Orr Zvika, Unger Shifra
J Nurs Educ. 2020 Aug 1;59(8):425-432. doi: 10.3928/01484834-20200723-02.
Structural competency is the trained ability to recognize how social, political, economic, and legal structures shape diseases and symptoms. Although structural competency has become an increasingly accepted framework for training and teaching, it usually has not addressed nursing students and has not included marginalized patients as trainers.
This article analyzes a structural competency training model for nursing students that includes five components: Theory, Observations, Learning from patients, Engagement, and Research (the TOLERance model).
The TOLERance model increases the understanding of the interrelation between the individual clinical level and the sociopolitical structural level. It encourages nursing students to actively engage in social, political, and policy issues that affect their patients' health and to advocate for policy change.
The moral and professional commitment of nurses to their patients demands that they do not ignore the structural forces that are detrimental to their patients' health. The TOLERance model provides nursing students with skills and competencies that help them to fulfill this commitment. [J Nurs Educ. 2020;59(8):425-432.].
结构胜任力是一种经过训练的能力，能够识别社会、政治、经济和法律结构如何塑造疾病和症状。尽管结构胜任力已成为培训和教学中越来越被认可的框架，但它通常未涉及护理专业学生，也未将边缘化患者纳入培训者范围。
本文分析了一种针对护理专业学生的结构胜任力培训模式，该模式包括五个组成部分：理论、观察、向患者学习、参与和研究（即宽容模型）。
宽容模型增进了对个体临床层面与社会政治结构层面之间相互关系的理解。它鼓励护理专业学生积极参与影响患者健康的社会、政治和政策问题，并倡导政策变革。
护士对患者的道德和职业承诺要求他们不能忽视对患者健康有害的结构力量。宽容模型为护理专业学生提供了帮助他们履行这一承诺的技能和胜任力。[《护理教育杂志》。2020年；59(8):425 - 432。]
