军队院校护理学专业教育标准的研究与构建
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摘要
目的:
     建立能突出军事素质特色,适应现代高新技术战争需求的军队护理人才素质质量结构理论模型和军队院校护理学专业建设结构理论模型,并在此模型的基础上构建具有良好军队适应性的我军院校护理学专业各层次人才教育标准,为有效地规范和调控我军医科院校护理人才培养提供参照标准。
     方法:
     1.通过文献研究,把握国内外、军地护理学及相关教育标准的研究现状和发展趋势。获取国内外、军地有关护理学以及医学的教育标准,并在此基础上对标准的内涵、结构和性质进行梳理和分析。
     2.对美国护理教育认证体系开展个案研究,包括了解美国护理教育的认证发展史、对教育标准开展内容分析和层次分析、认证机构的横向比较和历年标准的纵向比较,从而了解国际先进水平的教育标准研究趋势和特点。
     3.通过比较研究,筛选军队护理人才专业素质及专业建设中所需的特有指标。
     4.通过理论研究和专家工作会议,构建军队护理人才素质质量结构理论模型和军队院校护理学专业建设结构理论模型及军队院校护理学专业认证模型。
     5.通过专家咨询,修订、完善《军队院校护理学专业教育标准》。
     结果:
     1.界定了研究的相关概念,总结归纳了教育标准的类型、功能,搜集、分析了国际上现有的护理及相关权威标准。
     2.全面了解、分析了美国护理学专业认证体制。包括认证宗旨、发展史。其中认证组织具有数量多、发展专业化的特点;教育标准既有针对学校办学过程的过程标准又有针对毕业生质量的本质标准,并朝着宏观、灵活的趋势发展。认证程序都注意充分发挥院校的自主权和教学质量的持续改进。认证费用支出明确,可以避免铺张浪费、虚假歪风等事件的发生。
     3.总结、分析得出目前教育标准的研究方法具有以下共同点:①由专门的机构组织人员承担标准的构建;②方法学上均使用了文献研究和专家咨询。③注重代表不同利益人群的公众意见的征集。
     4.对《本科医学教育标准—临床医学专业(试行)》和《普通高等学校本科教学工作水平评估方案(试行)》的内容进行比较研究,理解和明确教育标准的定位和标准制定的粗细程度;对《军队院校本科教学工作评价方案》和《普通高等学校本科教学工作水平评估方案(试行)》的评估指标进行系统比较研究,解析出军队教学评估所特有的领域和指标;对军队和地方院校的护理人才培养目标进行比较研究,得出军队院校在各层次护理人才培养上所特有的态度、知识和技能等方面的要求;分析未来高新技术战争对军队卫勤保障和护理提出的新要求,结合有关伊拉克战争、海湾战争、越南战争等有关军队护士战争救护的文献报道,得出战争对军队护理人才专业素质提出的特殊要求。
     5.从教育的概念研究出发结合文献研究,提出了本研究的教育4要素说:教育目的、教育者、受教育者和教育资料;明确了4要素之间的内在联系,从而得出护理学专业建设中涉及的基本领域。
     6.以布卢姆的教育目标分类理论和斯塔弗尔姆的“CIPP”教育评价模式理论为指导,借鉴前期相关研究成果,构建完成了“军队护理人才专业素质质量结构理论模型”和“军队院校护理学专业建设要素结构理论模型”。
     7.在理论研究和专家会议的基础上,确立了教育标准构建的原则,完成《军队院校护理学专业教育标准》(征求意见稿)的撰写,并通过专家咨询进行了修订。
     结论:
     1.本研究总结、分析了国际上现有的护理及医学的教育标准,包括其内容、性质、功能以及建构程序与方法,为我国护理及其他专业教育标准的构建提供了内容和方法学的参考,有利于推动我国护理教育与国际护理接轨。
     2.本研究构建的军队院校护理学专业教育标准体系,具有突出军队需求,强化专业特色,彰显分类指导的功能,具有一定的科学性和实用性,将为我军护理学专业认证体系的开展奠定良好的基础。
     3.本研究构建了一套涵盖军队院校专、本、硕、博四个层次的完整的教育标准体系,为军校护理学专业不同层次的办学定位、人才培养和分层认证提供了科学依据,也为今后我国各层次护理学教育标准的构建提供良好的借鉴。
     4.今后应以标准为起点,积极开展军队院校专业认证体系的构建。对认证体系的构建有以下几点思考:以法律为框架,规范认证活动;以理论研究为先导,指引认证实践;以标准为依据,筛选认证指标;以中介组织为平台,健全认证机构;以认证方案为指导,实施认证活动。
Objective
     The theoretical model of army nurse'quality and the theoretical model of nursing specialty construction in military university with the prominent character of army competence was developed in order to meet the requirement of modern high and new technology war. Then, nursing education standards with good applicability in army was developed on the basis of the two models mentioned above. These standards which covered all programs ran by military colleges will help to improve the performance of nursing training in military colleges effectively.
