临床护理教学中循证理念和基本能力的培养
|
摘要
目的:探讨临床实习期间培养护理本科生循证护理基本知识和技能的有效教学策略。
方法:第一阶段通过自行设计的循证知信行问卷调查不同层次护理专业学生的循证基本知识、态度和信念以及循证实践行为水平,并分析其可能的影响因素。第二阶段将其中的80名护理本科临床实习学生以学校为整体组成15个学习小组,首先通过研究组编写的学习资料包和学习目标的提示,借助网络图书馆等资源,与同伴合作,对循证护理的基本知识和实践方法进行自主学习。之后借鉴文献评价的方法指南和实例,对指定科研文献开展评价,重点培养证据评鉴能力,并在WORKSHOP讨论会中汇报交流。通过问卷比较学生学习前后循证知信行水平差别,并反馈学习效果。
结果:
1.在理论分值为8-24,14-42,8-24范围内,目前临床实习护生循证护理相关知识、态度和信念、行为各维度的平均得分分别为10.85、34.34、10.84。
2.普通本科护生循证知识水平高于大专护生,其态度信念水平高于中专自考本科护生。既往的循证护理培训经历是现阶段循证知识和行为水平的积极因素,而既往的循证护理实践经历也是循证知识水平的积极影响因素。
3.循证学习项目开展后,本科护生的循证护理知识、循证态度和信念、循证实践行为自评得分均有显著提高(t=-11.64, -4.24, -8.95, P<0.01)。
4. 72名(97.3%)学生对学习过程持满意或基本满意态度。对开展文献评价活动的WORKSHOP满意度高于自我导向学习策略(χ2=4.5709, P<0.05)。学习者报告在分析解决问题能力、自主学习能力、团队合作能力、实证观念和科研能力方面达到提高的人数分别都超过了90%;而有显著提高的比率则分别达到31.1%,45.9%,44.6%,27.0%和24.3%。
5.超过半数的学习者(n=43, 58.1%)认为最佳学习途径应该是在临床实践中学习,而在学习过程中遇到的主要障碍是缺乏文献检索、评价等学习技巧(n=37, 50%)。
结论:
1.现阶段我国护理专业学生的循证基本知识技能和循证实践行为缺乏,但循证态度信念较积极。
2.普通本科护生循证基础知识水平最高,态度信念最积极,是开展循证学习的最适宜人群。应根据其能力基础确定适合的循证学习方案,重点开展循证培训。同时通过持续学习循证知识和开展循证护理实践来逐步建立临床工作中以实证为依据的护理行为习惯。
3.采用自我导向学习和WORKSHOP策略有利于帮助学生培养循证护理的基本能力,并在学习过程中促进自主学习能力、交流沟通技巧和团队合作精神等综合素质的提高,应加以借鉴推广。
4.建议在加强本科护生循证基本知识和能力培养的基础上,继续拓展循证学习内容,深入了解证据的内涵和等级系统,并通过加强临床护理师资人员的循证素质和能力培养,积极引导学生,师生配合促进证据在临床实践中的应用。
Objective To explore appropriate learning strategies to equip undergraduate nursing students with basic knowledge and skills and foster positive attitudes toward evidence-based practice (EBP) during their clinical practicum.
Methods During the first stage, the perceived EBP basic knowledge, attitude and behavior levels of all the nursing students practicing in the same hospital were investigated through a self-designed questionnaire and possible influencing factors were analyzed as well. In the second stage, a total of 80 undergraduate nursing students were recruited and divided into 15 groups to learn the basic knowledge of Evidence-Based Nursing (EBN) at first through a self-directed learning (SDL) approach with the help of a package of learning materials. Clinical preceptors and peer students played roles of facilitators and internet and library resources were utilized. Then students in the same group cooperate together for the purpose of learning how to critically evaluate research evidence with a research report evaluation guideline and literature appraisal examples as reference. They also made a presentation and had an in-depth discussion of their research evaluation report by means of workshop. The outcomes were evaluated through questionnaires to compare EBP competencies before and after the learning process and satisfaction and feedback were surveyed as well.
Results
1. The theoretical score range of EBP related knowledge, attitude and belief, and behavior were 8-24, 14-42, 8-24 and the mean scores clinical nursing students achieved were 10.85、34.34、10.84 respectively.
2. Multivariate analysis showed that educational background was the influencing factors of evidence-based knowledge level as well as attitude and belief of nursing students. The undergraduate nursing students had the highest level of EBN related knowledge and attitude. Previous experience of EBN training was a positive factor of the level of evidence-based knowledge and behavior at this stage, while previous experience of evidence-based practice was a positive influencing factor of current EBN related knowledge.
3. Statistically significant differences in the mean scores of EBP knowledge, attitude and belief, and behavior (t=-11.64, t=-4.24, t=-8.95, P<0.001) levels were found after students participated in the learning program.
4. A total of 72 participants (97.3%) showed some or complete satisfaction with the learning strategies and statistical difference (χ2=4.5709, P<0.05) and more satisfaction with workshop were shown in addition. More than 90% of the participants found improvement in analytical and problem-solving ability, independent learning ability, cooperative and communication ability, evidence-based conception and scientific research ability, among which the proportions for obvious improvement were 31.1%, 45.9%, 44.6%, 27.0% and 24.3% respectively.
5. More than half of the students (n=43, 58.1%) thought learn EBP in clinical practice as the best way to learn, while the primary barrier during learning process was a lack of literature retrieval and evaluation skills (n=37, 50%).
Conclusions
1. Although nursing students have positive attitudes and confidence about EBP, there remains a substantial gap in knowledge and practice level.
2. The undergraduate nursing students are the most appropriate people for EBP training. The evidence-based learning plan should be based on their competencies and we need provide more opportunities for their EBP training. Meanwhile, through continuous learning of EBN knowledge and implementing evidence-based practice they can gradually base nursing care on evidence in clinical work.
3. This study provides evidence that a learning program through the SDL and workshop strategies can effectively equip undergraduate nursing students with beginning competencies in EBP. Meanwhile, their independent learning abilities, cooperative and communicative skills were improved as well.
