情景模擬案例教學(xué)法對(duì)提升中醫(yī)專(zhuān)科護(hù)理能力的研究*

□ 張國(guó)娣 ZHANG Guo-di 徐東娥 XU Dong-e* 郭巧英 GUO Qiao-ying 周逸波 ZHOU Yi-bo

Objective To explore the effect of scenario simulation case study teaching on improving the Traditional Chinese Medicine (TCM) nursing capacity of on-the-job nurses. Methods A total of 130 new nurses were selected for TCM nursing training. They were randomly divided into control group (n=65)and experimental group (n=65) with the number table method. Scenario simulation case study teaching was adopted for the experimental group, and the traditional teaching method was adopted for the control group. Through the clinical practice assessment and questionnaire survey, the nursing ability and teaching effect of the two groups were compared. Results The TCM nursing capacity in the experimental group was significantly higher than that in the control group, and the difference was statistically significant (p=0.000). Nurses' evaluation of the teaching quality was better in the experimental group than in the control group in terms of knowledge, ability, and attitude or emotion, and the difference was statistically significant (p=0.000). Conclusion The scenario simulation case study teaching method can effectively improve the TCM nursing capacity.

2013年國(guó)家中醫(yī)藥管理局發(fā)布《關(guān)于加強(qiáng)中醫(yī)護(hù)理工作的意見(jiàn)》要求以中醫(yī)整體觀念為指導(dǎo)，以患者為中心，堅(jiān)持“辯證施護(hù)”的中醫(yī)臨床護(hù)理原則[1]，更好服務(wù)廣大人民群眾。但在醫(yī)院管理年驗(yàn)收和等級(jí)醫(yī)院復(fù)審中，發(fā)現(xiàn)中醫(yī)院普遍存在著中醫(yī)護(hù)理特色體現(xiàn)不足，臨床開(kāi)展中醫(yī)操作項(xiàng)目過(guò)少的現(xiàn)象，中醫(yī)院護(hù)理“西化”的問(wèn)題非常突出[2]。沈勤[3]等研究發(fā)現(xiàn)我國(guó)中醫(yī)院從中醫(yī)院校畢業(yè)的護(hù)士只占3%～10%，大部分臨床護(hù)士在校未經(jīng)過(guò)系統(tǒng)的中醫(yī)護(hù)理學(xué)習(xí)，中醫(yī)基礎(chǔ)薄弱[4-5]。護(hù)士在臨床實(shí)施中醫(yī)辯證施護(hù)的能力明顯不足，同時(shí)我國(guó)現(xiàn)有教學(xué)形式過(guò)于單一，課堂的枯燥嚴(yán)重影響了中醫(yī)護(hù)理臨床教學(xué)質(zhì)量[6]。情景模擬案例教學(xué)法是通過(guò)創(chuàng)設(shè)接近于真實(shí)的臨床情境，對(duì)事件或?qū)嵨锇l(fā)生與發(fā)展的環(huán)境、過(guò)程進(jìn)行模擬或虛擬再現(xiàn)，讓學(xué)習(xí)者參與其中，進(jìn)而獲取知識(shí)、提高能力、增進(jìn)情感體驗(yàn)的一種教學(xué)方法[7]。2016年3月我院護(hù)理部引入情景模擬案例教學(xué)法培訓(xùn)在職護(hù)士，旨在提升護(hù)士中醫(yī)專(zhuān)科護(hù)理能力，效果良好，報(bào)道如下。

對(duì)象與方法

1.研究對(duì)象。選擇2012、2013、2014年新入職護(hù)士，至2016年3月完成中醫(yī)護(hù)理100學(xué)時(shí)培訓(xùn)。納入標(biāo)準(zhǔn)：工作崗位在內(nèi)科或外科病區(qū)，中醫(yī)院校畢業(yè)護(hù)士?jī)?yōu)先原則。符合納入條件者，詳細(xì)告知其培訓(xùn)目的、意義、方法、時(shí)間及要求，簽署知情同意書(shū)后納入培訓(xùn)。采用整群抽樣方法，3年新入職護(hù)士共計(jì)346人，最終納入研究130人，采用隨機(jī)數(shù)字表法分為對(duì)照組和試驗(yàn)組，每組各65人。……