The Study On The Pattern Of Clinical Practice Training In MNS

Background:The clinical practice is essential to the academic quality of the postgraduates in Master of Nursing Specialist (MNS). It is also the important stage deciding whether the students could become advanced practice nurses in the fields of specific diseases. Due to the fact that MNS education in China has just started, there has been no referential training pattern so far. Medical institutions recruiting MNS students each have their own distinctive comprehensions for clinical practice training in MNS, which results in the large differences in their arrangements, methods, evaluations and management for clinic teaching, some even almost the same as those in undergraduate teaching. This could cause disparities in the achievements of teaching in domestic MNS education. Therefore, it is urgent that we put the construction of a scientific training pattern that fits the condition of our country as well as the development law of nursing personnel on the top of our agenda.Objectives:To understand and analyze the current status of the clinical practice training in foreign countries, find out the drawbacks in our own and discuss the elements constituting the MNS clinical practice ability system; to explore the composition and operating rules of clinical practice training; to propose the theoretical basis and constructing principles in the pattern of clinical practice training; to construct the training pattern based on that and meanwhile verify the effectiveness of the teaching strategies proposed by it in improving students’ clinical skills. To provide domestic MNS clinical practice training with more scientific and effective reference and thus to improve the MNS education in China.Methods and Contents of the Study:1. Comparative Study on Chinese and American Clinical Practice Training in MNSComparative study was applied on Chinese and American clinical practice training in MNS to conduct profound analysis of clinical practice training in4Chinese and American institutions offering MNS degree with the application of document research, case study and compared research, in order to obtain detailed knowledge of the situation in each institution. Compare and analyze the goals, arrangements, contents, teaching and evaluations of clinic practice as well as its subject orientation based on the elements in clinic practice with comparative study applied, in order to define the similarities and differences between domestic and foreign MNS clinic practice training and to find out the existing disparity, thus to lay the foundation for the construction of MNS clinical practice training pattern as well as to guide it further.2. Study on the Construction of MNS Clinical Practice Training PatternIn the construction of MNS clinical practice training pattern①The theoretical basis for MNS clinical practice training pattern applying document research was proposed.②The core concept of this study was defined through document research, questionnaires and depth interviews; relevant questionnaires were made to investigate MNS students in15nursing institutions in our county, in order to understand their expectations for what they can master in the education of clinic practice and their opinions on it; through the depth interviews with13experts in nursing education and clinical care in6institutions, a preliminary understanding of their opinions on the ability, goals, contents and methods of clinical practice that MNS graduates need, which laid the foundation for building a MNS clinical practice training pattern was obtained.③The construction principles of MNS clinical practice training pattern applying document research and model study was proposed, and on the basis of previous research results, the theoretical framework of MNS clinical practice training pattern was constructed initially.3. Research on the Teaching Strategy for MNS Clinical PracticeTeaching strategy for MNS clinical practice is to use educational action research method to do the empirical study on the cognitive apprenticeship basing teaching strategy proposed in MNS clinical practice training pattern and to discuss its effectiveness in promoting students’ability in clinical practice.Results:1. Definition, Connotation and Features of MNS Clinical Practice AbilityThe definition of MNS clinical practice ability is the quality of thinking and action capabilities demonstrated in clinical care during which students can apply their theoretical and practical knowledge in medicine and nursing and meanwhile can take full account of the health needs of service objects, including individuals, families and communities to address the complex care issues in clinic or the fields of professional services effectively, and provide them with appropriate, economic and qualified services. The connotation of MNS clinical practice ability is an aggregate constituted by a variety of elements; it is the capacity of flexible practice; it focuses on the ability to solve complicated issues in changeable working environments. The features of MNS clinical practice ability are that it is situational for it can be adapted into different clinical situations, dynamic for it is developing continuously and evaluable for it needs scientific and valid evaluations.2. Theoretical Basis for MNS Clinical Practice Training Pattern and the Logic Relationships between TheoriesMNS theoretical basis of clinical practice training pattern includes the theories of comprehensive development of human, Taxonomy of Educational Objectives, competency-based teaching theory, personality education and situational cognitive learning theory. Among them, comprehensive development of human is the core value, Taxonomy of Educational Objectives is the guide to establish targets, competency-based teaching theory provides the basic principles, personality education provides the basic requirements and cognitive learning theory provides the basic idea.3. Compositon of MNS Clinical Practice AbilityMNS clinical practice ability is mainly composed by the motivation, general ability, professional ability and situational capacity in MNS clinical practice. Among them, motivation includes practical interest, achivement target and practice pressure, general ability includes basic nursing skills, communication and collaboration capabilities, research capabilities, education and management ability as well as professional development capacity, professional ability includes theoretical and practical knowledge as well as nursing skills and clinical situational capacity includes the capability ot discovery, analysis and solve problems, critical thinking, decision-making power and executive ability.4. Compositon of MNS Clinical Practice Training PatternMNS clinical practice training pattern mainly includes training objectives, contents, teaching process, assessment and security mechanism, among which the training objectives are oriented element, the teaching process is procedural element, the assessment is evaluating element and the security mechanism is the dependent element. The characteristics of different students in this major have divided them into two kinds of patterns.5. Results of the Study on Cognitive Apprenticeship Basing Teaching Strategy in MNS Clinical Practice TeachingThe study on cognitive apprenticeship basing teaching strategy in MNS clinical practice teaching proves that this strategy can help improve MNS graduates’clinical skills and played a significant role in stimulating their interest and mobilizing their enthusiasm in clinical practice. The application model of teaching strategy is proposed based on the research.Conclusions:1. Defined the concept, connotation and characteristics of MNS clinical practice ability, and put forward the theoretical basis for clinical practice training pattern as well as the logical relationships between the theories applied, which can enrich the theoretical research in MNS education.2. Established the MNS clinical practice ability system composed by4elements as well as15hypo-elements, which provides a reference for the formulation of evaluation index system of MNS clinical practice ability.3. Constructed the clinical practice training pattern which includes5elements and reflects characteristics of different students, providing an operable framework for the education of MNS clinical practice.4. Verified the validity of cognitive apprenticeship basing teaching strategy in MNS clinical practice training in promoting MNS graduates’ ability in clinical practice and confirmed that it as one of the preferred teaching strategies in MNS clinical practice teaching.