Goh Yong-Shian, Seetoh Yu-Ting Michelle, Chng Mui-Lee, Ong Siang Loong, Li Ziqiang, Hu Yanan, Ho Chun-Man Roger, Ho Su Hui Cyrus
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Alice Lee Centre for Nursing Studies, National University Health System, Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Alice Lee Centre for Nursing Studies, National University Health System, Singapore.
Nurse Educ Today. 2020 Nov;94:104591. doi: 10.1016/j.nedt.2020.104591. Epub 2020 Sep 7.
The use of physical restraint to curtail dangerous or extremely disruptive behaviours in patients has been an established practice to help ensuring safety in healthcare providers' work environment. However, many have deemed it unnecessary and overused with reported negligence on patients' basic needs during its implementation. Studies have shown that having empathy and non-judgmental attitudes are vital in reducing and eliminating the use of restraint.
To explore whether experiential learning will improve empathy and confidence, among nursing and medical students when managing dangerous, aggressive, and violent patients.
A pre- and post-test, same group quasi-experimental design was used to explore the effectiveness of using the Empathetic CAre and REsponse (ECARE), an experiential learning session to equip nursing and medical students on managing dangerous, aggressive, and violent patients. Outcome measures include students' confidence when using verbal de-escalation, physical and chemical restraint techniques. Empathy scores were also compared.
A University offering both medical and nursing program from undergraduate to postgraduate level.
249 nursing and 50 medical students undergoing the mental health nursing module in Year 2 of their nursing program and psychiatry rotation in Year 3 of their medical education.
Results showed that, for both student populations, the empathy and confidence scores significantly improved after attending ECARE. ANCOVA conducted on the post-intervention Jefferson empathy score between the populations with an adjusted baseline score revealed a statistically significant adjusted mean difference between them.
This study demonstrated that experiential learning could improve the learners' empathy through the integration of hands-on learning. This in turn could enhance future healthcare professionals' care quality. Experiential learning opportunities should be incorporated into existing pedagogies as this helps to improve students' confidence in managing dangerous, aggressive and violent patients, reducing the use of physical restraint, thereby enhancing the quality of patient care.
使用身体约束来遏制患者的危险或极具破坏性的行为一直是一种既定做法，有助于确保医护人员工作环境的安全。然而，许多人认为这是不必要的且被过度使用，因为在实施过程中存在对患者基本需求的忽视。研究表明，具备同理心和无评判态度对于减少和消除约束的使用至关重要。
探讨体验式学习是否会提高护理和医学生在处理危险、攻击性和暴力患者时的同理心和自信心。
采用前后测试、同组准实验设计，以探讨使用“同理心关怀与反应”（ECARE）这一体验式学习课程的有效性，该课程旨在让护理和医学生掌握处理危险、攻击性和暴力患者的技能。结果指标包括学生在使用言语缓和、身体和化学约束技术时的自信心。还比较了同理心得分。
一所提供从本科到研究生层次医学和护理课程的大学。
249名护理专业学生和50名医学生，他们分别在护理课程的第二年接受心理健康护理模块学习，以及在医学教育的第三年进行精神病学轮转。
结果显示，对于这两组学生群体，参加ECARE课程后，同理心和自信心得分均显著提高。对调整基线得分后的两组人群干预后杰斐逊同理心得分进行协方差分析，结果显示两组之间存在统计学上显著的调整后平均差异。
本研究表明，体验式学习可以通过实践学习的整合来提高学习者的同理心。这反过来可以提高未来医护人员的护理质量。应将体验式学习机会纳入现有教学方法中，因为这有助于提高学生处理危险、攻击性和暴力患者的自信心，减少身体约束的使用，从而提高患者护理质量。
