CDIO教学模式联合巴林特小组在新护士规范化培训中的应用

doi:10.3760/cma.j.issn.1007-1245.2023.21.025

摘要/Abstract

摘要：

目的　探讨构思-设计-实现-运作（CDIO）教学模式联合巴林特小组干预在新护士规范化培训中的应用效果。方法　采用前瞻性研究方法，选择2020年1月至2021年12月广东省第二中医院新入职的94名护士为研究对象，根据入职时间进行分组，将2020年1月至12月入职的46名新护士设为对照组［女38例，男8例；年龄（22.48±1.21）岁］，进行常规培训；将2021年1月至12月入职的48名新护士设为观察组［女41例，男7例；年龄（22.25±1.19）岁］，在对照组的基础上实施CDIO教学模式联合巴林特小组活动干预。比较两组新护士的核心能力、职业认同感及培训满意度。采用t检验、χ²检验。结果　培训后，观察组护士核心能力量表中的总评分［（173.58±10.67）分］、法律与伦理实践维度评分［（23.58±4.76）分］、人际关系维度评分［（26.42±2.53）分］、临床护理维度评分［（34.38±3.21）分］、专业发展维度评分［（19.42±2.05）分］、领导能力维度评分［（26.92±4.63）分］、批判性思维与科研维度评分［（23.85±3.50）分］、教育与咨询维度评分［（19.02±3.04）分］，均高于对照组［（141.17±9.51）分、（18.35±5.04）分、（21.83±4.52）分、（28.17±5.36）分、（15.39±2.95）分、（22.89±5.84）分、（18.91±4.98）分、（15.63±3.61）分］，差异均有统计学意义（t=15.526、5.179、6.109、6.841、7.713、3.711、5.581、4.931，均P<0.001）。培训后，观察组护士职业认同感量表中的总评分［（121.23±9.96）分］、职业社会支持维度评分［（23.96±3.60）分］、职业认知评价维度评分［（37.21±5.57）分］、职业自我反思维度评分［（12.02±1.42）分］、职业挫折应对维度评分［（24.23±5.42）分］、职业社交技能维度评分［（23.81±4.54）分］，均高于对照组［（99.76±10.48）分、（19.87±4.91）分、（31.28±6.77）分、（9.5±2.35）分、（19.13±5.04）分、（19.98±4.78）分］，差异均有统计学意义（t=10.182、4.619、4.644、6.314、4.720、3.991，均P<0.001）。培训后，观察组护士对培训的总满意度率为91.7%（44/48），高于对照组的76.1%（35/46），差异有统计学意义（χ²=4.251，P=0.039）。结论　CDIO教学模式联合巴林特小组干预可提高新护士的核心能力和职业认同感，新护士对培训方式和质量的满意度更高。

关键词:

规范化培训, CDIO模式, 巴林特小组, 新护士

Abstract:

Objective　To explore the application effect of Conceive-Design-Implement-Operate (CDIO) teaching mode combined with Balint group intervention in standardized training for new nurses. Methods　A total of 94 new nurses in Guangdong Second Traditional Chinese Medicine Hospital from January 2020 to December 2021 were selected as the study subjects for a prospective study. They were divided into two groups according to the time of entry. The 46 new nurses who entered the hospital from January to December 2020 were set as the control group for routine training, including 38 females and 8 males, aged (22.48±1.21) years. The 48 new nurses who entered the hospital from January to December 2021 were set as the observation group for CDIO teaching mode combined with Balint group intervention based on the control group, including 41 females and 7 males, aged (22.25±1.19) years. The core competence, professional identity, and training satisfaction of the two groups were compared. t test and χ² test were used. Results　After training, the total score [(173.58±10.67) points] and the scores of legal and ethical practice dimension [(23.58±4.76) points], interpersonal relationship dimension [(26.42±2.53) points], clinical nursing dimension [(34.38±3.21) points], professional development dimension [(19.42±2.05) points], leadership dimension [(26.92±4.63) points], critical thinking and scientific research dimension [(23.85±3.50) points], educational consulting dimension [(19.02±3.04) points] of the Competency Inventory for Registered Nurses in the observation group were higher than those in the control group [(141.17±9.51) points, (18.35±5.04) points, (21.83±4.52) points, (28.17±5.36) points, (15.39±2.95) points, (22.89±5.84) points, (18.91±4.98) points, and (15.63±3.61) points], with statistically significant differences(t=15.526, 5.179, 6.109, 6.841, 7.713, 3.711, 5.581, and 4.931; all P<0.001). After training, the total score [(121.23±9.96) points] and the scores of occupational social support dimension [(23.96±3.60) points], occupational cognitive evaluation dimension [(37.21±5.57) points], occupational self-reflection dimension [(12.02±1.42) points], occupational frustration coping dimension [(24.23±5.42) points], and occupational social skill dimension [(23.81±4.54) points] of the Professional Identity Scale for Nurses in the observation group were higher than those in the control group [(99.76±10.48) points, (19.87±4.91) points, (31.28±6.77) points, (9.5±2.35) points, (19.13±5.04) points, and (19.98±4.78) points], with statistically significant differences (t=10.182, 4.619, 4.644, 6.314, 4.720, and 3.991; all P<0.001). After training, the overall satisfaction rate of the observation group with the training was 91.7% (44/48), higher than 76.1% (35/46) in the control group, with a statistically significant difference (χ²=4.251, P=0.039). Conclusion　CDIO teaching mode combined with Balint group intervention can improve the core competence and professional identity of new nurses, and new nurses are more satisfied with the training method and its quality.

