| ObjectiveTo study the application effect of Nursing-Mini-Clinical evaluation exercise in clinical teaching activities of undergraduate nursing,and To test the feasibility and validity of the tool to assess the performance of nursing students during clinical practice;Developed a scientific and effective caring teaching model based on both theoretical and Nursing-Mini-CEX tool,so as to perfect its teaching and evaluation function.MethodsThe first phase,applying convenient sampling and taking undergraduates nursing students and clinical teachers in a first-class hospital in the city of Dalian as objects.We used frame-of–reference training to start a three-hour Nursing-Mini-CEX workshop for 32 clinical nursing teachers in July2015.We made the demo video and get the standard score.Multi-sensory channels were used during the training by two videos.Then we observed the consistence and accuracy of the score.And then from September 2015 to April 2016,we implement a monthly Nursing-Mini-CEX assessment program to 146 undergraduates nursing students during the clinical practice.During the internship,each nursing student received an average of 3.3 assessment.A total of 468 Nursing-Mini-CEX forms were collected and analyzed.The second phase,applying convenient sampling and taking 35 grade 2011 undergraduates as control group,which will be given traditional practice teaching methods.42 students of grade 2012 undergraduates as observation group,given on the Nursing-Mini-CEX teaching model on the basis of the traditional practice teaching methods,the Nursing-Mini-CEX teaching model was established based on both theoretical and Nursing-Mini-CEX tool.At the end of the clinical practice,we used the Nursing-Mini-CEX tools and Teaching Efficacy Scale to evaluate the effect of the Nursing-Mini-CEX teaching model.Using the SPSS20.0 software to entry and analyzed the data.Using statistical descriptive,Normality test,Chi square test,Repeated measures analysis of variance and two-sample t-test to analysis the data.Results1.In the first phase,There was a statistically significant improvement in teachers' cognitive knowledge and score consistence after the teacher training,with the later video's Kendall's W was 0.818 and the weighted Kappa was 0.872,and there is no statistically significant between the score and the standard score(P>0.05).2.Examination result analysis: Every student obtaining at least 3.3 Nursing-Mini-CEX.The total number of encounters was 468.The examination time was divided into(19.91±6.87)minutes,the feedback time(9.6±4.39)minutes;The satisfaction score of the teachers and students is(7.22±0.92)and(7.66±0.97).Both teachers and students were satisfied with the Nursing-Mini-CEX assessment.Quality analysis of examination results: During the clinical practice,the scores of each item in the middle and later stages were increased gradually,and the variance analysis was significant(P<0.05).The nursing examination ability is relatively weak,with the score of(6.92±0.89).The average score of nursing diagnosis,nursing measures,health counseling,humane care,organizational effectiveness and overall evaluation is(7.47±0.82)?(7.47±0.96)?(7.39±0.96)?(7.43±0.73)?(7.63±0.95)?(7.45±0.74)?(7.40±0.80).All are in a relatively high level.In other words,the students were gradually improved in knowledge,skill and attitude.3.From the reliable quality of Nursing-Mini-CEX,the reliability analysis of Cronbach's ? is 0.862,each item correlation index between0.411 ~ 0.802.The criterion-related validity r=0.428(P<0.05),goodness of fit R2=0.301,showed that the Nursing-Mini-CEX scale score was positively correlated with the score of nurses' qualification examination.To some extent,it shows the effectiveness of Nursing-Mini-CEX evaluation.Item difficulty degree is 0.70~0.82,the average difficulty coefficient is 0.79,it can be accepted.item discrimination degree is between 0.35~0.75.4.In the second phase,the experimental group students' performance is higher than the control group in the Special care,nursing examination,nursing diagnosis,humanistic care,organizational effectiveness and overall evaluation(P<0.05).The achievement in peacetime,operational assessment results and the teaching efficacy of the experimental group were higher than the control group(P<0.05).Conclusion1.The frame-of-reference training could improve the consistence,accuracy,and satisfaction of the teacher and be worth of applying in clinical rater training.2.Nursing-Mini-CEX has good reliability,appropriate distinction,difficulty and criterion related validity.It is a reliable and scientific tool to evaluate and improve the clinical comprehensive ability of the nursing undergraduate students and benefits as well as teachers.3.Nursing-Mini-CEX teaching model make the clinical teaching more systematic and standardized,can realize the integration of teaching and evaluation functions.It can improve clinical teaching quality and it is well worth to apply in clinical. |
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