4. It is implicated the learning program may be extended to assist students gain an insight into the essence and hierarchy of evidence for EBP and more opportunities should be provided for clinical utilization of evidence in the future through strengthening and improving the evidence-based qualities and competencies of clinical preceptors.
方法:第一阶段通过自行设计的循证知信行问卷调查不同层次护理专业学生的循证基本知识、态度和信念以及循证实践行为水平,并分析其可能的影响因素。第二阶段将其中的80名护理本科临床实习学生以学校为整体组成15个学习小组,首先通过研究组编写的学习资料包和学习目标的提示,借助网络图书馆等资源,与同伴合作,对循证护理的基本知识和实践方法进行自主学习。之后借鉴文献评价的方法指南和实例,对指定科研文献开展评价,重点培养证据评鉴能力,并在WORKSHOP讨论会中汇报交流。通过问卷比较学生学习前后循证知信行水平差别,并反馈学习效果。
结果:
1.在理论分值为8-24,14-42,8-24范围内,目前临床实习护生循证护理相关知识、态度和信念、行为各维度的平均得分分别为10.85、34.34、10.84。
2.普通本科护生循证知识水平高于大专护生,其态度信念水平高于中专自考本科护生。既往的循证护理培训经历是现阶段循证知识和行为水平的积极因素,而既往的循证护理实践经历也是循证知识水平的积极影响因素。
3.循证学习项目开展后,本科护生的循证护理知识、循证态度和信念、循证实践行为自评得分均有显著提高(t=-11.64, -4.24, -8.95, P<0.01)。
4. 72名(97.3%)学生对学习过程持满意或基本满意态度。对开展文献评价活动的WORKSHOP满意度高于自我导向学习策略(χ2=4.5709, P<0.05)。学习者报告在分析解决问题能力、自主学习能力、团队合作能力、实证观念和科研能力方面达到提高的人数分别都超过了90%;而有显著提高的比率则分别达到31.1%,45.9%,44.6%,27.0%和24.3%。
5.超过半数的学习者(n=43, 58.1%)认为最佳学习途径应该是在临床实践中学习,而在学习过程中遇到的主要障碍是缺乏文献检索、评价等学习技巧(n=37, 50%)。
结论:
1.现阶段我国护理专业学生的循证基本知识技能和循证实践行为缺乏,但循证态度信念较积极。
2.普通本科护生循证基础知识水平最高,态度信念最积极,是开展循证学习的最适宜人群。应根据其能力基础确定适合的循证学习方案,重点开展循证培训。同时通过持续学习循证知识和开展循证护理实践来逐步建立临床工作中以实证为依据的护理行为习惯。
3.采用自我导向学习和WORKSHOP策略有利于帮助学生培养循证护理的基本能力,并在学习过程中促进自主学习能力、交流沟通技巧和团队合作精神等综合素质的提高,应加以借鉴推广。
4.建议在加强本科护生循证基本知识和能力培养的基础上,继续拓展循证学习内容,深入了解证据的内涵和等级系统,并通过加强临床护理师资人员的循证素质和能力培养,积极引导学生,师生配合促进证据在临床实践中的应用。
Objective To explore appropriate learning strategies to equip undergraduate nursing students with basic knowledge and skills and foster positive attitudes toward evidence-based practice (EBP) during their clinical practicum.
Methods During the first stage, the perceived EBP basic knowledge, attitude and behavior levels of all the nursing students practicing in the same hospital were investigated through a self-designed questionnaire and possible influencing factors were analyzed as well. In the second stage, a total of 80 undergraduate nursing students were recruited and divided into 15 groups to learn the basic knowledge of Evidence-Based Nursing (EBN) at first through a self-directed learning (SDL) approach with the help of a package of learning materials. Clinical preceptors and peer students played roles of facilitators and internet and library resources were utilized. Then students in the same group cooperate together for the purpose of learning how to critically evaluate research evidence with a research report evaluation guideline and literature appraisal examples as reference. They also made a presentation and had an in-depth discussion of their research evaluation report by means of workshop. The outcomes were evaluated through questionnaires to compare EBP competencies before and after the learning process and satisfaction and feedback were surveyed as well.
Results
1. The theoretical score range of EBP related knowledge, attitude and belief, and behavior were 8-24, 14-42, 8-24 and the mean scores clinical nursing students achieved were 10.85、34.34、10.84 respectively.
2. Multivariate analysis showed that educational background was the influencing factors of evidence-based knowledge level as well as attitude and belief of nursing students. The undergraduate nursing students had the highest level of EBN related knowledge and attitude. Previous experience of EBN training was a positive factor of the level of evidence-based knowledge and behavior at this stage, while previous experience of evidence-based practice was a positive influencing factor of current EBN related knowledge.
3. Statistically significant differences in the mean scores of EBP knowledge, attitude and belief, and behavior (t=-11.64, t=-4.24, t=-8.95, P<0.001) levels were found after students participated in the learning program.
4. A total of 72 participants (97.3%) showed some or complete satisfaction with the learning strategies and statistical difference (χ2=4.5709, P<0.05) and more satisfaction with workshop were shown in addition. More than 90% of the participants found improvement in analytical and problem-solving ability, independent learning ability, cooperative and communication ability, evidence-based conception and scientific research ability, among which the proportions for obvious improvement were 31.1%, 45.9%, 44.6%, 27.0% and 24.3% respectively.
5. More than half of the students (n=43, 58.1%) thought learn EBP in clinical practice as the best way to learn, while the primary barrier during learning process was a lack of literature retrieval and evaluation skills (n=37, 50%).
Conclusions
1. Although nursing students have positive attitudes and confidence about EBP, there remains a substantial gap in knowledge and practice level.
2. The undergraduate nursing students are the most appropriate people for EBP training. The evidence-based learning plan should be based on their competencies and we need provide more opportunities for their EBP training. Meanwhile, through continuous learning of EBN knowledge and implementing evidence-based practice they can gradually base nursing care on evidence in clinical work.