     Methods
     1. Literature research was used to master the current state and trend of research about nursing and related education standards in and abroad, army and civilian. Nursing and medical education standards were collected and analyzed from the content, structure and nature.
     2. Case research was used to study the US educational accredited system, which help us to catch up the research trend and characters of nursing education standards in international high level. Research content was as follow:access to the development history of nursing educational accreditation in US. Content analysis and the level analysis were used in the study of education standards. Comparative study was used to compare various accredited organizations in parallel way and standards of different years in vertical way.
     3. Comparative study was used to fill out the special indicators of nursing talent quality and specialty construction in military schools.
     4. Theoretical study and expert panel meeting were held to develop the theoretical model of army nurse'quality, the theoretical model of nursing specialty construction in military university and the specialty accreditation model for military colleges.
     5. Nursing Educational Standards for Military colleges were improved by the Delphi study.
     Results
     1. Mainly concepts in the research were defined. The types and function of the standards was summarized. Authoritative nursing and related standards were collected and analyzed.
     2. Make out and analysis the US accreditation system all-around including the aim and history of accreditation. We found that the accredited organizations were large in mount and with highly special characters in the development. The education standards could be divided into two types:one is used to evaluate the competence of students, the other is used to evaluate the quality of programs. Besides, these standards were developed in the macro and flexible way. The autonomy of the colleges and consistent quality improvement were caused attention in the accreditation procedure. The detailed and clear fee for accreditation would help to avoid the accidence of extravagance, waste and forgery.
     3. The common character of research methods for education standards was summarized and analyzed:①People from professional organizations were asked to undertake the task of standard development.②Literature study and experts consultation were the common used methods.③ollection and assimilation of public comment from different interest body was important.
     4. Chinese standard of the medical education—clinical medicine programs(trail) and Educational assessment for bachelor programs in civil colleges and universities (trail) was compared to find out the position of the education standard and the detail level of content for the standard developing. The indicators of Educational assessment for bachelor programs in military colleges and universities(trail) and Educational assessment for bachelor programs in civil colleges and universities (trail) was compared systematically to know the areas and indicators that were required particular by army. The training objective of nursing talents in military and civilian colleges was compared to find out the value, knowledge and abilities that were required particular by army. The particular requirement for army nurses by war was concluded mainly from the analysis of the new requirements for military health service and nursing by high and new technology war in the future. Beside, the literature study about the nursing in the war of Iraq, gulf and Vietnam was another resource.
     5. Four elements of education including aim, educators, educatee and materials, were proposed on the basis of literature study of the concept of pedagogy. Then, the relationship between four elements was explicated. At last, the basic areas of nursing specialty construction were obtained.
     6. The theoretical model of army nurse'quality and the theoretical model of nursing specialty construction in military university were developed by using Bloom's classification of educational objectives, Stufflebeam's CIPP Evaluation Model and the current research achievements made by our project team.
     7. The principles for the education standard construction were established on the basis of theoretical study and the expert panel meeting. Then, Nursing Educational Standards for Military colleges(a draft for discussion) was explored and improved by expert consultation.
     Conclusion
     1. In this study, the content, function, procedure and methods for construction of international nursing and medical education standards were summarized and analyzed, which can provide the reference for China to establish the nursing educational standards as well as other special educational standards and promote nursing education in China into line with the international nursing education.
     2. In this study, the system of military educational standards has the advances as follow:the military requirement is outstanding, nursing character is emphasized, the function of guidance is played in different level. Above all, the standard is scientific and practical, which will lay the foundation for the running of nursing accredited system in military.
     3. The whole system of educational standards developed in this study, including associate, bachelor, master and doctor programs, provides scientific basis for military nursing schools or department to decide the position of programs, talents training, and accreditation of different programs. Besides, the standards also offer the references to set up Chinese nursing educational standards for various programs.
     4. The accredited system of specialty for military universities needs to be constructed on the basis of the standards actively in the future. There are several suggestions for the system construction:first, accredited activities should be regulated by the law. Second, accredited activities should be carried out under the direction of theory. Third, accredited indicators should be developed in accordance with the standards. Forth, medium organization should be established to complete the accredited organizations. Fifth, accredited activities should be implemented in line with the accreditedplan.
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