“项目驱动”教学法对护生评判性思维和临床决策能力的影响(1)
[摘要]目的 探討项目驱动教学法对高职护生评判性思维和临床决策能力的影响。方法 选取本校2013级6年制65名高职大四护生作为研究对象，随机分组，1班32名为实验组，采用项目驱动教学法结合传统教学法，2班33名为对照组，采用传统教学法。比较两组护生的外科护理学期中成绩和期末成绩，评判性思维和临床决策能力的差异，分析评判性思维和临床决策能力的相关性。结果 实验组护生期中考试成绩[(82.93±7.90)分]与对照组[(81.15±7.84)分]比较，差异无统计学意义(P>0.05)。实验组护生期末考试成绩[(80.62±6.05)分]高于对照组[(72.73±6.21)分]，差异有统计学意义(P<0.05)。实验组护生评判性思维能力总分[(259±31.9)分]高于对照组[(237±7.8)分]，差异有统计学意义(P<0.05)；两组护生在自信心和求知欲方面比较，差异无统计学意义(P>0.05)。临床决策能力总得分普遍偏低，整体总分为[(77.49±8.7)分]，两组护生的确定目标和决策总分比较，差异有统计学意义(P<0.05)，其余四个子项目比较，差异无统计学意义(P>0.05)。临床决策能力中的确定目标与评判性思维中的5个子项目和评判总分成正相关(P<0.05)，实施决策与系统化成正相关(P<0.01)，临床决策能力总分与系统化成正相关(P<0.01)。结论 高职护生在进入临床前评判性思维能力处于中等水平，临床决策能力接近护理实习本科生和规范化培训护士，项目驱动教学法的实施有助于提升护生的评判性思维和临床决策能力，需要进一步加强培养方法的研究以提升护生自信心、求知欲、发现问题、决断方案、实施决策和评价反馈的能力，从而提高护生进入临床前的综合能力。
[关键词]项目驱动教学法；高职护生；评判性思维；临床决策能力
[中图分类号] R642.4 [文献标识码] A [文章编号] 1674-4721(2017)09(c)-0117-04
[Abstract]Objective To explore the influence of project-driven teaching method on critical thinking and clinical decision-making ability in higher vocational colleges.Methods Altogether 65 of nursing students in 6-year 2013-Grade senior nursing students of the higher vocational college were selected as the objects of this research and randomly divided into two class： 32 cases in Class 1 were taken as experiment group and taught by using the combination of project-driven teaching method and traditional teaching method，while 33 cases in Class 2 were taken as control group and taught by using traditional teaching methods.Mid-term exam results and final exam results of surgical nursing as well as the difference of critical thinking and clinical decision-making ability were compared between two groups，and the correlation between critical thinking and clinical decision-making ability was analyzed.Results The average mid-term exam results of experiment group [(82.93±7.90) scores] were compared with the control group [(81.15±7.84) scores]，and the difference was not statistically significant (P>0.05).The final exam results of experiment group [(80.62±6.05) scores] were compared with the control group [(72.73±6.21) scores]，and the difference was statistically significant (P<0.05).The total scores of critical thinking ability of experiment group [(259±31.9) scores] was higher than control group [(237±7.8) scores]，the difference was statistically significant (P<0.05)；the nursing students of two groups were compared in self-confidence and appetite for knowledge，and the difference was not statistically significant (P>0.05).The total scores of clinical decision-making ability of two groups were generally low and the overall score was [(77.49±8.7) scores]，statistically significant differences were only seen between two groups in goals determination and the total score of decision-making (P<0.05)，there was no statistically significant difference in the other four sub-projects (P>0.05).The determining goals of clinical decision-making ability was positively correlated with 5 sub-projects and the total scores of critical thinking ability (P<0.05)，decision implementation was positively correlated with systematization (P<0.01)，the systematization was positively correlated with the total score of clinical decision-making ability (P<0.01).Conclusion The critical thinking ability of higher vocational nursing students before learning clinical classes is in the middle level and their clinical decision-making ability is close to undergraduate nursing interns and standardized training nurses.The implementation of the project-driven teaching method is helpful to improve nursing students′ critical thinking and clinical decision-making ability.The study on cultivation methods needs to be further strengthened to enhance nursing students′ self-confidence，appetite for knowledge and the ability in finding problems，making decisions，implementing decisions and evaluation feedback so as to improve the comprehensive ability of nursing students pre-clinically., http://www.100md.com(潘太健 严文英 朱莹 王欣国 黄昌福 )
[关键词]项目驱动教学法；高职护生；评判性思维；临床决策能力
[中图分类号] R642.4 [文献标识码] A [文章编号] 1674-4721(2017)09(c)-0117-04
[Abstract]Objective To explore the influence of project-driven teaching method on critical thinking and clinical decision-making ability in higher vocational colleges.Methods Altogether 65 of nursing students in 6-year 2013-Grade senior nursing students of the higher vocational college were selected as the objects of this research and randomly divided into two class： 32 cases in Class 1 were taken as experiment group and taught by using the combination of project-driven teaching method and traditional teaching method，while 33 cases in Class 2 were taken as control group and taught by using traditional teaching methods.Mid-term exam results and final exam results of surgical nursing as well as the difference of critical thinking and clinical decision-making ability were compared between two groups，and the correlation between critical thinking and clinical decision-making ability was analyzed.Results The average mid-term exam results of experiment group [(82.93±7.90) scores] were compared with the control group [(81.15±7.84) scores]，and the difference was not statistically significant (P>0.05).The final exam results of experiment group [(80.62±6.05) scores] were compared with the control group [(72.73±6.21) scores]，and the difference was statistically significant (P<0.05).The total scores of critical thinking ability of experiment group [(259±31.9) scores] was higher than control group [(237±7.8) scores]，the difference was statistically significant (P<0.05)；the nursing students of two groups were compared in self-confidence and appetite for knowledge，and the difference was not statistically significant (P>0.05).The total scores of clinical decision-making ability of two groups were generally low and the overall score was [(77.49±8.7) scores]，statistically significant differences were only seen between two groups in goals determination and the total score of decision-making (P<0.05)，there was no statistically significant difference in the other four sub-projects (P>0.05).The determining goals of clinical decision-making ability was positively correlated with 5 sub-projects and the total scores of critical thinking ability (P<0.05)，decision implementation was positively correlated with systematization (P<0.01)，the systematization was positively correlated with the total score of clinical decision-making ability (P<0.01).Conclusion The critical thinking ability of higher vocational nursing students before learning clinical classes is in the middle level and their clinical decision-making ability is close to undergraduate nursing interns and standardized training nurses.The implementation of the project-driven teaching method is helpful to improve nursing students′ critical thinking and clinical decision-making ability.The study on cultivation methods needs to be further strengthened to enhance nursing students′ self-confidence，appetite for knowledge and the ability in finding problems，making decisions，implementing decisions and evaluation feedback so as to improve the comprehensive ability of nursing students pre-clinically., http://www.100md.com(潘太健 严文英 朱莹 王欣国 黄昌福 )