目的 评价基于屏幕的虚拟模拟(Screen-based simulation,SBS)作为模拟前准备在护理学专业学生小腿骨折情境模拟教学中的应用效果。方法 采用横断面研究设计调查国内某院校的本科护理学专业三年级93名学生。作为模拟前准备,学生在小腿骨折的现场模拟之前完成SBS练习。在现场模拟中,教师根据“小腿骨折——学生表现核查表”评估学生在现场模拟中的表现;现场模拟结束后,采用护士临床推理量表和临床学习环境比较调查表对学生进行问卷调查。结果 85名(91.4%)学生认为SBS练习对现场模拟有很大或非常大帮助;学生在现场模拟中的表现评分均值为72.83分,高于上届学生均值(57.67分);学生的临床推理量表总分为(62.28±6.94)分,处于较高水平;学生在现场模拟教学环境中的临床学习环境比较调查表总分高于屏幕模拟教学环境,分别为(87.14±13.36)分和(77.77±16.79)分,其差异具有统计学意义(P<0.001)。结论 采用SBS作为模拟前准备,有效改善了学生在现场模拟中的表现,并训练了学生的临床推理能力。今后需要进一步研究SBS作为模拟前准备的最佳实践,以及是否可以纳入更多的SBS来提高模拟的教学效果。
Objective To evaluate the effectiveness of screen-based simulation (SBS) as presimulation preparation for a lower leg fracture simulation for undergraduate nursing students. Methods A cross-sectional study was employed among 93 junior nursing students from nursing school of a university. They were required to complete SBS as presimulation preparation for a lower leg fracture simulation. The students' performance in in-person simulation were evaluated by facilitators according to a demonstrating checklist for simulation of lower leg fracture. After in-person simulation, students were invited to answer the Nurses Clinical Reasoning Scale (NCRS) and Clinical Learning Environment Comparison Survey (CLECS). Results Totally 85(91.4%) students believed that SBS was of great or very great help to in-person simulation. The mean score of the students' performance in in-person simulation was 72.83, which was higher than that of previous students (57.67). The total NCRS score was 62.28±6.94, indicating a high level of clinical reasoning ability. The total CLECS score in in-person simulation was higher than that in SBS, which was 87.14±13.36 and 77.77±16.79 respectively, and the difference was statistically significant (P<0.001). Conclusions The use of SBS as presimulation preparation was effective in improving the students' performance score in simulation and training their clinical reasoning ability. Further study is needed to determine best practices of using SBS before in-person simulation, and whether more SBS could be involved to enhance the learning outcomes.
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