高职高专护理学生评判性思维能力现况调查及培养对策研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
研究目的
     了解高职高专护理学生评判性思维能力现况,比较不同年级、不同类型护理学生评判性思维能力的特点和差异。据此提出教学对策,在“3+2”高职护生《护理综合》课程中运用PBL教学法并对效果进行评价,以探索提高高职高专护理学生评判性思维能力的有效教学策略。
     研究方法
     第一部分采用问卷调查法,使用中文版评判性思维能力测量表(CTDI-CV)对某高职高专院校3个年级460名大专护理学生和2个年级705名高职护理学生进行问卷调查,了解高职高专护理学生整体评判性思维能力现况,以及不同年级、不同类型护理学生评判性思维能力的特点和差异。第二部分采用干预研究的方法,将311名高职护理学生分为实验班和对照班,在《护理综合》课程中实验班运用PBL教学法而对照班运用传统教学法。学生在课程前、后填写中文版评判性思维能力测量表(CTDI-CV),课程结束后进行理论及实验考试并对结果进行比较分析。
     研究结果
     1、高职高专护理学生CTDI-CV总分为285.09±29.55分,评判性思维能力强的比例为1.63%。七个维度得分由低到高依次是:寻找真相(36.25±6.41分)、系统化能力(37.61±6.55分)、评判性思维的自信心(39.90±6.55分)、认知成熟度(41.12±6.53分)、开放思想(41.28±5.92分)、分析能力(43.94±5.37分)和求知欲(44.98±6.82分)。
     2、大专三个年级护理学生在CTDI-CV总分以及寻找真相、开放思想、系统化能力、求知欲和认知成熟度五个维度得分上的差异均有统计学意义(P<0.05)。两两比较的结果显示三年级护理学生在CTDI-CV总分以及以上五个维度得分上高于二年级(P<0.05);在CTDI-CV总分以及系统化能力、求知欲、认知成熟度三个维度得分上高于一年级(P<0.05)。一年级护理学生在寻找真相维度得分上高于二年级(P<0.05)。高职两个年级护理学生在CTDI-CV总分以及所有七个维度得分上差异均有统计学意义(P<0.05),二年级得分高于一年级。
     3、一年级大专护理学生和高职护理学生在CTDI-CV总分以及寻找真相、开放思想、分析能力、求知欲和认知成熟度五个维度得分上的差异均有统计学意义(P<0.05)。大专护生高于高职护生。
     4、《护理综合》课程前,高职实验班和对照班护理学生在CTDI-CV得分和成绩测评上差异无统计学意义(P<0.05)。课程结束后实验班在理论和实验考试成绩上优于对照班,在CTDI-CV总分及寻找真相、开放思想、分析能力、求知欲四个维度得分上高于对照班,差异有统计学意义(P<0.05);实验班课后CTDI-CV总分及所有七个维度得分均高于课前,差异有统计学意义(P<0.05)。
     研究结论
     1、高职高专护理学生评判性思维能力总体虽然达到正性水平,但是接近于正性下限(280分)。评判性思维能力强的学生比例很小。护生寻找真相和系统化能力欠缺,评判性思维的自信心不高。
     2、在校学习的二年级大专学生与一年级学生相比,评判性思维能力不升反降。进入临床实习的学生评判性思维能力得到普遍提升。说明学校前期教学在发展护理学生评判性思维能力方面可能存在一定缺陷。临床实习能有效提高护理学生的评判性思维能力。
     3、同一层次不同类型入学的护理学生(大专、高职)在评判性思维能力上具有差异和特点。教学中应该因材施教。
     4、在高职护理学生的《护理综合》课程中应用PBL教学法能有效提高评判性思维能力,同时促进理论知识和实践技能的掌握。
Objective:
     To investigate the critical thinking ability and compare difference in different grades,different types of education of nursing students from higher vocational schools and colleges. Based on this,to put forward the teaching countermeasures,to explore the application and effects of PBL in integrated nursing course of higher vocational nursing students.
     Methods:
     Questionnaire method was adopted in Part 1.The Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV) was used to investigate 460 college nursing students from 3 grades and 705 higher vocational nursing students from 2 grades. Intervention study was adopted in Part 2.311 higher vocational nursing students were randomly divided into two groups, the experimental group and the control group. PBL was applied to the experimental group while traditional method was applied to the control group during the integrated nursing course. All the students fulfilled the CTDI-CV before and after the course. Theory and practical examinations were administrated after the course.
     Results:
     1.The total score of CTDI-CV of all students was 285.09±29.55.1.63% students characterized strong ability.The subscale scores were listed as follows:Truth-seeking(36.25±6.41),Systematicity(37.61±6.55),Critical thinking self-confidence (39.90±6.55),Cognitive maturity(41.12±6.53),Open-mindedness(41.28±5.92),Analyticity(43.94±5.37),Inquisitiveness(44.98±6.82).