3. This study provides evidence that a learning program through the SDL and workshop strategies can effectively equip undergraduate nursing students with beginning competencies in EBP. Meanwhile, their independent learning abilities, cooperative and communicative skills were improved as well.
4. It is implicated the learning program may be extended to assist students gain an insight into the essence and hierarchy of evidence for EBP and more opportunities should be provided for clinical utilization of evidence in the future through strengthening and improving the evidence-based qualities and competencies of clinical preceptors.
引文
1. Ingersoll GL. Evidence-based nursing: what it is and what it isn’t[J]. Nursing Outlook, 2000, 48(4): 151-152.
2.李晓玲,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(5): 389-391.
3.胡雁,李晓玲.循证护理的理论与实践[M].上海:复旦大学出版社. 2007: 12-13, 18.
4. Kitson A. The state of the art and science of evidence-based nursing in UK and Europe[J]. Worldviews Evid Based Nurs, 2004, 1(1): 6-8.
5.陈耀龙,沈建通,李琳,等.循证医学术语介绍IV[J].中国循证医学杂志, 2009, 9(4): 376-383.
6. MeSH Database. National Center for Biotechnology Information, U.S. National Library of Medicine[EB/OL]. [2010-12-01]. http://www.ncbi.nlm.nih.gov/mesh?term=evidence-based%20nursing
7.陈耀龙,艾昌林,李幼平.“循证”冠名的医学期刊比较研究[J].中国循证医学杂志, 2007,7(4): 289~295.
8. Greiner A., Knebel E. Health professions education: A bridge to quality[M]. Washington, DC: National Academies Press. 2003: 46.
9. Fineout-Overholt EL, Johnston L. Teaching EBP: a challenge for educators in the
21st century[J]. Worldviews Evid Based Nurs, 2005, 2(1): 37-39.
10.王艳,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(1): 4-6.
11.朱丹,成翼娟,龚姝.循证护理学[J].护士进修杂志, 2003, 18(2): 102-105.
12.谷波,张骏,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(3): 197-199.
13.宋锦平,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(4): 292-293.
14.侯晓静,徐丽华.“循证”冠名的中国护理文献发表现状分析[J].中国循证医学杂志, 2007,7(7): 542~546.
15.曾国艳,杨青,梁金清,等.临床护理人员循证认知和实践状况的调查研究[J].护士进修杂志, 2009, 24(20): 1885-1887.
16.矫海莲,胡雁,曹育玲,等.上海地区本科及以上临床护理人员循证护理认知现状及相关因素的调查[J].护理研究, 2009, 23(7A): 1693-1697.
17.安力彬,张秀英,李文涛.中国循证护理的发展研究检索分析[J].护士进修杂志, 2009, 24(7): 593-595.
18.龙莉艳,张磊,张桂云,等.护理人员信息行为研究[J].护理管理杂志, 2007, 7(2): 36-37.
19.王斌全,李洁.循证护理的发展[J].护理研究, 2007, 21(5A): 1221.
20.苏茜,王维利,李惠萍.国内有关系统评价的护理文献分析[J].护理学报, 2008, 15(6): 14-17.
21. Thiel L, Ghosh Y. Determining registered nurses' readiness for evidence-based practice[J]. Worldviews Evid Based Nurs, 2008, 5(4): 182-92.
22.朱叶卉,刘晓华.循证护理实践障碍因素及对策[J].现代临床护理, 2009, 8(8): 87-91.
23. Melnyk B M. Calling all educators to teach and model evidence-based practice in academic settings[J]. Worldviews Evid Based Nurs, 2006, 3(3): 93-94.
24.蒋志娟,周琪范,?周琦,等.高等护理教育开展循证护理教学的现状与对策[J].解放军护理杂志,?2007,?24(11B):?68-69.
25.崔洁.护理本科生循证护理认知现状调查[J].全科护理, 2009, 7(6): 478-479.
26.胡静,张艳芬.本科护生循证护理学习期望的调查分析[J].护理学杂志, 2009, 24(2): 64-65.
27. Fineout-Overholt E, Melnyk BM, Schultz A.Transforming health care from the inside out: advancing evidence-based practice in the 21st century[J]. J Prof Nurs, 2005, 21(6): 335-344.
28. Melnyk BM. The evidence-based practice mentor: a promising strategy for implementing and sustaining EBP in healthcare systems[J]. Worldviews Evid Based Nurs, 2007, 4(3): 123-125.
29. Schmidt N A, Brown J M. Use of the innovation-decision process teaching strategy to promote evidence-based practice[J]. J Prof Nurs, 2007, 23(3): 150-156.
30. Fineout-Overholt E, Stillwell S B, Kent B. Teaching EBP through problem-based learning[J]. Worldviews Evid Based Nurs, 2008, 5(4): 205-207.
31. Hart P, Eaton L A, Buckner M., et al. Effectiveness of a computer-based educational program on nurses' knowledge, attitude, and skill level related to evidence-based practice[J]. Worldviews Evid Based Nurs, 2008, 5(2): 75-84.
32. Kim S C, Brown C E, Fields W, et al. Evidence-based practice-focused interactive teaching strategy: a controlled study[J]. J Adv Nurs, 2009, 65(6): 1218-1227.
33.蒋运兰,余阳燊,王芳,等.高等护理专业不同时期开设循证护理教学的效果比较[J].护理研究, 2006, 20(11A): 2852-2853.
34.陈华英,余华琴,贺莉.循证护理教育对培养临床护生评判性思维能力的作用[J].中国循证医学杂志, 2009, 9(1): 34-36
35.孟清,胡定伟,吴玉琼,等.循证护理教育在本科实习护生教学查房中的实践[J].护士进修杂志, 2008, 23(11): 1002-1004
36.周明芳,李巍,舒勤,等.开设循证护理学的教学实践与思考[J].护理研究, 2005, 19(7A): 1210-1211.
37.缪群芳,许毅.护生在循证护理临床实践中存在的问题和思考[J].护士进修杂志, 2006, 21(7): 639-640.
38.严谨,欧阳冬生,陶新陆,等.循证护理教学及效果评价[J].中华护理杂志, 2004, 39(3): 224-225.
