护士标准化病人在精神科护理学临床见习和客观结构化考核中的应用  

Effects of nurse as standardized patient in clinical apprenticeship and objective structured clinical examination of psychiatric nursing

作　　者：吕文君[1] 张燕红[1,2] 钱瑞莲 黄皓莲[1] 袁京梅[1] Lyu Wenjun;Zhang Yanhong;Qian Ruilian;Huang Haolian;Yuan Jingmei(Nursing Department,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;School of Nursing,Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]南京医科大学附属脑科医院护理部,南京210029 [2]南京医科大学护理学院,211166

出　　处：《中华现代护理杂志》2020年第10期1376-1381,共6页Chinese Journal of Modern Nursing

基　　金：南京医科大学2017年教育研究课题一般项目(62)。

摘　　要：目的探索基于护士标准化病人(NSP)的精神科护理学临床见习和客观结构化考核(OSCE)的应用效果。方法采用便利抽样法,选取某医科大学护理学院2017级护理本科生260名为试验组,在临床见习教学过程中应用临床真实病人和NSP相结合的教学方法,并采用NSP参与的客观结构化考核进行临床见习技能的考核;2016级护理本科生286名为对照组,采用传统的临床见习教学和考核方法。考量试验组考核的区分度和难度;比较两组护生的考试成绩、护生对考核形式的认可度、评判性思维能力。结果最终试验组247名、对照组280名护生完成研究。考试难度系数及区分度符合考核要求;两组护生见习成绩比较差异有统计学意义(P<0.01);OSCE考核后,两组护生对OSCE考核模式认可得分分别为对照组(3.22±0.64)分,试验组(4.17±0.58)分,两组得分比较差异有统计学意义(P<0.01);两组护生评判性思维能力测量表总分分别为对照组(278.29±25.66)分,试验组(289.53±35.43)分,两组得分比较差异有统计学意义(P<0.01);两组思想开放性、分析能力、系统化能力、自信心4个维度得分比较,差异均有统计学意义(P<0.05)。结论基于NSP的精神科护理学临床见习和OSCE体系具有可行性和实用性,可以提升学生的批判性思维能力,有借鉴和推广价值。Objective To explore the effects of nurse as standardized patient(NSP)in clinical apprenticeship and objective structured clinical examination(OSCE)of psychiatric nursing.Methods Totally 260 undergraduate nursing students admitted to the School of Nursing of a medical university in 2017 were selected into experimental group,who were taught in combination of real patients and NSP,and received assessment of clinical apprenticeship skills through OSCE involving NSP.Totally 286 undergraduate nursing students admitted in 2016 were selected into control group,who received conventional clinical apprenticeship teaching and assessment.The discrimination and difficulty of the assessment of the experimental group was considered,and the test scores,the degree of recognition of the assessment form by the nursing students,and the ability of critical thinking were compared between the two groups.Results Totally 247 nursing students in the experimental group and 280 in the control group completed the study.The degree of difficulty and discrimination met the assessment requirements.There was a statistically significant difference in apprenticeship performance between the two groups(P<0.01).After OSCE,the recognition scores of the two groups for OSCE were(3.22±0.64)and(4.17±0.58),respectively,and the difference was statistically significant(P<0.01).The total scores of Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV)of the two groups were(278.29±25.66)and(289.53±35.43),respectively,and the difference was statistically significant(P<0.01).There were statistically significant differences in the scores of CTDI-CV in 4 dimensions between the two groups,they are open-mindedness,analytical ability,systematic ability and self-confidence(P<0.05).Conclusions The NSP-based clinical apprenticeship and OSCE for psychiatric nursing is feasible and practical,which can improve students'critical thinking ability,and is worth referencing and promoting.

关 键 词：精神病护理学 临床见习 护士标准化病人 客观结构化考核 

分 类 号：G642[文化科学—高等教育学] R47-4[文化科学—教育学]