本科护理教育中的身体评估复兴——学习哪些技能很重要，以及这些技能在临床轮转期间如何应用？一项队列研究。
Revitalizing physical assessment in undergraduate nursing education - what skills are important to learn, and how are these skills applied during clinical rotation? A cohort study.
作者信息
Egilsdottir H Ösp, Byermoen Kirsten Røland, Moen Anne, Eide Hilde
机构信息
Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045 Drammen, Norway.
2Institute for Health and Society, Faculty of Medicine, University of Oslo, Kirkeveien 166, Fredrik Holsts hus, 0450 Oslo, Norway.
出版信息
BMC Nurs. 2019 Sep 5;18:41. doi: 10.1186/s12912-019-0364-9. eCollection 2019.
BACKGROUND
The preparedness of newly graduated registered nurses for a demanding work environment and care practices takes form during nursing education. Norwegian nursing education at one university has implemented a selection of basic physical assessment skills (B-PAS) in the nursing curriculum in order to prepare nursing students for a demanding work environment post-graduation.
METHODS
A mixed-method cohort design. We evaluated nursing students' self-reported use of B-PAS during their clinical rotation using the "Survey of Examination Techniques Performed by Nurses" questionnaire (30 items). In addition, two focus group interviews elicited factors that hinder or facilitate the actual use of B-PAS during clinical rotation. We recruited students from a bachelor's degree programme for nursing at a Norwegian university. Three hundred and sixty-three of 453 eligible nursing students in the first, second, and third year of the bachelor's degree programme participated in the study (80%).
RESULTS
ANOVA showed a significant progression ( < 0.016) in students' self-reported use of B-PAS. Auscultation and percussion skills were graded below the median score of 3, which indicates that these skills were less used throughout the programme. The nursing students highlighted contextual factors for their use of B-PAS when in clinical rotation. Preceptors are important gatekeepers for successful implementation, and there is a need for close collaboration between the university and clinical practice.
CONCLUSION
Despite the reduced PAS taught in the curricula, there is still a lack of application of such skills in clinical rotations. This study highlights that research should explore how different work environments influence the utilisation of learned skills, and which learning strategies are appropriate or most successful for stimulating clinical reasoning and the extensive use of physical assessment.
背景
新毕业的注册护士为适应高要求的工作环境和护理实践所做的准备在护理教育期间形成。挪威一所大学的护理教育在护理课程中实施了一系列基本身体评估技能（B-PAS），以使护理专业学生为毕业后的高要求工作环境做好准备。
方法
采用混合方法队列设计。我们使用“护士执行检查技术调查”问卷（30项）评估了护理专业学生在临床轮转期间自我报告的B-PAS使用情况。此外，两次焦点小组访谈引出了在临床轮转期间阻碍或促进B-PAS实际使用的因素。我们从挪威一所大学的护理学学士学位课程中招募学生。该学士学位课程一、二、三年级的453名合格护理专业学生中有363名参与了研究（80%）。
结果
方差分析显示学生自我报告的B-PAS使用情况有显著进展（<0.016）。听诊和叩诊技能得分低于中位数3分，这表明在整个课程中这些技能的使用较少。护理专业学生强调了他们在临床轮转时使用B-PAS的情境因素。带教老师是成功实施的重要把关人，大学与临床实践之间需要密切合作。
结论
尽管课程中教授的身体评估技能有所减少，但在临床轮转中这些技能的应用仍然不足。本研究强调，研究应探索不同的工作环境如何影响所学技能的运用，以及哪些学习策略对于激发临床推理和广泛使用身体评估是合适的或最成功的。
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