39. Levett-Jones TL. Self-directed learning: implications and limitations for undergraduate nursing education[J]. Nurse Educ Today, 2005, 25(5): 363-368.
40.刘建平.循证护理学方法与实践[M].北京:科学出版社, 2007: 111-115.
41. Bradley P, Oterholt C, et al. Comparison of directed and self-directed learning in evidence-based medicine: a randomised controlled trial[J]. Med Educ, 2005, 39(10): 1027-1035.
42. Zadvinskis I M. Increasing knowledge level of evidence-based nursing through self-directed learning: lessons learned for staff development[J]. J Nurses Staff Dev, 2008, 24(4): E13-E19.
43. Johnston L, Fineout-Overholt E. Teaching EBP: the critical step of critically appraising the literature[J]. Worldviews Evid Based Nurs, 2006, 3(1):44-46.
44. Krainovich-Miller B, Haber J, Yost J, et al. Evidence-based practice challenge: teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students[J]. J Nurs Educ, 2009, 48(4):186-195.
45. Johnston JM, Leung GM, et al. The development and validation of a knowledge, attitude and behaviour questionnaire to assess undergraduate evidence-based practice teaching and learning[J]. Med Educ, 2003, 37(11): 992-1000.
46.仇玉兰,张静.研究生循证医学教学效果评估[J].上海交通大学学报·医学版, 2008, 28(B11): 40-42.
47. Fineout-Overholt EL, Johnston L. Teaching EBP: asking searchable, answerable clinical questions[J]. Worldviews Evid Based Nurs, 2005,2(3): 157-160.
48.张洪,廖少玲,邱锡坚,等.护理干预对妊高症住院患者睡眠质量及血压的影响[J].护理学杂志, 2009,24(16):45-47.
49.皮慧敏,魏莉,郑元梅.延迟小结追加反馈对基础护理操作技能学习的影响[J].护理学杂志, 2009,24(17):5-7.
50.汪小冬,高音,朱建英.脊柱侧凸患者对不同牵引方法依从性的比较研究[J].护理学杂志, 2009,24(18):21-23.
51.王菊吾,严林娟,钱君,等.护士对病人实施关怀照护的效果研究[J].中华护理杂志, 2005, 40(8): 561-563.
52.肖顺贞.护理研究(第3版)[M].北京:人民卫生出版社, 2006:140-147, 162-174.
53.段丽娟,蒋晓莲.循证护理:护理教育发展的机遇和挑战[J].护理研究, 2008, 22(5A): 1129-1131.
54.邓甲秀,应燕萍,黄惠桥.循证护理在培养护理本科学生评判性思维中的应用[J].中华护理教育, 2010, 7(3): 122-124.
55.朱云,田萍,王梅新.新疆护理本科生对循证护理知晓状况分析与对策[J].护理实践与研究, 2009, 6(24): 123-125.
56.周清.从以服务为宗旨、以就业为导向、以岗位需求为标准看护理专业课程设置[J].卫生职业教育, 2009, 27(9): 74-75.
57. Heye M L, Stevens K R. Using new resources to teach evidence-based practice[J].J Nurs Educ, 2009, 48(6): 334-339.
58.周丽萍,陈进,艾昌林,等.循证医学教学对研究生相关知识、技能、态度和行为的影响研究[J].中国循证医学杂志, 2007, 7(5): 337-343.
59. Varnell G., Haas B, Duke G, et al. Effect of an educational intervention on attitudes toward and implementation of evidence-based practice[J]. Worldviews Evid Based Nurs, 2008, 5(4): 172-181.
60.齐炜炜,刘晓华.护理人员循证护理实践基本素质构成及研究现状[J].现代临床护理, 2009, 8(8): 92-95.
61.嵇艳,崔焱.护理人员循证实践基本素质构成的研究[J].中国实用护理杂志, 2007, 23(2B): 6-8.
62.周西,李领侠,马淑霞,等. Meta分析法在我国护理科研中的应用现状[J].护理学杂志,?2009,?24(2):?77-79.
63. Bonnel, W. Sharing the evidence, adding our clinical wisdom[J]. J Gerontol Nurs, 2009, 35(5): 3-4.
64.蒋志娟,周琦,周琪范,等.《护理学基础》教学中应用循证护理的研究[J].护士进修杂志, 2008, 23(13): 1171~1172.
65.林毅,姜安丽.自我导向学习及其在护理教育中的应用[J].解放军护理杂志, 2003, 20(2): 44-46.
66.韩继明,王亚飞,薛继红.循证护理在护理教学中的运用现状[J].护理管理杂志, 2006, 6(3): 16.
67. Russell SS. An overview of adult-learning processes[J]. Urol Nurs, 2006, 26(5): 349-352, 370.
68.袁秋环,雷晓玲,高静静,等.本科护生学业自我效能感、成就动机与自主学习能力的关系[J].护理学杂志, 2008, 23(3): 48-51.
69.王伟,程云,袁浩斌,等.护理实习生自主学习准备度及影响因素分析[J].中华护理杂志, 2010, 45(4): 355-357.
70.王平,王勤,肖烈虹.大专护生自我导向学习技能的影响因素研究[J].护理管理杂志, 2005, 5(2): 19-21.
71.王艳.循证护理与护理教育[J].护士进修杂志, 2005, 20(12): 1087-1088.
72.李昌茂,赵春娟.成人高等护理教育与循证护理新理念[J].护理研究, 2009, (6A): 1415-1416.
73. Smith-Str?m H, Nortvedt MW. Evaluation of evidence-based methods used to teach nursing students to critically appraise evidence [J]. J Nurs Educ, 2008, 47(8): 372-375.
74. Grace JT, Powers BA. Claiming our core: appraising qualitative evidence for nursing questions about human response and meaning[J]. Nurs Outlook, 2009, 57(1): 27-34.
75.朱莲莲,高丽红.国内质性研究的护理文献分析[J].护理学杂志, 2009, 24(11): 79-81.
