| Aims The aim of this study was to establish an evaluation system which is suitable for standardized training for novice nurses based on the basic framework of Mini Clinical Evaluation Exercise,combined with literature review method and Delphi expert consultation method.And to explore the effects on novice nurses' core competencies,satisfaction towards assessment methods,qualified rate of theory/operation assessment,qualified rate of practical clinical work ability assessment,patients' satisfaction and department retension willingness through empirical study.Methods 1.Research on the establishment of a standardized training evaluation system for novice nurses based on Mini Clinical Evaluation Exercise Based on the framework of Mini Clinical Evaluation Exercise and the characteristics of nursing work,the framework of standardized training evaluation system for new nurses based on Mini Clinical Evaluation Exercise was preliminarily established,and the expert consultation questionnaire was compiled.According to the criteria for the inclusion of experts,60 experts were selected and 2 rounds of Delphi expert consultation were conducted.The first and second level items were selected and revised according to the relevant indicators such as the mean value assigned to items,coefficient of variation,full score ratio,and the written opinions of experts.The scientificity and reliability of the results of expert consultation were analyzed by the positive coefficient of experts,the degree of authority of experts,the degree of coordination of experts' opinions and the degree of concentration of experts' opinions.The weight of the first-level items was determined by the analytic hierarchy process.2.Empirical study on the evaluation system of standardized training for novice nurses based on Mini Clinical Evaluation Exercise An evaluation team was set up to conduct unified training of the assessors.Novice nurses recruited in 2016 and 2017 from Zhongda Hospital affiliated to Southeast University were selected and included in the control group and the experimental group respectively.A total of 103 novice nurses who met the criteria were enrolled in the two groups.Prospective,controlled trials were conducted to intervene novice nurses in the experimental group from April 2018 to December 2018 by using the standardized training evaluation system based on Mini Clinical Evaluation Exercise.From April 2017 to December 2017,the novice nurses in the control group received standardized training and evaluation using traditional evaluation methods.Data were collected after 9 months of intervention,and t-test analysis was used to compare the differences in 7 core competencies between the two groups of novice nurses.The chi-square test was used to analyze and compare the differences between the two groups in novice nurses' satisfaction with the assessment method,the qualified rate of the novice nurses' theory/operation assessment,the qualified rate of the novice nurses' clinical practical work ability assessment,the patients' satisfaction and department retention willingness.Results 1.Research on the construction of evaluation system(1)Scientific and reliability analysis of the Delphi expert consultation: in the 2 rounds of expert consultation,the positive coefficient of the experts was 100% and 98.33%,indicating that the experts were highly motivated to participate in this study;The coefficient Cr of expert authority degree was 0.86 and 0.88,both greater than 0.7.The Kendall W values of the first-level items was 0.23 and 0.42,and the Kendall W values of the second-level items was 0.19 and 0.07,respectively.The differences were statistically significant(P<0.001).After 2 rounds of consultation,the mean value of the importance assigned to the first and second level items was >3.5,the minimum value was 4.11,the standard deviation was <1,the coefficient of variation was <0.25,and the expert opinions were relatively concentrated.(2)Analysis of the content and importance of the items: an evaluation system including 8 first-level items and 66 second-level items was formed by applying the analytic hierarchy process after two rounds of consultation by experts.After applying the analytic hierarchy process to analyze the importance degree of the first-level items,first-level items were ranked from the largest to the smallest according to the assigned value of weight: nurse-patient communication,nursing evaluation,nursing measures,humanistic care,health education,nursing diagnosis/nursing problems,work efficiency and overall evaluation.There are differences in the importance of each first-level items.2.Empirical study In this study,a total of 103 subjects were collected from the two groups,including 48 subjects from the experimental group and 55 subjects from the control group.There was no significant difference in baseline data between the two groups(P > 0.05).After 9 months of intervention,the results of statistical analysis of various indicators were as follows:(1)Core competencies of novice nurses: there were statistically significant differences between the two groups in critical thinking ability,clinical nursing ability,interpersonal ability,professional development ability and health education ability(P<0.05),but no statistically significant differences in legal/ethical ability and leadership ability(P>0.05).(2)Novice nurses' satisfaction towards the assessment method: the study subjects' satisfaction towards the assessment method was 97.92% in the intervention group and 85.45% in the control group,and the difference was stastically significant(P < 0.05).(3)The qualified rate of the theoretical test of novice nurses: the qualified rate of the theoretical test in the intervention group and the control group was 100% and 98.18%,respectively,and the difference had no stastical significance(P>0.05).(4)The qualified rate of the operation test of novice nurses: the qualified rate of the operation test for the interventiongroup and the control group was 95.83% and 81.82%,respectively,and the difference was stastically significant(P < 0.05).(5)The qualified rate of clinical practical work ability assessmentof the novice nurses: the qualied rate ofclinical practical work ability assessment of the interventiongroup and the control group wwas 93.75% and 76.36%,respectively,and the difference was stastically significant(P < 0.05).(6)Patients' satisfaction towards novice nurses: patients' satisfaction with the intervention group and the control group was 95.83% and 81.82%,respectively,and the difference was statistically significant(P<0.05).(7)Department retention willingness: department retention willingness of the intervention group and the control group was 95.75% and 86.45%,and the difference was statistically significant(P<0.05).Conclusions 1.The standardized training evaluation system for novice nurses based on Mini Clinical Evaluation Exercise constructed in this study is a scientific,reliable and feasible evaluation method for the reality of standardized training of novice nurses,which conforms to the objective requirements for the work ability of novice nurses and the current focus of current standardized training.2.Systematic training for examiners for many times is conducive to improving the uniformity and homogeneity of scoring.3.The empirical study shows that the evaluation system constructed in this study has obvious advantages in most of the core competencies(critical thinking ability,clinical nursing ability,interpersonal ability,professional development and health education ability),novice nurses' satisfaction towards the assessment method,qualified rate of the operation test of novice nurse,qualified rateof the clinical practical work ability assessment and patients satisfaction and department retention willingness.The statistical difference of legal/ethical and leadership aspects of core competencies and the qualified rate of the theoretical test of novice nurses are not significant.It may be related to single center,small sample size and short research period.In the future,multiple centers can be selected to expand the sample size,extend the intervention period and further explore its effects. |
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