Uys Leana R, Van Rhyn Lily L, Gwele Nomthandaso S, McInerney Patricia, Tanga Tobeka
School of Nursing, University of KwaZulu-Natal, Durban, South Africa.
J Adv Nurs. 2004 Dec;48(5):500-9. doi: 10.1111/j.1365-2648.2004.03232.x.
This paper reports a study describing and evaluating the outcomes of problem-based learning (PBL) programmes in nursing schools in South Africa in terms of the competence of graduates to solve problem in actual clinical settings, and comparing this competence with that of graduates from non-PBL programmes.
The nursing literature tends to equate problem-solving with patient-centred problems or the nursing process. However, it is also a skill used in managing the work role, working in a team and managing a health care unit. Problem-solving refers to the process of selectively attending to information in a patient care setting. The investigation of problem-solving in nursing is complicated by the complex relationships between different cognitive processes.
A qualitative evaluation study, descriptive and comparative in nature, was carried out. In-depth interviews were held with graduates and their supervisors, asking them to identify problem-solving incidents in which they had been involved. Template analysis style and Benner's interpretive approach were used to analyse the data.
The majority of the incidents described by the graduates (84%) were graded at the advanced beginner level or above. The majority of incidents at the novice level came from the non-PBL group. 'Using people skills' and 'being assertive' were the two problem-solving strategies most often used. The PBL group fared better than the non-problem-based group in the level of their problem-solving ability.
The findings of this study suggest that further research is warranted into the problem-solving abilities of PBL graduates, their personal development over time and at different stages of practice. In addition, it would be interesting to follow the development of their problem-solving abilities over time.
本文报告一项研究,该研究描述并评估了南非护理学校基于问题的学习(PBL)课程的成果,具体涉及毕业生在实际临床环境中解决问题的能力,并将这一能力与非PBL课程毕业生的能力进行比较。
护理文献倾向于将解决问题等同于以患者为中心的问题或护理程序。然而,它也是一种用于管理工作角色、团队协作和管理医疗保健单位的技能。解决问题是指在患者护理环境中选择性地关注信息的过程。护理中解决问题的研究因不同认知过程之间的复杂关系而变得复杂。
开展了一项定性评估研究,本质上具有描述性和比较性。对毕业生及其导师进行了深入访谈,要求他们识别自己参与过的解决问题事件。采用模板分析风格和本纳的解释方法对数据进行分析。
毕业生描述的大多数事件(84%)被评为高级初学者水平或以上。新手水平的大多数事件来自非PBL组。“运用人际交往技巧”和“坚定自信”是最常使用的两种解决问题策略。PBL组在解决问题能力水平上比非PBL组表现更好。
本研究结果表明,有必要对PBL毕业生的解决问题能力、他们随时间推移以及在不同实践阶段的个人发展进行进一步研究。此外,跟踪他们解决问题能力随时间的发展情况会很有趣。