     2.There were significant differences in total score and some subscale scores of CTDI-CV among the college nursing students from 3 grades.
     3.There was significant difference in total score and some subscale scores of CTDI-CV between college nursing students and higher vocational nursing students of grade 1.
     4.There was significant difference in the scores of theory and practical examinations between the two groups of higher vocational nursing students. There was significant difference in total score and some subscale scores of CTDI-CV between the two groups after the integrated nursing course, and also between the beginning and the end for the experimental group.
     Conclusions:
     1.The total score of CTDI-CV of Nursing Students from Higher Vocational Schools and Colleges showed positive,but a few students characterized strong ability.Nursing students were deficient in the ability of Truth-seeking, Systematicity and Critical thinking self-confidence.
     2.The college nursing student's critical thinking ability of grade 2 was below than grade 1,which indicats shortage in current nursing education in promoting critical thinking ability. The critical thinking ability was improved in student practical nurses,which indicates the clinical practice can effectively improve the critical thinking ability of nursing students.
     3.Nursing students of different types of education shows different characteristics in critical thinking ability,we must teach students according to their aptitude.
     4.The application of PBL in integrated nursing course can effectively improve the critical thinking ability, and can promote the mastery of knowledge and skills.
引文
[1]Betsy S P, Gioria M. Clarifying the concept of critical thinking in nursing[J]. J Nurs Educ,1993,32(9):425-428.
    [2]Facione N C, Facione P A, Giancarlo C A. California Critical Thinking Disposi-tion Inventory(CCTDI)[M]. Millbrae:California Academic Press,2001:5.
    [3]肖灿华,刘军红.培养护士批判性思维在我国护理教育中的迫切性[J].中华护理杂志,2002,37(4):304-306.
    [4]蒋艳,沈宁.评判性思维在护理教育中的研究进展[J].护理研究,2004,18(2):196-198.
    [5]Noreen C F. Crtical thinking and clinical judgment:Goals 2000 for Nursing Science. http//www.calpress.com/nurse 2000.
    [6]Thurmond V A. The holism in critical thinking:A concept analysis[J]. J Holist Nurs,2001,19(4):375-389.
    [7]Pless B S, Clayton G M. Clarifying the concept of critical thinking in nursing [J]. J Nurs Educ,1993,32(9):425-428.
    [8]Morrison S, Free K W. W riting multiple-choice test items that promote and measure critical thinking[J]. J Nurs Educ,2001,40(1):17-24.
    [9]Bowles K. The relationship of critical-thinking skills and the clinical-judgement skills of baccalaureate nursing students[J]. J Nurs Educ,2000,39(8):373-376
    [10]李小寒,李小妹,吕爱莉.中国、日本及萨摩亚护理本科生评判性思维能力比较性研究[J].护理研究,2006,20(6B):1521-1523.
    [11]张国芳,余晓平,金仁康.浙江省高职毕业生就业情况调查[J].教育与职业,2006,(4):70.
    [12]周芳明,王振钺编译.PBL在美国药学教育中的研究现状[J].药学教育,2003,19(1):58-60.
    [13]Langelotz C, Junghans T, Gunther N, et al. Problem-based learning for surgery:Increased motivation with less teaching personnel [J]. Chirurg,2005, 76(5):481-486.
    [14]国务院关于大力发展职业教育的决定.国发[2005]35号.
    [15]浙江省教育厅关于加强五年制高职教育管理的意见.浙教职成[2003]11号.
    [16]姜芬,吴艳平,张青海.PBL教学法对高职护生学业自我效能感的影响[J].护理学报,2009,16(1A):8-10.
    [17]聂超,张蕾,柯世怀.以护理药理教学为例优化高职医学PBL教学模式[J].医学教育探索,2008,7(9):943-944.
    [18]邹立人.护理学专业“3+2”五年制职业教育培养模式的研究[J].卫生职业教育,2002,20(6):17-18.
    [19]彭美慈,汪国成,陈基乐,等.批判性思维能力测量表的信效度测试研究[J].中华护理杂志,2004,39(9):644-647.
    [20]Giancarlo C A, Facione P A. A look across four years at the disposition toward critical thinking among undergraduate students[J]. J Gen Educ,2001,50(1): 29-55.
    [21]赵海平,于春妮.护理本科生批判性思维认知技能和态度倾向性的相关性[J].护理研究,2007,21(5A):1158-1162.
    [22]李丹,张琳,蔡小红,等.高职护理专业护生评判性思维的测量及相关因素分析[J].中华护理杂志,2007,42(1):68-70.
