反思性學(xué)習(xí)法對(duì)護(hù)生的臨床能力的影響

論文編號(hào):HL198  論文字?jǐn)?shù):12462.頁數(shù):23

論文題目：反思性學(xué)習(xí)法對(duì)護(hù)生的臨床能力的影響
摘　要
 目的：把反思性學(xué)習(xí)法應(yīng)用于護(hù)生臨床實(shí)踐，為護(hù)生臨床能力的提高提供一種有效的實(shí)踐方法；同時(shí)，對(duì)實(shí)驗(yàn)組護(hù)生的反思日記和反思小組討論會(huì)內(nèi)容進(jìn)行質(zhì)性分析，探索和理解護(hù)生臨床實(shí)踐期間遇到的問題和真實(shí)的心理狀態(tài)，為完善臨床教學(xué)管理提供依據(jù)。
 方法：用分層隨機(jī)抽樣的原則選取實(shí)驗(yàn)組和對(duì)照組同學(xué)各80名，對(duì)照組同學(xué)采用常規(guī)實(shí)習(xí)程序?qū)嵙?xí)； 實(shí)驗(yàn)組護(hù)生在常規(guī)實(shí)習(xí)的基礎(chǔ)上，對(duì)其進(jìn)行反思性學(xué)習(xí)相關(guān)知識(shí)培訓(xùn)，并要求書寫反思日記和定期組織反思小組討論會(huì)； 6個(gè)月后收集反思日記，對(duì)試驗(yàn)組同學(xué)的反思日記和反思小組討論內(nèi)容進(jìn)行定性研究；并用《護(hù)理生臨床能力評(píng)價(jià)表》對(duì)兩組同學(xué)進(jìn)行評(píng)價(jià)，對(duì)定量資料用SPSSl3.0統(tǒng)計(jì)軟件包進(jìn)行統(tǒng)計(jì)分析。
 結(jié)果：(1) 對(duì)護(hù)生的反思日記和反思小組討論會(huì)內(nèi)容進(jìn)行質(zhì)性分析，萃取出4個(gè)主要結(jié)構(gòu)概念：人際關(guān)系、知識(shí)和技能、情感體驗(yàn)、實(shí)習(xí)環(huán)境。在4個(gè)主要結(jié)構(gòu)概念中共含7個(gè)次要結(jié)構(gòu)概念：對(duì)護(hù)患關(guān)系和護(hù)患溝通技巧的反思、對(duì)臨床帶教老師的反思、對(duì)護(hù)理操作的反思、對(duì)臨床學(xué)習(xí)方法的反思、對(duì)人生和生死的反思、對(duì)護(hù)士職業(yè)的反思、對(duì)工作環(huán)境的反思；(2) 對(duì)定量資料進(jìn)行統(tǒng)計(jì)分析顯示：在α=0．05(雙側(cè))檢驗(yàn)水準(zhǔn)下，兩組學(xué)生的臨床護(hù)理能力分值不同，有統(tǒng)計(jì)學(xué)意義，實(shí)驗(yàn)組學(xué)生優(yōu)于對(duì)照組(P<0.05)。實(shí)驗(yàn)組學(xué)生在臨床處置能力、護(hù)理溝通能力、健康教育能力、護(hù)理科研能力、職業(yè)心理素質(zhì)五個(gè)方面優(yōu)于對(duì)照組(t值分別為3.2l，6.59，2.02，8.17，7.27，P<0．05)，在臨床教學(xué)能力和臨床管理能力方面差異無統(tǒng)計(jì)學(xué)意義(t值分別為1.78，1.52，P>0.05)。
 結(jié)論：反思性學(xué)習(xí)是一種有效的提高護(hù)生臨床能力的實(shí)踐方法，并且能夠?yàn)橥晟婆R床教學(xué)管理提供依據(jù)。。
 關(guān)鍵詞: 反思性學(xué)習(xí)；臨床實(shí)踐；護(hù)理臨床能力
 
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．a(chǎn)nd 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  錄
 
1 緒論 1
1.1 背景及意義 1
1.2目的及目標(biāo) 1
1.3關(guān)鍵詞及定義 1
1.4文獻(xiàn)回顧…………………………………………………………………………….2
2研究設(shè)計(jì)……………………………………………………………………………………5
2.1研究設(shè)計(jì)…………………………………………………………………………….5
2.2研究對(duì)象…………………………………………………………………………….5
2.3研究工具…………………………………………………………………………….5
2.4研究步驟…………………………………………………………………………….5
2.5統(tǒng)計(jì)分析…………………………………………………………………………….6
3研究結(jié)果……………………………………………………………………………………7
3.1干預(yù)前兩組護(hù)生臨床護(hù)理能力的分值統(tǒng)計(jì)及結(jié)果報(bào)告………………………….7
3.2干預(yù)6個(gè)月后兩組護(hù)生臨床護(hù)理能力的分值統(tǒng)計(jì)及結(jié)果報(bào)告………………….7
3.3自評(píng)與他評(píng)結(jié)果的一致性檢驗(yàn)…………………………………………………….9
4討論………………………………………………………………………………………..10
4.1反思日記和反思小組討論會(huì)內(nèi)容的質(zhì)性分析…………………………………...10
4.2反思性學(xué)習(xí)對(duì)護(hù)生臨床處置能力的影響………………………………………...10
4.3反思性學(xué)習(xí)有助于本科護(hù)生臨床溝通能力的提高……………………………...10
4.4反思性學(xué)習(xí)有助于本科護(hù)生臨床科研能力的提高 11
4.5反思性學(xué)習(xí)有助于提高本科護(hù)生的健康教育能力 11
4.6 反思性學(xué)習(xí)對(duì)本科護(hù)生臨床教學(xué)能力、臨床管理能力作用不顯著 11
4.7 小結(jié) 12
5 推論及建議 13
致    謝 14
參考文獻(xiàn) 15