臨床實(shí)習(xí)階段的應(yīng)用效果,驗(yàn)證Nursing-Mini-CEX量表的科學(xué)性和有效性;構(gòu)建基于Nursing-Mini-CEX量表的臨床教學(xué)模式并實(shí)施,完善Nursing-Mini-CEX量表教學(xué)與評(píng)估一體化功能。研究方法第一階段,便利抽樣法選取大連市某三級(jí)甲等醫(yī)院的本科實(shí)習(xí)護(hù)生及臨床護(hù)理教師,應(yīng)用參照系培訓(xùn)法對(duì)32名臨床護(hù)理教師進(jìn)行護(hù)理迷你臨床演練評(píng)估評(píng)分培訓(xùn),培訓(xùn)前制作示范錄像并獲得標(biāo)準(zhǔn)分;培訓(xùn)中通過(guò)播放兩組錄像,調(diào)動(dòng)教師多感官融入培訓(xùn);培訓(xùn)后獲得臨床護(hù)理教師的培訓(xùn)效果。隨后,在每月出科考核中應(yīng)用Nursing-Mini-CEX量表評(píng)估146名本科護(hù)生的臨床護(hù)理能力;實(shí)習(xí)期間每名護(hù)生平均接受3.3次測(cè)評(píng),共收回436份Nursing-Mini-CEX量表,并對(duì)量表得分進(jìn)行考核成績(jī)分析和考核成績(jī)質(zhì)量分析。第二階段,便利抽樣法選取在大連市某三級(jí)甲等醫(yī)院臨床實(shí)習(xí)的2012級(jí)本科護(hù)生42人為對(duì)照組,2013級(jí)本科護(hù)生47人為實(shí)驗(yàn)組。對(duì)照組采用傳統(tǒng)實(shí)習(xí)帶教方法帶教,實(shí)驗(yàn)組在傳統(tǒng)實(shí)習(xí)帶教計(jì)劃的基礎(chǔ)上應(yīng)用基于Nursing-Mini-CEX量表的教學(xué)模式帶教。實(shí)習(xí)結(jié)束后采用Nursing-Mini-CEX量表、實(shí)習(xí)出科考核成績(jī)、教師教學(xué)效能感量表分別評(píng)價(jià)臨床教師及兩組護(hù)生。采用SPSS 20.0軟件對(duì)數(shù)據(jù)進(jìn)行雙人核對(duì)錄入,應(yīng)用正態(tài)性檢驗(yàn)、重復(fù)測(cè)量方差分析、信效度、難度、區(qū)分度以及t檢驗(yàn)等對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。研究結(jié)果1.師資培訓(xùn)后,錄像2 Kendall’s W值為0.818,加權(quán)Kappa系數(shù)為0.872,總體一致性均高于錄像1;評(píng)分與標(biāo)準(zhǔn)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.考核成績(jī)分析:(1)實(shí)習(xí)期間本科護(hù)生Nursing-Mini-CEX量表得分呈正態(tài)分布;量表考核時(shí)間平均為(19.91±6.87)分鐘,反饋時(shí)間平均(9.60±4.39)分鐘;臨床教師及護(hù)生對(duì)Nursing-Mini-CEX滿意度得分分別為(7.22±0.92)分、(7.66±0.97)分,考核滿意度較高。(2)護(hù)生實(shí)習(xí)前、中、后期各考核項(xiàng)目得分由中等水平逐步增加到中高等水平,方差分析差異顯著(P0.05)。其中實(shí)習(xí)末期護(hù)理查體項(xiàng)目平均得分為(6.92±0.89)分,護(hù)理查體能力相對(duì)薄弱;護(hù)理問診、護(hù)理診斷、護(hù)理措施、健康咨詢、人文關(guān)懷、組織效能、整體評(píng)價(jià)項(xiàng)目得分依次為(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,均處于相對(duì)較高水平。實(shí)習(xí)期間護(hù)生成績(jī)由合格逐漸達(dá)到優(yōu)秀,知識(shí)、技能、素質(zhì)各方面能力穩(wěn)步提升。3.考核成績(jī)質(zhì)量分析:(1)本研究中Nursing-Mini-CEX量表考核得分總Cronbach'sα系數(shù)為0.862,各項(xiàng)目相關(guān)系數(shù)介于0.411~0.802,信度良好。(2)Nursing-Mini-CEX量表得分與護(hù)士資格考試成績(jī)的效標(biāo)關(guān)聯(lián)效度r=0.428(P0.05),擬合度R2=0.301,呈中度正相關(guān),在一定程度上表明Nursing-Mini-CEX量表對(duì)護(hù)生臨床護(hù)理能力評(píng)價(jià)結(jié)果的一致性和有效性。(3)Nursing-Mini-CEX考核的難度在0.70~0.82之間,平均難度為0.79,難度是可以接受的。(4)Nursing-Mini-CEX考核的區(qū)分度介于0.35~0.75之間,表明考核區(qū)分度較好,能體現(xiàn)出不合格、合格、優(yōu)秀各等級(jí)成績(jī)的護(hù)生水平。4.實(shí)驗(yàn)性研究結(jié)果顯示,實(shí)驗(yàn)組Nursing-Mini-CEX量表護(hù)理問診、護(hù)理查體、護(hù)理診斷、人文關(guān)懷、組織效能、整體評(píng)價(jià)各維度得分顯著高于對(duì)照組(P0.05);實(shí)驗(yàn)組實(shí)習(xí)平時(shí)考核成績(jī)、出科操作成績(jī)、教師教學(xué)效能感得分顯著高于對(duì)照組,且差異顯著(P0.05)。研究結(jié)論1.參照系培訓(xùn)法提高了護(hù)理迷你臨床演練評(píng)估培訓(xùn)教師的評(píng)分一致性、準(zhǔn)確性。2.Nursing-Mini-CEX量表具有較高的信度、效標(biāo)關(guān)聯(lián)效度、合理的難度及區(qū)分度,是可靠的新型臨床能力考評(píng)工具。同時(shí),揭示了護(hù)生臨床能力的薄弱環(huán)節(jié),全面客觀、科學(xué)有效的評(píng)估并提升了護(hù)生的臨床綜合能力,為臨床教學(xué)改革提供理論依據(jù)。3.基于Nursing-Mini-CEX量表的教學(xué)模式使臨床教學(xué)更加制度化、規(guī)范化,可完善Nursing-Mini-CEX的教學(xué)與評(píng)估一體化功能,實(shí)現(xiàn)教學(xué)相長(zhǎng),保證并提升臨床護(hù)理教學(xué)質(zhì)量,值得在臨床護(hù)理教學(xué)中推廣應(yīng)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.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R47-4;G642

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