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护理实践中从胜任力到专业技能的提升。

Competence to expertise in nursing practice.

作者信息

Welch Susan

机构信息

Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, USA.

出版信息

Contemp Nurse. 2025 Apr;61(2):195-202. doi: 10.1080/10376178.2024.2445276. Epub 2024 Dec 23.

Abstract

BACKGROUND

A shift from a content-focused curriculum to a competency-based curriculum has occurred in nursing education. Competency-based education (CBE) is highly debated within higher education despite the need for competency. Competency-based education (CBE) is a form of education that takes a curriculum from a focus on an actual role or analysis perspective to an individual student's progress based on their demonstrated performance of aspects of the role. While debate exists regarding the pros and cons of CBE, theories of expertise exist to understand competency via the worldview of expert performance. Researchers and educational scholars are delving into the role of knowledge, particularly clinical knowledge, in developing and enhancing expertise and the practice of experts. In addition, CBE focuses on individual students' development and skill performance into experts. Many competency frameworks prioritize applying clinical knowledge, skills, and abilities as the building blocks of professional expertise. However, these models often overlook the capability of a nurse to handle unforeseen challenges effectively in practice as an expert.

AIM AND DESIGN

This discussion piece is dedicated to exploring the ongoing debates and developments in the conceptualization of expertise. It also serves to underscore the urgent and crucial need for a paradigm shift in our approach to competency-based education (CBE) in nursing. The discussion will delve into various cognitive perspectives on expertise, particularly how accumulated knowledge is conceptualized in expert development and practice models and the implications for understanding competence through expert performance. This piece will also provide critical implications for understanding competence through expert performance, such as the conceptualizations of knowledge. Finally, this discussion will highlight the significant impact of competence as expertise within CBE, emphasizing the weight and importance of competency as expertise in nursing education.

FINDINGS AND CONCLUSION

Literature has found that expertise in nursing practice is a result of a developmental pathway involving appropriate training and substantial practice. We propose that an integrated understanding of expertise could lead to a more comprehensive set of expert nursing practice competencies. This integration of educational concepts and situated knowledge into competency and expertise understanding requires a shift in learning environments where future experts are educated.

摘要

背景

护理教育已从以内容为重点的课程转向以能力为基础的课程。尽管对能力有需求,但基于能力的教育(CBE)在高等教育中仍备受争议。基于能力的教育(CBE)是一种教育形式,它使课程从关注实际角色或分析视角转向基于个体学生在角色各方面表现的进步。虽然关于CBE的利弊存在争议,但存在专业技能理论,可通过专家表现的世界观来理解能力。研究人员和教育学者正在深入研究知识,尤其是临床知识,在发展和提升专业技能以及专家实践中的作用。此外,CBE注重个体学生成长为专家的发展和技能表现。许多能力框架将应用临床知识、技能和能力作为专业技能的基石。然而,这些模式往往忽视护士在实践中作为专家有效应对意外挑战的能力。

目的与设计

本讨论文章致力于探讨专业技能概念化方面持续存在的争议和发展。它还旨在强调在护理领域基于能力的教育(CBE)方法上进行范式转变的迫切且关键需求。讨论将深入探讨关于专业技能的各种认知视角,特别是在专家发展和实践模式中积累的知识是如何被概念化的,以及通过专家表现理解能力的影响。本文还将阐述通过专家表现理解能力的关键影响,如知识的概念化。最后,本讨论将突出能力作为CBE中专业技能的重大影响,强调能力作为护理教育中专业技能的重要性和权重。

研究结果与结论

文献发现,护理实践中的专业技能是一个涉及适当培训和大量实践的发展路径的结果。我们提出,对专业技能的综合理解可能会产生一套更全面的专家护理实践能力。将教育概念和情境知识整合到能力和专业技能理解中,需要改变培养未来专家的学习环境。

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