Construction And Application Of PBL Teaching Scheme In Improving The Clinical Ability Of Emergency Nursing Students

ObjectiveTo construct the PBL teaching scheme of undergraduate nursing students in emergency department,to discuss the application effect of PBL teaching scheme in improving the clinical ability of undergraduate nursing students and the experience of nursing students in the PBL teaching scheme and find out the problems existing in the implementation of PBL teaching scheme,to provide evidence or reference for the optimization of clinical PBL teaching scheme and cultivation of nursing students with clinical ability in emergency department.MethodsThis study includes three parts.Part I: Literature review and analysis is used in the study.The current domestic and foreign PBL teaching scheme and nursing students’ clinical ability are reviewed.Combined with the syllabus of colleges and universities,the emergency nursing students’ clinical competence assessment scale and emergency PBL teaching scheme(process and case)initial content are formed,and through three rounds of expert consultation the emergency PBL teaching scheme course content and methods are determined.Part II: A cluster randomized controlled trial is used to select the nursing students who met the inclusion criteria.The subjects are divided into two groups,PBL group(N=20)and control group(N=21).The control group received routine nursing care in emergency department.The emergency PBL teaching scheme is adopted to intervene the nursing students in PBL teaching group.Through " the clinical teaching environment measurement questionnaire ","student assessment scale","undergraduate nursing students emergency clinical ability evaluation index" and theoretical examination to compare emergency department of different teaching methods and research object itself before and after the implementation of efficiency.Part III: The convenience sampling method is used to select 12 cases of emergency nursing students who received emergency PBL teaching scheme,and the experience and the problems of PBL teaching scheme were discussed.Claizzi seven step analysis method is used to analyze,extract and summarize the interview data.ResultsPart Ⅰ: 15 experts were selected,and the positive coefficients of the three experts were all at the level of 100%,and the degree of expert authority was about 0.856.After three rounds of expert consultation eventually formed the emergency clinical ability of PBL teaching program,including the PBL scheme of teaching process,PBL(emergency cases of acute organophosphate poisoning,acute heart failure)and evaluate the clinical competence of undergraduate nursing students in emergency questionnaire(7 dimensions,26 items).The content validity of the PBL teaching scheme was 0.868,the content validity of the emergency clinical competence scale was 0.799,and the Cronbach’s α was 0.826.Part II: No statistically significant was found on the baseline data of the nursing students before the intervention,with evidenced comparability.After the intervention:(1)Satisfaction and recognition of clinical teaching environment: The intervention group intern on the process of learning experience with grading and clinical teaching environment recognition,perceptual learning of clinical teachers perceived approval(except group interpersonal items),academic self-perception,the perception of environment recognition,self-perceived social competence and learning effect of project acceptance was significantly higher than the control group.(2)Class performance: The total score of learning attitude and learning ability of the intervention group was(88.27±2.62),and the control group was(84.31±2.46),the difference between the two groups was statistically significant(P<0.01);The learning attitude and learning ability scores of the intervention group were significantly higher than those of the control group(P<0.01)in the third week and the fourth week.(3)Clinical competence in emergency department: After two weeks of intervention,the clinical ability score of PBL group was(7.01± 0.13),which was in a good grade,while the control group(6.56±0.28)score was in the general level;In addition to the clinical treatment ability,the scores of each dimension of the intervention group and the total score of emergency clinical ability were higher than those of the control group,the difference was statistically significant(P<0.01);After four weeks of intervention,the clinical ability score of PBL group was(8.06±0.24),and was in a better grade.The score of the control group(6.99±0.31)was in good grade,the intervention group in addition to the ability of clinical management,emergency clinical ability of each dimension scores and total scores were significantly higher than those in the control group,the difference was statistically significant(P<0.01);There was no significant difference in the evaluation of the emergency ability of nursing students and the self-evaluation of nursing students(P > 0.05);(4)Theoretical examination: The score of intervention group was(89.55±1.93),the control group was(83.71±1.92),the difference between the two groups was statistically significant(P<0.01).Part III: The PBL teaching plan is well implemented in nursing undergraduate interns,and six themes were formed: clinical management capability improvement,communication skills improvement,the ability of health education improvement,clinical research ability improvement,clinical teaching ability improvement,psychological quality enhancement.There were four major problems in the process of PBL teaching: the role formation dependency,excessively brief problems,lack of solutions to problems,the drill is short in the feedback solution.ConclusionThe PBL teaching scheme of emergency clinical ability in this study and the evaluation of emergency clinical ability have a certain degree of scientific nature,and the clinical situation of teaching cases in PBL teaching plan meets the needs of nursing students.The clinical teaching plan of emergency ability of PBL in this study can improve the emergency ability of undergraduate nursing students.The implementation of the PBL teaching scheme of emergency clinical ability in this study is generally better,but there are still some problems.The clinical teachers should pay attention to the aspects of the nursing students in the implementation process of PBL,such as the allocation of roles aspect,asking questions aspect,finding answers to the questions aspect.Also the clinical teachers should identify student types timely and guide students to put forward deeper problems and pay attention to the operation skills.