76.钟玉杰,段明娟,钟秋.护理本科生循证护理认知现状调查[J].护理研究, 2008, 22(12B): 3211-3213.
77. Moch, SD, Cronje RJ. New knowledge discussion groups: counteracting the common barriers to evidence-based practice[J]. Worldviews Evid Based Nurs, 2007, 4(2): 112-115.
78. Stone C, Rowles C J. Nursing students can help support evidence-based practice on clinical nursing units[J]. J Nurs Manag, 2007, 15(3): 367-370.
1. Melnyk BM, Fineout-Overholt E, Stetler C, et al. Outcomes and implementation strategies from the first U.S. Evidence-Based Practice Leadership Summit[J]. Worldviews Evid Based Nurs, 2005, 2(3): 113-121.
2.李晓玲,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(5): 389-391.
3.李玉梅,王敏,胡敏.我国临床实践中循证护理的运用情况与影响因素分析[J].护士进修杂志, 2007, 22(11): 981-983.
4.曾国艳,杨青,梁金清,等.临床护理人员循证认知和实践状况的调查研究[J].护士进修杂志, 2009, 24(20): 1885-1887.
5.矫海莲,胡雁,曹育玲,等.上海地区本科及以上临床护理人员循证护理认知现状及相关因素的调查[J].护理研究, 2009, 23(7A): 1693-1697.
6.蒋志娟,周琪范,周琦,等.高等护理教育开展循证护理教学的现状与对策[J].解放军护理杂志, 2007, 24(11B): 68-69.
7. Fineout-Overholt E, Melnyk B M, Schultz A. Transforming health care from the inside out:advancing evidence-based practice in the 21st century[J]. J Prof Nurs, 2005, 21(6): 335-344.
8. Melnyk B M. Calling all educators to teach and model evidence-based practice in academic settings[J]. Worldviews Evid Based Nurs, 2006, 3(3): 93-94.
9.朱云,田萍,王梅新.新疆护理本科生对循证护理知晓状况分析与对策[J].护理实践与研究, 2009, 6(24): 123-125
10.李秀娥,李文秀,李英英.读书研讨会在循证护理中的应用[J].护士进修杂志, 2005, 20(1): 74-75.
11.许勤,王婷,宋燕波.以科室为单位强化ICU护士呼吸机相关性肺炎循证护理培训[J].中华护理杂志, 2010, 45(4): 317-320.
12.李亚洁,蔡文智,李瑛,等.护理人员循证护理认知现状调查与启示[J].中华护理杂志, 2004, 39(8): 627—629.
13.侯晓静,徐丽华.“循证”冠名的中国护理文献发表现状分析[J].中国循证医学杂志, 2007, 7(7): 542~546.
14.朱小翠.循证护理在急性心肌梗死病人护理中的应用[J].护理实践与研究, 2010, 7(4): 42-43.
15.祁丽艳,郭春萍.妇科恶性肿瘤化疗患者循证护理的实践[J].国际护理学杂志, 2009, 28(10): 1394-1395.
16.管敬东.腹腔镜全结直肠切除术患者的循证护理[J].护理学杂志, 2010, 25(4): 22-24.
17.张小燕,吴婉玲,苏永静,等.循证护理方法在护理人员评判性思维能力培养中的应用[J].中华护理教育, 2009, 6(4): 156-158.
18.安力彬,张秀英,李文涛.中国循证护理的发展研究检索分析[J].护士进修杂志, 2009, 24(7): 593-595
19. Strickland, R. J. and C. O'Leary-Kelley. Clinical nurse educators' perceptions of research utilization: barriers and facilitators to change. J Nurses Staff Dev 2009, 25(4): 164-171.
20.朱叶卉,刘晓华.循证护理实践障碍因素及对策[J].现代临床护理, 2009, 8(8): 87-91
21.龙莉艳,张磊,张桂云,等.护理人员信息行为研究[J].护理管理杂志, 2007, 7(2):
36-37.
22. McConnell, E. S., D. Lekan, et al. Teaching evidence-based nursing practice in geriatric care settings: the geriatric nursing innovations through education institute[J]. J Gerontol Nurs, 2009, 35(4): 26-33.
23.胡雁,李晓玲.循证护理的理论与实践[M].上海:复旦大学出版社. 2007:90-92.
24. Melnyk B M, Fineout-Overholt E, Feinstein N F, et al. Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift[J]. Worldviews Evid Based Nurs 2004, 1(3): 185-193.
25. Alan Pearson,胡雁.循证护理的实践模式[J].护士进修杂志, 2009, 24(14): 1251-1254.
26.蒋运兰,余阳燊,王芳,等.高等护理专业不同时期开设循证护理教学的效果比较[J].护理研究, 2006, 20(11A): 2852-2853.
27.陈华英,余华琴,贺莉.循证护理教育对培养临床护生评判性思维能力的作用[J].中国循证医学杂志, 2009, 9(1): 34-36.
28.孟清,胡定伟,吴玉琼,等.循证护理教育在本科实习护生教学查房中的实践[J].护士进修杂志, 2008, 23(11): 1002-1004
29.陈亚华,季晓鹏.“循证护理WORKSHOP”在本科护理教学中的实践[J].现代护理, 2006,12(1): 67~69.
30.张丽莉,乔秋阁,吴爱须,等.循证护理在本科生临床教学实践中的应用[J].护士进修杂志, 2005, 20(3): 258-260
31.周明芳,李巍,舒勤,等.开设循证护理学的教学实践与思考[J].护理研究, 2005, 19(7A): 1210-1211.
32.缪群芳,许毅.护生在循证护理临床实践中存在的问题和思考[J].护士进修杂志, 2006, 21(7): 639-640.
33.严谨,欧阳冬生,陶新陆,等.循证护理教学及效果评价[J].中华护理杂志, 2004, 39(3): 224-225.
34. de Cordova PB, Collins S, et al. Implementing evidence-based nursing with student nurses and clinicians: uniting the strengths[J]. Appl Nurs Res, 2008, 21(4): 242-245.
35. Stone C, Rowles C J. Nursing students can help support evidence-based practice on clinical nursing units[J]. J Nurs Manag, 2007, 15(3): 367-370.