    [23]施翠芬,巫向前.护理专业学生批判性思维气质与技能的相关性研究[J].护理学杂志,2009,24(12):78-81.
    [24]蒋小平,郑显兰,何英,等.不同层次护生评判性思维能力的对比研究[J].护士进修杂志,2007,22(8):687-689.
    [25]许虹,彭美慈,汪国成,等.护理本科生评判性思维能力特征及相关因素的分析[J].中华护理杂志,2006,41(2):155-157.
    [26]成静.不同年级本科护生评判性思维能力的比较研究[J].护理研究,2007,21(29):2658-2659.
    [27]刘素珍,李继平,张玉芳,等.本科护生批判性思维能力的调查分析[J].实用护理杂志,2003,19(5):53-55.
    [28]李小妹,Marcia A Petrini, Asako Kawashima,等.中国与日本护理本科生评判性思维能力的比较[J].中华护理杂志,2005,40(10):730-733.
    [29]Yeh M L. Assessing the reliability and validity of the Chinese version of the California Critical Thinking Disposition Inventory[J]. Int J Nurs Stud,2002, 39(2):123-132.
    [30]姚利民.国外对教学促进大学生批判性思维发展的研究及启示[J].高等理科教育,2001,(5):18-24.
    [31]王志稳,孙宏玉,吴雪,等.不同年级在校学习本科护生评判性思维倾向的比较[J].中华护理教育,2009,6(3):123-125.
    [32]夏素华,孙宏玉,郑修霞.护理专业本科生评判性思维的测定及相关因素的分析[J].中华护理杂志,2006,41(5):445-447.
    [33]孟艳君,王斌全,商临萍,等.本科护生客观结构化临床考试中评判性思维能力测评结果分析[J].护理研究,2008,22(7):570-571.
    [34]万学英,刘化侠,徐迎春,等.实习模式对本专科护生批判性思维性格的影响[J].中国实用护理杂志,2006,22(8A):69-71.
    [35]成静,崔焱.不同层次护理本科生评判性思维能力比较[J].护理学杂志,2008,23(5):8-10.
    [36]车文芳.本科与专科实习护生评判性思维的比较研究[J].护理学杂志,2007,22(22):64-65.
    [37]常广明,芦桂芝,王磊,等.不同学历实习护生评判性思维能力分析[J].护理学报,2009,16(11B):15-17.
    [38]姜安丽,王建荣,朱京慈,等.护理学科的发展和展望[J].解放军护理杂志,2005,22(9):1-4.
    [39]张大均.教育心理学(第二版)[M].北京:人民教育出版社,2003.
    [40]胡寅生.教育学(第一版)[M].北京:高等教育出版社,1984.
    [41]钱美华等译.多元智慧与问题式学习[M].北京:中国轻工业出版社,2005.
    [42]Susarla S M, Bergman A V, Howell T H, et al. Problem-based learning and research at the Harvard School of Dental Medicine:a ten-year follow-up[J]. J Dent Edu,2004,68(1):71-76.
    [43]Problem-Based Learning. http//www.c2t2.cal/lo/pbl.html.
    [44]胡君娥,黄振元,丁永艳.以问题为基础教学法的临床实践与思考[J].南方护理学报,2005,12(7):81-83.
    [45]张红菱,陈靖,舒剑萍,等.以问题为基础的教学法效果评价[J].护理研究,2004,18(1):73-74.
    [46]李蓉,孟秀,张瑞丽,等.以问题为基础的学习在我国护理教育中的应用现状[J].中国实用护理杂志,2004,20(10A):65-66.
    [47]Williams B. Developing critical reflection for professional practice through problem-based learning. J Adv Nurs,2001,34(1):27-34.
    [48]Wilkie K, Burns L. Problem-based Learning:A handbook for nurses[M]. London:Palgrave Macmillian,2003:1-4.
    [49]杨芳宇,沈宁.PBL在护理教育中的应用现状[J].国外医学(护理学分册),2002,21(2):55-58.
    [50]Glen S. Developing critical thinking in the higher education[J]. Nurse Edu Today,1995,15:170.
    [51]姚苏宁,严小惠.问题教学法在高护生药理学教学中的应用[J].卫生职业教育,2005,23(4):19-20.
    [52]于征淼,陈晶.单门课程PBL教学中出现的问题[J].山西医科大学学报(基础医学教育版),2005,7(5):501-503.
    [1]Facione N C, Facione P A, Giancarlo C A. California Critical Thinking Disposition Inventory(CCTDI). Millbrae:California Academic Press,2001:5.
    [2]Staib S. Teaching and measuring critical thinking. J Nurs Educ,2003,42 (11): 498-508.
