反思性学习法对护生的临床能力的影响

论文编号:HL198  论文字数:12462.页数:23

论文题目：反思性学习法对护生的临床能力的影响
摘　要
 目的：把反思性学习法应用于护生临床实践，为护生临床能力的提高提供一种有效的实践方法；同时，对实验组护生的反思日记和反思小组讨论会内容进行质性分析，探索和理解护生临床实践期间遇到的问题和真实的心理状态，为完善临床教学管理提供依据。
 方法：用分层随机抽样的原则选取实验组和对照组同学各80名，对照组同学采用常规实习程序实习； 实验组护生在常规实习的基础上，对其进行反思性学习相关知识培训，并要求书写反思日记和定期组织反思小组讨论会； 6个月后收集反思日记，对试验组同学的反思日记和反思小组讨论内容进行定性研究；并用《护理生临床能力评价表》对两组同学进行评价，对定量资料用SPSSl3.0统计软件包进行统计分析。
 结果：(1) 对护生的反思日记和反思小组讨论会内容进行质性分析，萃取出4个主要结构概念：人际关系、知识和技能、情感体验、实习环境。在4个主要结构概念中共含7个次要结构概念：对护患关系和护患沟通技巧的反思、对临床带教老师的反思、对护理操作的反思、对临床学习方法的反思、对人生和生死的反思、对护士职业的反思、对工作环境的反思；(2) 对定量资料进行统计分析显示：在α=0．05(双侧)检验水准下，两组学生的临床护理能力分值不同，有统计学意义，实验组学生优于对照组(P<0.05)。实验组学生在临床处置能力、护理沟通能力、健康教育能力、护理科研能力、职业心理素质五个方面优于对照组(t值分别为3.2l，6.59，2.02，8.17，7.27，P<0．05)，在临床教学能力和临床管理能力方面差异无统计学意义(t值分别为1.78，1.52，P>0.05)。
 结论：反思性学习是一种有效的提高护生临床能力的实践方法，并且能够为完善临床教学管理提供依据。。
 关键词: 反思性学习；临床实践；护理临床能力
 
Title: Applying reflective learning in clinical practice for nursing students
ABSTRACT
Objective
 Applying reflective learning in clinical practice and provide aspecial method to enhance the clinical competence of nursing undergraduates．Simultaneously,the diaries of the experiment group were analyzed by Hermeneutic Phenomeno--logical Method,to explore and understand the problems faced by college nursing students and their mental status in clinical practice,and to provide references for nursing educators．
Methods
 These students were divided into the experiment group(N=80)and the control group(N=80)by randomization．The control group took routine clinical practice．The experiment group took routine clinical practice and reflective learning．After 6 months，the diaries of the experiment group were collected and analyzed by Hermeneutic Phenomenw--logical Method．Then clinical competence of the students in the two groups were measured by questionnaire and the data were analyzed by Statiscal Package for Social Science(SPSS)13.0．
Results
 (1) The diaries were analyzed，four themes were found：interpersonal relations；knowledge and skill；emotion experience；clinical environment.Seven secondary concepts were included：reflection on nurse-patient relationship, clinical mentor，basic nursing procedure，clinical study methods，on life，death，professional attitude,and clinical environment．
 (2) Undergraduate nursing students’clinical competence：the experiment group students better than the control group students in clinical dispose competence，clinical communication competence，health education competence，nursing research competence．and professional quality．(t values were 2．23，4．5，2．58，5．45，3．71，P<0．05)However,there were no differences between two group students in clinical teaching competence and clinical manage competence．(t values were 1．12，1．53，P>0．05)．
Conclusion
 Reflective learning can effectively improve the clinical nursing competence for undergraduate practice nursing students，and can provide references for nursing educators．

Key words：Reflective learning;Clinical practice; Nursing clinical competence

目  录
 
1 绪论 1
1.1 背景及意义 1
1.2目的及目标 1
1.3关键词及定义 1
1.4文献回顾…………………………………………………………………………….2
2研究设计……………………………………………………………………………………5
2.1研究设计…………………………………………………………………………….5
2.2研究对象…………………………………………………………………………….5
2.3研究工具…………………………………………………………………………….5
2.4研究步骤…………………………………………………………………………….5
2.5统计分析…………………………………………………………………………….6
3研究结果……………………………………………………………………………………7
3.1干预前两组护生临床护理能力的分值统计及结果报告………………………….7
3.2干预6个月后两组护生临床护理能力的分值统计及结果报告………………….7
3.3自评与他评结果的一致性检验…………………………………………………….9
4讨论………………………………………………………………………………………..10
4.1反思日记和反思小组讨论会内容的质性分析…………………………………...10
4.2反思性学习对护生临床处置能力的影响………………………………………...10
4.3反思性学习有助于本科护生临床沟通能力的提高……………………………...10
4.4反思性学习有助于本科护生临床科研能力的提高 11
4.5反思性学习有助于提高本科护生的健康教育能力 11
4.6 反思性学习对本科护生临床教学能力、临床管理能力作用不显著 11
4.7 小结 12
5 推论及建议 13
致    谢 14
参考文献 15