Key words:

Standardized training, CDIO mode, Balint Group, New nurses

严金霞杨依琴寇丽霞林健杜炜.

CDIO教学模式联合巴林特小组在新护士规范化培训中的应用 [J]. 国际医药卫生导报, 2023, 29(21): 3103-3107.

Yan Jinxia, Yang Yiqin, Kou Lixia, Lin Jian, Du Wei.

Application of CDIO teaching mode combined with Balint group in standardized training for new nurses [J]. International Medicine and Health Guidance News, 2023, 29(21): 3103-3107.

参考文献

[1] 毕亚平,王革,庞佳坭,等. 规范化培训护士反馈寻求行为与创新行为的相关性研究[J]. 护理学杂志,2022,37(24):35-38. DOI: 10.3870/j.issn.1001-4152.2022.24.035.
[2] Adatara P, Boni GS. New graduate nurses' experiences and challenges during a one-year clinical rotation programme in the volta region of Ghana: implications for nursing management and nursing workforce retention[J]. Biomed Res Int, 2022, 19(20): 5023419. DOI: 10.1155/2022/5023419.
[3] 国家卫生和计划生育委员会.关于印发«新人职护士培训大纲(试行)»的通知[EB/OL]. (2016-02-16)[2022-07-03]. http://www.nhc.gov.cn/yzygj/s3593/201602/91b5a8fa3c9a45859b036558a5073875.shtml.
[4] 丁炎明,吴欣娟,刘飞,等. 三级综合医院新护士规范化培训的现状调查[J]. 中华护理杂志,2020,55(3):331-336. DOI: 10.3761/j.issn.0254-1769.2020.03.002.
[5] 韩鹏,张朋佳,姜金霞,等. 新护士对规范化培训真实体验质性研究的Meta整合[J]. 护士进修杂志,2022,37(6):487-492. DOI: 10.16821/j.cnki.hsjx.2022.06.002.
[6] 肖舒静,蔡姣芝,杨敏菲,等. PBL结合CBL混合式教学在肿瘤科规培护士癌痛教学中的效果研究[J]. 国际医药卫生导报,2023,29(6):872-876. DOI:10.3760/cma.j.issn.1007- 1245.2023.06.030.
[7] 张晓乐,易永红,江燕,等. 基于CDIO模式的护理创新实践在儿科新护士培训中的应用[J]. 护理学杂志,2019,34(4):58-61. DOI:10.3870/j.issn.1001-4152.2019.04.058.
[8] 谭韡,肖文静,吕小斌,等. 巴林特小组活动在内科住院医师规范化培训中的应用[J]. 中华医学教育探索杂志,2022,21(7):906-909. DOI: 10.3760/cma.j.cn116021- 20200410-00931.
[9] Liu M, Yin L, Ma E, et al. Competency inventory for registered nurses in Macao: instrument validation[J]. J Adv Nurs, 2009, 65(4): 893-900. DOI: 10.1111/j.1365-2648.2008.04936.x.
[10] 刘玲,郝玉芳,刘晓虹. 护士职业认同评定量表的研制[J]. 解放军护理杂志,2011,28(3):18-20. DOI: 10.3969/j.issn.1008-9993.2011.03.006.
[11] 钱孔嘉,徐红贞,程晓英,等. 新生儿专科护士核心能力评价指标体系的构建[J]. 中国实用护理杂志,2023,39(1):46-52. DOI: 10.3760/cma.j.cn211501-20220406-01033.
