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临床推理指南对护理学生诊断准确性的影响:一项临床试验。

Effect of a guide for clinical reasoning on Nursing students' diagnostic accuracy: A clinical trial.

机构信息

Universidade Federal do Paraná, Curitiba, PR, Brasil.

Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil.

出版信息

Rev Lat Am Enfermagem. 2022 Mar 21;30:e3515. doi: 10.1590/1518-8345.5452.3515. eCollection 2022.

DOI:10.1590/1518-8345.5452.3515
PMID:35319625
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9015704/
Abstract

OBJECTIVE

to evaluate the effect of the Self-Instructional Guide for Clinical Reasoning on the diagnostic accuracy of undergraduate Nursing students.

METHOD

a randomized, parallel and double-blind (researchers and outcome evaluators) clinical trial, carried out with undergraduate Nursing students. Validated case studies were applied in two phases to identify the patient's Nursing diagnosis/problem, etiology and clues, using the Guide with the intervention group in the second phase. The outcomes - diagnostic and etiological accuracy and number of clues - were evaluated using validated rubrics. Descriptive statistics were used to analyze demographic data; Fisher's exact test for similarities in prior education and confidence; Mann-Whitney's test for age; and non-parametric ANOVA test in the evaluation of the hypothesis of differences in performance.

RESULTS

final sample composed of 24 students in the control group and 27 in the intervention group; no difference as to gender, age and schooling. There was a difference in diagnostic (p=0.041) and etiological (p=0.0351) accuracy in the intervention group, showing a negative effect of using the Guide.

CONCLUSION

the one-time self-instruction was not effective in impacting the diagnostic accuracy of students solving case studies. Repeated application of the Guide as a teaching tool can be effective in improving such outcome. REBEC: RBR-4bhr78.

摘要

目的

评估临床推理自学指南对本科护理学生诊断准确性的影响。

方法

这是一项随机、平行、双盲(研究人员和结果评估者)的临床试验,对象为本科护理学生。在两个阶段使用验证后的病例研究来识别患者的护理诊断/问题、病因和线索,在第二阶段使用指南对干预组进行干预。使用验证后的评分表评估诊断和病因准确性以及线索数量。使用描述性统计分析人口统计学数据;Fisher 精确检验比较前期教育和信心的相似性;Mann-Whitney 检验年龄差异;非参数方差分析检验假设差异。

结果

对照组最终样本由 24 名学生组成,干预组由 27 名学生组成;性别、年龄和教育程度无差异。干预组在诊断(p=0.041)和病因(p=0.0351)准确性方面存在差异,表明使用指南有负面影响。

结论

一次性自学对提高学生解决病例研究的诊断准确性没有效果。作为一种教学工具,重复使用指南可能会有效提高这一结果。REBEC:RBR-4bhr78。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b71f/9015704/5d75f71f108b/1518-8345-rlae-30-e3515-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b71f/9015704/5d75f71f108b/1518-8345-rlae-30-e3515-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b71f/9015704/5d75f71f108b/1518-8345-rlae-30-e3515-gf2.jpg

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2
Prognostic indicators of short-term survival of ineffective airway clearance in children with acute respiratory infection: a longitudinal study.急性呼吸道感染患儿无效气道清除短期生存的预后指标:一项纵向研究。
Contemp Nurse. 2020 Aug;56(4):376-387. doi: 10.1080/10376178.2020.1813045. Epub 2020 Sep 18.
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Effects of Clinical Reasoning Prompts on Nursing Students' Clinical Judgment for a Patient Experiencing Respiratory Distress.
评价一项涉及临床病例和护理学生的教育干预(edworkcases):一项横断面观察性研究。
Rev Lat Am Enfermagem. 2022;30:e3723. doi: 10.1590/1518-8345.6190.3723.
临床推理提示对呼吸窘迫患者护理学生临床判断的影响。
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Reflective and critical thinking in nursing curriculum.护理课程中的反思性与批判性思维。
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Debriefing evaluation in nursing clinical simulation: a cross-sectional study.护理临床模拟中的汇报评估:一项横断面研究。
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