Research On The Construction And Application Of ECMO Nursing Staff Training System Based On ADDIE Model

ObjectiveGuided by ADDIE model(Analysis,Design,Development,Implementation,Evaluation),To investigate and analyze the current training status and needs of Extracorporeal Membrane Oxygenation(ECMO)technical nurses,establish a scientific and feasible training system for ECMO nurses,and evaluate the application effect.For the purpose of exploring the ECMO nursing training system suitable for the practical needs of clinical nursing,and providing the feasible teaching ideas for the development of ECMO nursing training.MethodThe first part:Establish a research team of ECMO nursing training system,determine the questionnaire through literature review,group discussion and expert consultation,and investigate the status quo of ECMO development in various hospitals,learners’ learning difficulties,obstructive factors,training status,training needs and other aspects.The training needs of ECMO nursing staff in different hospitals,different regions and different educational backgrounds were analyzed.The draft of ECMO nursing staff training system was developed under the guidance of evidence-based theory and combined with the results of previous investigation and research.Fifteen experts were selected for Delphi expert consultation,and group discussion was carried out based on the consultation results and expert suggestions.Indicators of importance assignment mean ≤3.5 or coefficient of variation ≥0.25 were deleted from the consultation results.The remaining indicators were revised after discussion by the research team,and the revised questionnaire was issued to invite experts to score and revise again.Until the experts converge.The final draft of ECMO nursing staff training system will be finalized after the revision is completed.The second part: Nursing staff who participated in the extracorporeal life support training base of a third-class A hospital from February 2022 to January2023 were selected as research objects by convenience sampling method.The control group included 20 students from February to July 2022,who received regular ECMO training.The observation group consisted of 20 trainees from August 2022 to January 2023.The ECMO nursing staff training system based on ADDIE model was implemented.The two groups of trainees were compared in terms of theoretical assessment results,operational assessment results,characteristic elements of core competence of ECMO nurses(including 7 themes:clinical professional knowledge,clinical practice skills,critical thinking ability,professional development ability,communication and coordination ability,management ability,personal traits),trainee training satisfaction,and trainee self-efficacy.ResultsThe first part:1.A total of 584 ICU nurses from 17 provinces such as Guangdong,Shandong,Jiangsu,and three municipalities directly under the Central government such as Shanghai and Beijing were surveyed.All of them were from Grade 3 Grade A hospitals that had carried out or planned to carry out ECMO technology.Among them,48.8% participated in ECMO related training,mainly internal training(90.18%);66.78% of nurses need to participate in ECMO related training;96.4% of nurses hoped to construct a scientific and complete training body for ECMO nursing staff department;In terms of ECMO training status and needs,there are differences in training content and form.2.Two rounds of expert letter consultation were conducted in this study.The positive coefficient of the two rounds of expert letter consultation was 86.7% and100%,the coefficient of judgment(Ca)was 0.846 and 0.915,the degree of familiarity(Cs)was 1 and 0.957,and the coefficient of authority(Cr)was 0.923 and 0.936,respectively.Kendall harmony coefficient(W)of the two rounds was0.461 and 0.478,respectively,and expert opinions gradually converged.After the first round of letter consultation,one first-level indicator and one third-level indicator were modified,and three third-level indicators were added.After the second round of correspondence consultation,one three-level index was added,and finally the "ECMO Nursing teaching training System based on ADDIE model" was determined to include 4 first-level indicators,16 second-level indicators and 32 third-level indicators.After the first round of letter consultation,one first-level indicator and one third-level indicator were modified,and three third-level indicators were added.After the second round of correspondence consultation,one three-level index was added,and finally the "ECMO Nursing teaching training System based on ADDIE model" was determined to include 4 first-level indicators,16 second-level indicators and 32 third-level indicators.The second part:Comparison of general information between the two groups: there were no significant differences in gender,age,professional title,educational background,years of work,ICU nature and time distribution of ECMO exposure between the two groups(P > 0.05).1.The results of the two groups were compared: the total score of the observation group(472.55 ± 10.65)was higher than that of the control group(459.05±10.17),and the differences were statistically significant(P < 0.05).The test scores of operational skills,clinical comprehensive ability and in-class homework in the observation group were all higher than those in the control group,with statistical significance(P<0.05),but there was no statistical significance between the test scores of theoretical knowledge(91.50 ± 5.19)and the control group(90.45±3.71)(P > 0.05).2.Comparison of self-evaluation results of ECMO nurse core competence between the two groups of trainees: The total score of the observation group(27.05± 1.57)was higher than that of the control group(23.25± 2.53),and the scores of personal traits,clinical professional knowledge,professional development ability,clinical practice skills,communication and coordination ability were all higher than those of the control group,with statistical significance(P < 0.05).However,there was no significant difference between the scores of management ability and critical thinking ability and the control group(P > 0.05).Conclusions1.At present,there are differences in the status quo and needs of ECMO training for ICU nursing staff,so it is urgent to build an ECMO training system oriented to the needs of clinical ECMO nursing staff.2.The ECMO nursing teaching and training system built based on ADDIE model in this study has a scientific and rigorous construction process,systematic system content,and strong reliability of the research results,which can provide reference for the training of ECMO nursing staff.3.The ECMO nursing teaching and training system based on ADDIE model can improve the training content and form in the training of ECMO nursing staff,guide the training of ECMO nursing staff,improve the effect of ECMO nursing training and improve the clinical nursing level of ECMO...