Laschinger H K, McWilliam C L, Weston W
Interdisciplinary Studies, School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London.
J Nurs Educ. 1999 Nov;38(8):347-56. doi: 10.3928/0148-4834-19991101-05.
The effects of community-based family nursing and medicine clinical rotations on students' confidence in their knowledge and ability to counsel clients in selected health promotion areas were examined from the perspective of Bandura's (1986) self-efficacy theory. Nursing students (n=66) enrolled in a community family nursing course and medical students (n=71) enrolled in a 6-week family practice clerkship rotation completed questionnaires at three points: prior to, at completion of, and 3 months following their clinical rotations. Nursing and medical students' self-efficacy levels at pretest were similar. At-posttest, nursing students' self-efficacy was significantly higher than that of the medical students. This difference was sustained at 3 months follow up. Students' conception of health (clinical vs. nonclinical) did not have an effect on posttest self-efficacy levels. Self-efficacy scores accounted for 63% of the variance in the nursing students' self-reported use of health promotion principles in their daily practice; but only 11% of the variance in medical students' daily practice. The results of this exploratory study provide information to guide theory-informed curricular decisions to design clinical learning activities that foster the development of health promotion counseling skills in both nursing and medical students.
从班杜拉（1986）的自我效能理论角度，研究了社区家庭护理和医学临床轮转对学生在特定健康促进领域为客户提供咨询的知识和能力信心的影响。参加社区家庭护理课程的护理专业学生（n = 66）和参加为期6周家庭医疗实习轮转的医学专业学生（n = 71）在三个时间点完成问卷调查：临床轮转前、结束时以及结束后3个月。护理专业和医学专业学生在预测试时的自我效能水平相似。在后测试时，护理专业学生的自我效能显著高于医学专业学生。这种差异在3个月随访时仍然存在。学生对健康的概念（临床与非临床）对后测试自我效能水平没有影响。自我效能得分在护理专业学生自我报告的日常实践中健康促进原则使用差异中占63%；但在医学专业学生日常实践差异中仅占11%。这项探索性研究的结果为指导基于理论的课程决策提供了信息，以设计临床学习活动，促进护理专业和医学专业学生健康促进咨询技能的发展。
