CAJ | 학술논문

目的：分析临床实习前后护理研究生的临床实践能力水平，筛查实践能力培养中的不足点，为完善研究生临床实践能力培养模式提供参考依据。方法对山西医科大学2008-2011级160名护理学硕士研究生实行“临床实践指导教师制”管理，根据实践要求设计《护理研究生临床实践记录手册》并应用于实践教学管理，应用“护理问题对应行动”（ OPSN）和“护理行为目标达成度”（ NPGA）两个量表进行实习前后临床实践能力的测评。结果临床实习后“OPSN”量表中的“组织、应用信息探索发现问题”“提供个性化护理解决患者问题”“为解决问题给患者心理支持”和“对已解决问题进行自我评价”4个维度得分分别为（20．28±2．78），（17．23±1．92），（26．81±2．59），（20．76±2．59）分，临床实习前得分分别为（17．82±3．47），（14．53±3．03），（24．82±3．44），（18．31±4．40）分，差异有统计学意义（t值分别为3．98，5．40，3．32，3．43；P＜0．05）；维度“为解决问题协调护患行为”临床实习前后得分分别为（16．76±2．72），（17．51±1．96）分，差异无统计学意义（t＝1．61，P＞0．05）。“NPGA”量表中“自主决策”“个性化护理”“促进患者理解/参与”“开放性交流”“个性尊重”“团队中工作角色”和“个人发展”7个维度得分差异均无统计学意义（P＞0．05）。结论现有临床教学环境下学生习得的临床实践能力与标准要求有差距，具有局限性，应针对临床实践能力薄弱项目开展专项培训。
목적：분석림상실습전후호리연구생적림상실천능력수평，사사실천능력배양중적불족점，위완선연구생림상실천능력배양모식제공삼고의거。방법대산서의과대학2008-2011급160명호이학석사연구생실행“림상실천지도교사제”관리，근거실천요구설계《호리연구생림상실천기록수책》병응용우실천교학관리，응용“호리문제대응행동”（ OPSN）화“호리행위목표체성도”（ NPGA）량개량표진행실습전후림상실천능력적측평。결과림상실습후“OPSN”량표중적“조직、응용신식탐색발현문제”“제공개성화호리해결환자문제”“위해결문제급환자심리지지”화“대이해결문제진행자아평개”4개유도득분분별위（20．28±2．78），（17．23±1．92），（26．81±2．59），（20．76±2．59）분，림상실습전득분분별위（17．82±3．47），（14．53±3．03），（24．82±3．44），（18．31±4．40）분，차이유통계학의의（t치분별위3．98，5．40，3．32，3．43；P＜0．05）；유도“위해결문제협조호환행위”림상실습전후득분분별위（16．76±2．72），（17．51±1．96）분，차이무통계학의의（t＝1．61，P＞0．05）。“NPGA”량표중“자주결책”“개성화호리”“촉진환자리해/삼여”“개방성교류”“개성존중”“단대중공작각색”화“개인발전”7개유도득분차이균무통계학의의（P＞0．05）。결론현유림상교학배경하학생습득적림상실천능력여표준요구유차거，구유국한성，응침대림상실천능력박약항목개전전항배훈。
Objective To evaluate and analyze the clinical practical competence level of nursing graduates before and after internship and to screen its deficiency under current clinical practical ability training model and provide references for developing nursing graduates education of clinical practice ability and for improving clinical practical competence training pattern in clinical setting .Methods To implement the clinical practice guide tutor system to 160 graduate students in Shanxi Medical University from 2008 to 2011 , the students were asked to complete the clinical practical manual , which were designed to evaluate their clinical practical competence level using “OPSN” ( self-evaluation scale of oriented problem solving behavior in nursing practice) and “NPGA” (nursing practice goal attainment ).Results In the dimension of “OPSN” scale, the scores of “to discover problems by organizing and applying information ” “to offer psychological support for patients problem solution” “to provide personalized care for patients” and “to evaluate for solved problems”were (20.28 ±2.78), (17.23 ±1.92), (26.81 ±2.59), (20.76 ±2.59) after the internship, which were (17.82 ±3.47), (14.53 ±3.03), (24.82 ±3.44), (18.31 ±4.40), respectively, before the internship, and the differences were statistically significant (t=3.98, 5.40, 3.32, 3.43, respectively;P<0.05).The scores of “coordination of behavior between nurses and patients” were (16.76 ±2.72) and (17.51 ±1.96) before and after the internship, which had no significant difference (t=1.61, P>0.05).Each dimension of“NPGA” scale was not statistically significant before and after the internship (P>0.05).Conclusions There is still a gap between standard requirements and acquisition of practice ability under current clinical teaching environment .The project training for graduate students should be added according to the weak points in clinical practice ability training .