36. Moch, SD, Cronje RJ. New knowledge discussion groups: counteracting the common barriers to evidence-based practice[J]. Worldviews Evid Based Nurs, 2007, 4(2): 112-115.
2.李晓玲,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(5): 389-391.
3.胡雁,李晓玲.循证护理的理论与实践[M].上海:复旦大学出版社. 2007: 12-13, 18.
4. Kitson A. The state of the art and science of evidence-based nursing in UK and Europe[J]. Worldviews Evid Based Nurs, 2004, 1(1): 6-8.
5.陈耀龙,沈建通,李琳,等.循证医学术语介绍IV[J].中国循证医学杂志, 2009, 9(4): 376-383.
6. MeSH Database. National Center for Biotechnology Information, U.S. National Library of Medicine[EB/OL]. [2010-12-01]. http://www.ncbi.nlm.nih.gov/mesh?term=evidence-based%20nursing
7.陈耀龙,艾昌林,李幼平.“循证”冠名的医学期刊比较研究[J].中国循证医学杂志, 2007,7(4): 289~295.
8. Greiner A., Knebel E. Health professions education: A bridge to quality[M]. Washington, DC: National Academies Press. 2003: 46.
9. Fineout-Overholt EL, Johnston L. Teaching EBP: a challenge for educators in the
21st century[J]. Worldviews Evid Based Nurs, 2005, 2(1): 37-39.
10.王艳,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(1): 4-6.
11.朱丹,成翼娟,龚姝.循证护理学[J].护士进修杂志, 2003, 18(2): 102-105.
12.谷波,张骏,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(3): 197-199.
13.宋锦平,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(4): 292-293.
14.侯晓静,徐丽华.“循证”冠名的中国护理文献发表现状分析[J].中国循证医学杂志, 2007,7(7): 542~546.
15.曾国艳,杨青,梁金清,等.临床护理人员循证认知和实践状况的调查研究[J].护士进修杂志, 2009, 24(20): 1885-1887.
16.矫海莲,胡雁,曹育玲,等.上海地区本科及以上临床护理人员循证护理认知现状及相关因素的调查[J].护理研究, 2009, 23(7A): 1693-1697.
17.安力彬,张秀英,李文涛.中国循证护理的发展研究检索分析[J].护士进修杂志, 2009, 24(7): 593-595.
18.龙莉艳,张磊,张桂云,等.护理人员信息行为研究[J].护理管理杂志, 2007, 7(2): 36-37.
19.王斌全,李洁.循证护理的发展[J].护理研究, 2007, 21(5A): 1221.
20.苏茜,王维利,李惠萍.国内有关系统评价的护理文献分析[J].护理学报, 2008, 15(6): 14-17.
21. Thiel L, Ghosh Y. Determining registered nurses' readiness for evidence-based practice[J]. Worldviews Evid Based Nurs, 2008, 5(4): 182-92.
22.朱叶卉,刘晓华.循证护理实践障碍因素及对策[J].现代临床护理, 2009, 8(8): 87-91.
23. Melnyk B M. Calling all educators to teach and model evidence-based practice in academic settings[J]. Worldviews Evid Based Nurs, 2006, 3(3): 93-94.
24.蒋志娟,周琪范,?周琦,等.高等护理教育开展循证护理教学的现状与对策[J].解放军护理杂志,?2007,?24(11B):?68-69.
25.崔洁.护理本科生循证护理认知现状调查[J].全科护理, 2009, 7(6): 478-479.
26.胡静,张艳芬.本科护生循证护理学习期望的调查分析[J].护理学杂志, 2009, 24(2): 64-65.
27. Fineout-Overholt E, Melnyk BM, Schultz A.Transforming health care from the inside out: advancing evidence-based practice in the 21st century[J]. J Prof Nurs, 2005, 21(6): 335-344.
28. Melnyk BM. The evidence-based practice mentor: a promising strategy for implementing and sustaining EBP in healthcare systems[J]. Worldviews Evid Based Nurs, 2007, 4(3): 123-125.
29. Schmidt N A, Brown J M. Use of the innovation-decision process teaching strategy to promote evidence-based practice[J]. J Prof Nurs, 2007, 23(3): 150-156.
30. Fineout-Overholt E, Stillwell S B, Kent B. Teaching EBP through problem-based learning[J]. Worldviews Evid Based Nurs, 2008, 5(4): 205-207.
31. Hart P, Eaton L A, Buckner M., et al. Effectiveness of a computer-based educational program on nurses' knowledge, attitude, and skill level related to evidence-based practice[J]. Worldviews Evid Based Nurs, 2008, 5(2): 75-84.
32. Kim S C, Brown C E, Fields W, et al. Evidence-based practice-focused interactive teaching strategy: a controlled study[J]. J Adv Nurs, 2009, 65(6): 1218-1227.
33.蒋运兰,余阳燊,王芳,等.高等护理专业不同时期开设循证护理教学的效果比较[J].护理研究, 2006, 20(11A): 2852-2853.
34.陈华英,余华琴,贺莉.循证护理教育对培养临床护生评判性思维能力的作用[J].中国循证医学杂志, 2009, 9(1): 34-36
35.孟清,胡定伟,吴玉琼,等.循证护理教育在本科实习护生教学查房中的实践[J].护士进修杂志, 2008, 23(11): 1002-1004
36.周明芳,李巍,舒勤,等.开设循证护理学的教学实践与思考[J].护理研究, 2005, 19(7A): 1210-1211.
37.缪群芳,许毅.护生在循证护理临床实践中存在的问题和思考[J].护士进修杂志, 2006, 21(7): 639-640.
38.严谨,欧阳冬生,陶新陆,等.循证护理教学及效果评价[J].中华护理杂志, 2004, 39(3): 224-225.
39. Levett-Jones TL. Self-directed learning: implications and limitations for undergraduate nursing education[J]. Nurse Educ Today, 2005, 25(5): 363-368.
40.刘建平.循证护理学方法与实践[M].北京:科学出版社, 2007: 111-115.