[12] 汤敏,王雪菲,陈莉霞,等. 构思-设计-实现-运作培训模式在新入职护士临床带教中的应用[J]. 临床护理杂志,2018,17(5):66-68. DOI: 10.3969/j.issn.1671-8933.2018.05.025.
[13] 郭娜,李真,王巍,等. 双导师制联合巴林特小组法在提升新护士培训体验及核心能力中的应用效果[J]. 中国护理管理,2021,21(6): 808-812. DOI: 10.3969/j.issn.1672-1756. 2021.06.003.
[14] 方业香,韩江英,申小侠,等. CDIO模式在新护士岗前护理技能培训中的应用[J]. 齐鲁护理杂志,2021,27(2):161-163. DOI: 10.3969/j.issn.1006-7256.2021.02.067.
[15] 袁正林,李蜀鄂,谢梦茹,等. 融入课程思政的CDIO模式在口腔医学拔尖创新人才培养中的应用[J]. 中华医学教育探索杂志,2022,21(1):39-42. DOI: 10.3760/cma.j.cn116021- 20210825-00727.
[16] 周彤,宣玲,王冬梅,等. 基于CDIO理念的教学模式在心血管护理实践教学中的应用[J]. 中华全科医学,2022,20(9):1569-1572. DOI: 10.16766/j.cnki.issn.1674-4152.002651.
[17] 柳琼,潘莘莘,徐小群. 巴林特小组对90后新护士心理资本和职业倦怠的影响研究[J]. 青年发展论坛,2022,32(4):35-44. DOI: 10.3969/j.issn.1672-2108.2022.04.004.
[18] 张晓瑾,叶霞燕,周慧洁,等. 巴林特小组岗位培训措施对新护士岗位应对及沟通能力的干预效果分析[J]. 中国药物与临床,2019,19(2):313-315. DOI: 10.11655/zgywylc2019. 02.062.
[19] 陈艳,孔方. 新入职护士人文执业能力与职业价值观、职业认同感相关性分析[J]. 医药高职教育与现代护理,2021,4(3):208-211. DOI: 10.3969/j.issn.2096- 501X.2021.03.007.
[20] Purvis JK. Applying a Foucauldian lens to the Canadian code of ethics for registered nurses as a discursive mechanism for nurses professional identity[J]. Nurs Inq, 2023, 30(2): e12536. DOI: 10.1111/nin.12536.
[21] 蒋晓珍,陈爱娥,连芬,等. 贝尔宾角色理论对新护士角色转换及职业认同感的影响研究[J]. 中国高等医学教育,2022(1):104-105. DOI: 10.3969/j.issn.1002-1701.2022. 01.051.
[22] 杨丽,龙艳芳,陈熙,等.新入职护士职业认同感现状及影响因素分析[J].中华现代护理杂志,2020,26(29):4038-4042.DOI:10.3760/cma.j.cn115682-20191119-04214.
[23] 邓秀梅,文清德,蒋雪丽,等.基于构思-设计-实施-运作的翻转课堂教学模式在护理操作培训中的应用[J].现代临床护理,2023,22(4):53-56. DOI:10.3969/j.issn.1671-8283. 2023.04.009.
[24] 王雨琴,李育玲. 团体心理辅导联合巴林特小组活动对新入职护士职业认同感的影响[J]. 护理研究,2022,36(9):1676-1680. DOI: 10.12102/j.issn.1009-6493.2022. 09.033.
[25] 郭娜,张蒙,吴欣娟,等. 新护士规范化培训满意度现状及其影响因素调查分析[J]. 中国护理管理,2022,22(1):101-106. DOI: 10.3969/j.issn.1672-1756.2022.01.021.
[26] 陈英,徐庆梅,张磊. PBL-Seminar结合鲶鱼效应在ICU护士新技术能力培训中的应用[J]. 国际医药卫生导报,2022,28(4):563-568. DOI: 10.3760/cma.j.issn.1007-1245. 2022.04.030.
[27] 张平,赵宏波,毕磊,等. 问题引导式联合CDIO模式教学在手术室新护士培训中的应用[J]. 护理实践与研究,2021,18(9):1401-1404. DOI: 10.3969/j.issn.1672-9676.2021.09.038.