三相视频辅助汇报对护生汇报经历、感知压力及促进者实践的影响：一项混合方法研究。

The impact of a three-phase video-assisted debriefing on nursing students' debriefing experiences, perceived stress and facilitators' practices: A mixed methods study.

作者信息

Zhang H, Wang W, Goh S H L, Wu X V, Mörelius E

机构信息

Department of Health, Medicine and Caring Sciences, Linköping University, Sweden and Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

Nurse Educ Today. 2020 May 1;90:104460. doi: 10.1016/j.nedt.2020.104460.

DOI:10.1016/j.nedt.2020.104460

PMID:32408245

Abstract

BACKGROUND

As an integral part of simulation, debriefing helps learners to construct knowledge through reflecting, internalizing, and relating. Video-assisted debriefing (VAD) adds audio-visual captures and reviews to support traditional verbal debriefing (VD), but evidence evaluating its educational effects has been mixed, with limited attention focusing on its structure development.

AIMS

This study aimed to 1) investigate the effects of a three-phase VAD in enhancing nursing students' debriefing experiences and perceived stress compared to VD and 2) to explore its impact on facilitators' debriefing practices.

METHODS

A mixed-methods design was adopted. The quantitative phase involved a prospective controlled trial on 145 nursing students from a university in Singapore who were randomized into the intervention cluster (n = 72) and the control cluster (n = 73). The debriefing experience scale (DES), the stress visual analogue scale (Stress VAS), and the debriefing assessment for simulation in healthcare (DASH© student version) were used as outcome measures. For the qualitative component, a purposive sample of eight facilitators evaluated their own debriefing practices using the DASH© instructor version and each completed an open-ended question survey. Qualitative data were analyzed using content analysis.

RESULTS

Students from the intervention cluster significantly improved their debriefing experiences (p = 0.01), experienced comparable stress, and had better impressions of VAD facilitators' practices (p < 0.001) compared to those in the control cluster. Repeated VAD significantly reduced students' stress (p < 0.001). Students viewed the VAD facilitators as more effective than the VD facilitators. Three categories were derived from the qualitative comments: the act of debriefing, the crux of VAD, and debriefing for success.

CONCLUSION

The three-phase VAD significantly improved nursing students' debriefing experiences without adding extra stress. It also helped to improve facilitators' practices. Future research will benefit from exploring how experts facilitate the three-phase VAD "on the ground" and its effect on learning transfer and cost-effectiveness.

摘要

背景

作为模拟的一个组成部分，总结汇报有助于学习者通过反思、内化和关联来构建知识。视频辅助总结汇报（VAD）增加了视听捕捉和回顾，以支持传统的口头总结汇报（VD），但评估其教育效果的证据不一，对其结构发展的关注有限。

目的

本研究旨在1）调查与VD相比，三相VAD在增强护生总结汇报体验和感知压力方面的效果，以及2）探讨其对引导者总结汇报实践的影响。

方法

采用混合方法设计。定量阶段涉及对新加坡一所大学的145名护生进行前瞻性对照试验，这些护生被随机分为干预组（n = 72）和对照组（n = 73）。总结汇报体验量表（DES）、压力视觉模拟量表（Stress VAS）和医疗保健模拟总结汇报评估（DASH©学生版）用作结局指标。对于定性部分，从八名引导者中选取有目的的样本，使用DASH©教师版评估他们自己的总结汇报实践，并每人完成一份开放式问题调查。定性数据采用内容分析法进行分析。

结果

与对照组相比，干预组的学生显著改善了他们的总结汇报体验（p = 0.01），经历了相当的压力，并且对VAD引导者的实践有更好的印象（p < 0.001）。重复进行VAD显著降低了学生的压力（p < 0.001）。学生们认为VAD引导者比VD引导者更有效。定性评论得出了三类：总结汇报的行为、VAD的关键以及成功的总结汇报。