41. Bradley P, Oterholt C, et al. Comparison of directed and self-directed learning in evidence-based medicine: a randomised controlled trial[J]. Med Educ, 2005, 39(10): 1027-1035.
42. Zadvinskis I M. Increasing knowledge level of evidence-based nursing through self-directed learning: lessons learned for staff development[J]. J Nurses Staff Dev, 2008, 24(4): E13-E19.
43. Johnston L, Fineout-Overholt E. Teaching EBP: the critical step of critically appraising the literature[J]. Worldviews Evid Based Nurs, 2006, 3(1):44-46.
44. Krainovich-Miller B, Haber J, Yost J, et al. Evidence-based practice challenge: teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students[J]. J Nurs Educ, 2009, 48(4):186-195.
45. Johnston JM, Leung GM, et al. The development and validation of a knowledge, attitude and behaviour questionnaire to assess undergraduate evidence-based practice teaching and learning[J]. Med Educ, 2003, 37(11): 992-1000.
46.仇玉兰,张静.研究生循证医学教学效果评估[J].上海交通大学学报·医学版, 2008, 28(B11): 40-42.
47. Fineout-Overholt EL, Johnston L. Teaching EBP: asking searchable, answerable clinical questions[J]. Worldviews Evid Based Nurs, 2005,2(3): 157-160.
48.张洪,廖少玲,邱锡坚,等.护理干预对妊高症住院患者睡眠质量及血压的影响[J].护理学杂志, 2009,24(16):45-47.
49.皮慧敏,魏莉,郑元梅.延迟小结追加反馈对基础护理操作技能学习的影响[J].护理学杂志, 2009,24(17):5-7.
50.汪小冬,高音,朱建英.脊柱侧凸患者对不同牵引方法依从性的比较研究[J].护理学杂志, 2009,24(18):21-23.
51.王菊吾,严林娟,钱君,等.护士对病人实施关怀照护的效果研究[J].中华护理杂志, 2005, 40(8): 561-563.
52.肖顺贞.护理研究(第3版)[M].北京:人民卫生出版社, 2006:140-147, 162-174.
53.段丽娟,蒋晓莲.循证护理:护理教育发展的机遇和挑战[J].护理研究, 2008, 22(5A): 1129-1131.
54.邓甲秀,应燕萍,黄惠桥.循证护理在培养护理本科学生评判性思维中的应用[J].中华护理教育, 2010, 7(3): 122-124.
55.朱云,田萍,王梅新.新疆护理本科生对循证护理知晓状况分析与对策[J].护理实践与研究, 2009, 6(24): 123-125.
56.周清.从以服务为宗旨、以就业为导向、以岗位需求为标准看护理专业课程设置[J].卫生职业教育, 2009, 27(9): 74-75.
57. Heye M L, Stevens K R. Using new resources to teach evidence-based practice[J].J Nurs Educ, 2009, 48(6): 334-339.
58.周丽萍,陈进,艾昌林,等.循证医学教学对研究生相关知识、技能、态度和行为的影响研究[J].中国循证医学杂志, 2007, 7(5): 337-343.
59. Varnell G., Haas B, Duke G, et al. Effect of an educational intervention on attitudes toward and implementation of evidence-based practice[J]. Worldviews Evid Based Nurs, 2008, 5(4): 172-181.
60.齐炜炜,刘晓华.护理人员循证护理实践基本素质构成及研究现状[J].现代临床护理, 2009, 8(8): 92-95.
61.嵇艳,崔焱.护理人员循证实践基本素质构成的研究[J].中国实用护理杂志, 2007, 23(2B): 6-8.
62.周西,李领侠,马淑霞,等. Meta分析法在我国护理科研中的应用现状[J].护理学杂志,?2009,?24(2):?77-79.
63. Bonnel, W. Sharing the evidence, adding our clinical wisdom[J]. J Gerontol Nurs, 2009, 35(5): 3-4.
64.蒋志娟,周琦,周琪范,等.《护理学基础》教学中应用循证护理的研究[J].护士进修杂志, 2008, 23(13): 1171~1172.
65.林毅,姜安丽.自我导向学习及其在护理教育中的应用[J].解放军护理杂志, 2003, 20(2): 44-46.
66.韩继明,王亚飞,薛继红.循证护理在护理教学中的运用现状[J].护理管理杂志, 2006, 6(3): 16.
67. Russell SS. An overview of adult-learning processes[J]. Urol Nurs, 2006, 26(5): 349-352, 370.
68.袁秋环,雷晓玲,高静静,等.本科护生学业自我效能感、成就动机与自主学习能力的关系[J].护理学杂志, 2008, 23(3): 48-51.
69.王伟,程云,袁浩斌,等.护理实习生自主学习准备度及影响因素分析[J].中华护理杂志, 2010, 45(4): 355-357.
70.王平,王勤,肖烈虹.大专护生自我导向学习技能的影响因素研究[J].护理管理杂志, 2005, 5(2): 19-21.
71.王艳.循证护理与护理教育[J].护士进修杂志, 2005, 20(12): 1087-1088.
72.李昌茂,赵春娟.成人高等护理教育与循证护理新理念[J].护理研究, 2009, (6A): 1415-1416.
73. Smith-Str?m H, Nortvedt MW. Evaluation of evidence-based methods used to teach nursing students to critically appraise evidence [J]. J Nurs Educ, 2008, 47(8): 372-375.
74. Grace JT, Powers BA. Claiming our core: appraising qualitative evidence for nursing questions about human response and meaning[J]. Nurs Outlook, 2009, 57(1): 27-34.
75.朱莲莲,高丽红.国内质性研究的护理文献分析[J].护理学杂志, 2009, 24(11): 79-81.
76.钟玉杰,段明娟,钟秋.护理本科生循证护理认知现状调查[J].护理研究, 2008, 22(12B): 3211-3213.
77. Moch, SD, Cronje RJ. New knowledge discussion groups: counteracting the common barriers to evidence-based practice[J]. Worldviews Evid Based Nurs, 2007, 4(2): 112-115.
