School of Nursing, Sun Yat-sen University, Guangzhou, China.
School of Nursing, Jinan University, Guangzhou, China.
Nurse Educ Today. 2022 Apr;111:105312. doi: 10.1016/j.nedt.2022.105312. Epub 2022 Feb 23.
History-taking is an essential skill for nurses. In nursing education, it is necessary to objectively assess history-taking skills in a way that accurately reflects differences among students. Current history-taking evaluation methods lack objectivity, consistency and standardization, which makes it difficult to identify factors that influence history-taking skill. A virtual standardized patient (VSP) can provide history-taking practice with repeatability and consistency. It can make objective and standardized assessment possible by eliminating the subjectivity of different teachers and patients.
To evaluate the history-taking skills of nursing undergraduates using a VSP, and to explore its independent influencing factors.
A cross-sectional design was employed with a sample of convenience from 3 universities. All 174 nursing undergraduates had their history-taking level evaluated using one VSP via computer or mobile terminal. For each query raised by the students, the VSP could give a preset response. The responses were assigned corresponding scores according to their importance, with a total score of 100. The students' general demographics were documented, and their self-efficacy, critical thinking and communication skills were measured online with the Nursing History-taking Self-Efficacy Questionnaire, Yoon's Critical Thinking Disposition Instrument and the Supportive Communicative Scale. Univariate analysis, Pearson correlation analysis and multiple linear regression were performed.
The mean total history-taking score was 58.53 ± 14.32. History-taking scores were well discriminated among the students tested, with 10% of the students scoring above 80, 37% between 60 and 80, 22% between 50 and 60 and 31% scored below 50. The history-taking level of the nursing students was significantly associated with ethnicity, previous academic performance, and Supportive Communicative Scale scores.
Using the VSP as a history-taking assessment method is an effective way to achieve a relatively objective, standardized and consistent assessment of history-taking education. Ethnicity, previous academic performance and supportive communication skills independently influenced the students' history-taking level. Mature history-taking skills require not only solid theoretical knowledge but good communication skills.
问诊是护士的一项基本技能。在护理教育中，有必要以一种能够准确反映学生之间差异的方式客观评估问诊技能。目前的问诊评估方法缺乏客观性、一致性和标准化，难以确定影响问诊技能的因素。虚拟标准化患者（VSP）可以提供具有可重复性和一致性的问诊实践。它可以通过消除不同教师和患者的主观性来实现客观和标准化的评估。
使用 VSP 评估护理本科生的问诊技能，并探讨其独立影响因素。
采用横断面设计，从 3 所大学中采用方便抽样法抽取样本。所有 174 名护理本科生均通过计算机或移动终端使用一个 VSP 进行问诊水平评估。对于学生提出的每个问题，VSP 可以给出预设的回答。根据问题的重要性为回答分配相应的分数，满分为 100 分。记录学生的一般人口统计学资料，在线使用护理问诊自我效能问卷、Yoon 的批判性思维倾向量表和支持性沟通量表测量他们的自我效能感、批判性思维和沟通技能。进行单变量分析、Pearson 相关分析和多元线性回归分析。
平均总问诊得分为 58.53 ± 14.32。接受测试的学生之间的问诊得分差异明显，其中 10%的学生得分高于 80 分，37%的学生得分在 60-80 分之间，22%的学生得分在 50-60 分之间，31%的学生得分低于 50 分。护理学生的问诊水平与民族、以往学业成绩和支持性沟通量表得分显著相关。
使用 VSP 作为问诊评估方法是实现问诊教育相对客观、标准化和一致评估的有效方法。民族、以往学业成绩和支持性沟通技能独立影响学生的问诊水平。成熟的问诊技能不仅需要扎实的理论知识，还需要良好的沟通技巧。
