The Construction Of A Clinical Teaching Base Evaluation Index System For Wound,Ostomy,and Continence Nurses(WOCN)

ObjectiveThe aim of this study is to construct an evaluation index system for clinical teaching bases of wound,ostomy,and continence nurses(WOCN)that conforms to international standards and adapts to China’s national conditions.This system will provide a speciaized quality control evaluation tool for accredited clinical teaching bases of WOCN and facilitate their continuous improvement and homogenization.Methods1.Literature search: The search involved searching domestic and international literature databases to understand the accreditation,evaluation,development,and pending problems of the clinical teaching base for WOCN at home and abroad.The initial framework of the clinical teaching base evaluation system for WOCN was designed using the CIPP evaluation model as the theoretical framework.2.Semi-structured interviews: An interview outline was designed based on the literature review.The interviews were conducted with experts from the fields of wound stoma incontinence,postgraduate nursing education,and nursing management.A preliminary questionnaire was developed using Colaizzi analysis based on the interviews.The semi-structured interviews were pre-consulted and revised according to the experts’ opinions to form a formal questionnaire.3.Delphi expert correspondence: Purposive sampling was used to select experts from four national fields of wound stoma incontinence specialties: medical,nursing,postgraduate nursing education,and nursing management,to participate in two rounds of correspondence.Experts were asked to assign importance values to the entries using a5-point Likert scale and were asked to revise the entries.The selection criteria for the entries were: importance rating greater than 3,approval rate greater than 50%,and full score greater than 20% in the first round of consultation;importance rating greater than3.5,full score greater than 20%,and coefficient of variation less than 0.25 in the second round of consultation;combined with the group’s discussion,the entries were modified or deleted to form the final evaluation index system for the clinical teaching base of wound stoma incontinence specialist nurses.4.Statistical methods: The collected data were processed using Excel 2019 and SPSS 26.0.The importance assignment method was used to calculate the index weights.The general information of the correspondence experts was statistically described by rate and mean standard deviation;the reliability of the consultation results was mainly based on the positivity,concentration,coordination,and authority of experts’ opinions.The importance of the entries is expressed by the mean,standard deviation,and weight value.Results1.Literature review results: A literature search and selection criteria identified 149 articles related to this study.The non-directly relevant literature(124 articles)covered the current situation,training mode,and core competencies of WOCN training;the directly relevant literature(25 articles)mainly focused on the construction of clinical teaching base for WOCN,teaching objectives,leading teachers,curriculum,clinical practice,and quality control.Through analysis of the literature,the initial framework of the evaluation system of the clinical teaching base for WOCN was constructed,including four aspects:base orientation and training needs;base conditions and teaching level;management control and implementation;and training effectiveness.2.Semi-structured interview results: Eight experts from two wound ostomy incontinence specialty nursing clinical teaching bases were interviewed one-on-one using a semi-structured format.Through sorting and analyzing the interview data,six main themes(hospital and base positioning,base teaching conditions,teaching staff situation,base teaching implementation,base teaching management,and base teaching outcomes)and 14 sub-themes were extracted based on the four evaluation dimensions of the CIPP model(context,input,process,and product).3.Delphi expert consultation results: A total of 24 experts from 19 tertiary care institutions in 14 provinces and cities were invited to participate in the correspondence questionnaire,of whom 19 completed two rounds of correspondence.Two rounds of correspondence questionnaires with a return rate of 80% and 79%,respectively,The coefficients of authority of the experts were 0.937 and 0.942,respectively;the mean importance of indicators at all levels was greater than 3.5,and the coefficient of variation was less than 0.25;Kendall’s coordination coefficients were 0.149 and 0.189,respectively;and the coefficients of variation were 0.149 and 0.189,respectively.The chi-square test for the significance of Kendall’s coordination coefficients in the two rounds was less than 0.05,which was statistically significant.4.The evaluation indexes of the clinical teaching base for WOCN were divided into4 dimensions(background evaluation,input evaluation,process evaluation,and result evaluation),6 primary indicators(base training orientation and planning,base teaching conditions,base teaching capacity,base teaching implementation,base teaching management,and base teaching achievements),20 secondary indicators and 67 tertiary indicators,and the weights of each indicator were calculated using the importance-assigned mean proportion distribution method.ConclusionThis study uses a literature review,semi-structured interviews,and Delphi expert correspondence to construct an evaluation index system for the clinical teaching base of WOCN that is scientific in its construction and reasonable in its content setting.It can provide a standardized and specialized quality control evaluation tool for the accredited clinical teaching base of WOCN in China and provide a reference basis and theoretical guidance for the development of homogenization for the clinical teaching bases of WOCN.