78. Stone C, Rowles C J. Nursing students can help support evidence-based practice on clinical nursing units[J]. J Nurs Manag, 2007, 15(3): 367-370.
1. Melnyk BM, Fineout-Overholt E, Stetler C, et al. Outcomes and implementation strategies from the first U.S. Evidence-Based Practice Leadership Summit[J]. Worldviews Evid Based Nurs, 2005, 2(3): 113-121.
2.李晓玲,成翼娟.循证护理学[J].护士进修杂志, 2003, 18(5): 389-391.
3.李玉梅,王敏,胡敏.我国临床实践中循证护理的运用情况与影响因素分析[J].护士进修杂志, 2007, 22(11): 981-983.
4.曾国艳,杨青,梁金清,等.临床护理人员循证认知和实践状况的调查研究[J].护士进修杂志, 2009, 24(20): 1885-1887.
5.矫海莲,胡雁,曹育玲,等.上海地区本科及以上临床护理人员循证护理认知现状及相关因素的调查[J].护理研究, 2009, 23(7A): 1693-1697.
6.蒋志娟,周琪范,周琦,等.高等护理教育开展循证护理教学的现状与对策[J].解放军护理杂志, 2007, 24(11B): 68-69.
7. Fineout-Overholt E, Melnyk B M, Schultz A. Transforming health care from the inside out:advancing evidence-based practice in the 21st century[J]. J Prof Nurs, 2005, 21(6): 335-344.
8. Melnyk B M. Calling all educators to teach and model evidence-based practice in academic settings[J]. Worldviews Evid Based Nurs, 2006, 3(3): 93-94.
9.朱云,田萍,王梅新.新疆护理本科生对循证护理知晓状况分析与对策[J].护理实践与研究, 2009, 6(24): 123-125
10.李秀娥,李文秀,李英英.读书研讨会在循证护理中的应用[J].护士进修杂志, 2005, 20(1): 74-75.
11.许勤,王婷,宋燕波.以科室为单位强化ICU护士呼吸机相关性肺炎循证护理培训[J].中华护理杂志, 2010, 45(4): 317-320.
12.李亚洁,蔡文智,李瑛,等.护理人员循证护理认知现状调查与启示[J].中华护理杂志, 2004, 39(8): 627—629.
13.侯晓静,徐丽华.“循证”冠名的中国护理文献发表现状分析[J].中国循证医学杂志, 2007, 7(7): 542~546.
14.朱小翠.循证护理在急性心肌梗死病人护理中的应用[J].护理实践与研究, 2010, 7(4): 42-43.
15.祁丽艳,郭春萍.妇科恶性肿瘤化疗患者循证护理的实践[J].国际护理学杂志, 2009, 28(10): 1394-1395.
16.管敬东.腹腔镜全结直肠切除术患者的循证护理[J].护理学杂志, 2010, 25(4): 22-24.
17.张小燕,吴婉玲,苏永静,等.循证护理方法在护理人员评判性思维能力培养中的应用[J].中华护理教育, 2009, 6(4): 156-158.
18.安力彬,张秀英,李文涛.中国循证护理的发展研究检索分析[J].护士进修杂志, 2009, 24(7): 593-595
19. Strickland, R. J. and C. O'Leary-Kelley. Clinical nurse educators' perceptions of research utilization: barriers and facilitators to change. J Nurses Staff Dev 2009, 25(4): 164-171.
20.朱叶卉,刘晓华.循证护理实践障碍因素及对策[J].现代临床护理, 2009, 8(8): 87-91
21.龙莉艳,张磊,张桂云,等.护理人员信息行为研究[J].护理管理杂志, 2007, 7(2):
36-37.
22. McConnell, E. S., D. Lekan, et al. Teaching evidence-based nursing practice in geriatric care settings: the geriatric nursing innovations through education institute[J]. J Gerontol Nurs, 2009, 35(4): 26-33.
23.胡雁,李晓玲.循证护理的理论与实践[M].上海:复旦大学出版社. 2007:90-92.
24. Melnyk B M, Fineout-Overholt E, Feinstein N F, et al. Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift[J]. Worldviews Evid Based Nurs 2004, 1(3): 185-193.
25. Alan Pearson,胡雁.循证护理的实践模式[J].护士进修杂志, 2009, 24(14): 1251-1254.
26.蒋运兰,余阳燊,王芳,等.高等护理专业不同时期开设循证护理教学的效果比较[J].护理研究, 2006, 20(11A): 2852-2853.
27.陈华英,余华琴,贺莉.循证护理教育对培养临床护生评判性思维能力的作用[J].中国循证医学杂志, 2009, 9(1): 34-36.
28.孟清,胡定伟,吴玉琼,等.循证护理教育在本科实习护生教学查房中的实践[J].护士进修杂志, 2008, 23(11): 1002-1004
29.陈亚华,季晓鹏.“循证护理WORKSHOP”在本科护理教学中的实践[J].现代护理, 2006,12(1): 67~69.
30.张丽莉,乔秋阁,吴爱须,等.循证护理在本科生临床教学实践中的应用[J].护士进修杂志, 2005, 20(3): 258-260
31.周明芳,李巍,舒勤,等.开设循证护理学的教学实践与思考[J].护理研究, 2005, 19(7A): 1210-1211.
32.缪群芳,许毅.护生在循证护理临床实践中存在的问题和思考[J].护士进修杂志, 2006, 21(7): 639-640.
33.严谨,欧阳冬生,陶新陆,等.循证护理教学及效果评价[J].中华护理杂志, 2004, 39(3): 224-225.
34. de Cordova PB, Collins S, et al. Implementing evidence-based nursing with student nurses and clinicians: uniting the strengths[J]. Appl Nurs Res, 2008, 21(4): 242-245.
35. Stone C, Rowles C J. Nursing students can help support evidence-based practice on clinical nursing units[J]. J Nurs Manag, 2007, 15(3): 367-370.
36. Moch, SD, Cronje RJ. New knowledge discussion groups: counteracting the common barriers to evidence-based practice[J]. Worldviews Evid Based Nurs, 2007, 4(2): 112-115.