    [3]姚本先.论学生问题意识的培养.教育研究,1995,(10):40.
    [4]关兴丽.论墨家的批判性思维.社会科学辑刊,2001,2:31-36.
    [5]岳晓东.批判思维的形成与培养:西方现代教育的实践及其启示.教育研究,2000,8:65-69.
    [6]朱秀丽.护理教育中的评判性思维.国外医学(护理学分册),2000,19(10):463-466.
    [7]蒋艳,沈宁.评判性思维在护理教育中的研究进展.护理研究,2004,18(2):196-198.
    [8]Noreen C F. Crtical thinking and clinical judgment:Goals 2000 for Nursing Science. http//www.calpress.com/nurse 2000.
    [9]胡爱萍,夏强.全球医学教育最基本要求及其推广的相关问题和对策.中国高等医学教育,2005,(2):6-8.
    [10]Thurmond V A. The holism in critical thinking:A concept analysis. J Holist Nurs,2001,19(4):375-389.
    [11]邓友芳,姚琴,刘中俊.护士评判性思维能力的培养.护理学杂志,2005,20(24):48-49.
    [12]Bowles K. The relationship of critical thinking skills and the clinical-judgement skills of baccalaureate nursing student. J Nurs Educ,2000,39(8):373-376.
    [13]American Association of Colleges of Nursing. A vision of baccalaureate and graduate nursing education:the next decade. J Prof Nurs,1999,15(1):59-65.
    [14]沈宁.护理专业教学改革研究报告.北京:高等教育出版社,2000:37-47.
    [15]王侠,于兰贞.护士核心能力的研究进展.护士进修杂志,2007,22(7):638-640.
    [16]李小寒,李小妹,吕爱莉.中国、日本及萨摩亚护理本科生评判性思维能力比较性研究.护理研究,2006,20(6B):1521-1523.
    [17]Watson G, Glaser E M. Watson-Glaser Critical Thinking Appraisal Manual. Cleveland:The Psychological Corporation,1980.
    [18]Facione P A, Facione N C. The California Critical Thinking SkillsTest:Test manual. Millbrae, CA:Calfifornia Academic Press,1992.
    [19]Facione P A, Facione N C,Sanchez C A. The California Critical Thinking Dispostition Inventory. Test manual. Millbrae, CA:California Academic Press, 1992.
    [20]朱秀丽,沈宁.WGCTA量表和CCTDI量表的信度及效度测定.护理学杂志,2004,21(19):56-58.
    [21]彭美慈,汪国成,陈基乐,等.批判性思维能力测量表的信效度测试研究.中华护理杂志,2004,39(9):644-647.
    [22]夏素华,孙宏玉,郑修霞.护理专业本科生评判性思维的测定及相关因素的分析.中华护理杂志,2006,41(5):445-447.
    [23]余丽君,康晓凤,于络薇.护理专业学生批判性思维能力的培养评价.护理研究,2004,18(1):71-73.
    [24]刘素珍,李继平,朱丹.不同层次护生批判性思维意向及影响因素的研究.现代护理,2005,11(7):496-498.
    [25]蒋小平,郑显兰,何英,等.不同层次护生评判性思维能力的对比研究.护士进修杂志,2007,22(8):687-689.
    [26]许虹,彭美慈,汪国成,等.护理本科生评判性思维能力特征及相关因素的分析.中华护理杂志,2006,41(2):155-157.
    [27]成静.不同年级本科护生评判性思维能力的比较研究.护理研究,2007,21(29):2658-2659
    [28]刘素珍,李继平,张玉芳,等.本科护生批判性思维能力的调查分析.实用护理杂志,2003,19(5):53-55.
    [29]王志稳,孙宏玉,吴雪,等.不同年级在校学习本科护生评判性思维倾向的比较.中华护理教育,2009,6(3):123-125.
    [30]车文芳.本科与专科实习护生评判性思维的比较研究.护理学杂志,2007,22(22):64-65.
    [31]Vaughan-Wrobel B C, O'sullivan P, Smith L. Evaluating critical skills of baccalaureate nursing students. J Nurs Edu,1997,36(10):485-488.
    [32]Giancarlo C A, Facione P A. A look across four years at the disposition toward critical thinking among undergraduate students. J Gen Educ,2001,50(1): 29-55.
    [33]王庆华,郝玉玲,林振涛,等.不同类型护理本科生评判性思维能力调查与思考.中国护理管理,2008,8(9):47-49.
    [34]陈良英,郑玉仁,魏丽丽,等.在校学习护生评判性思维倾向的调查与分析.青岛大学医学院学报,2010,46(1):80-83.
    [35]Yeh M L. Assessing the reliability and validity of the Chinese version of the California CriticalThinking Disposition Inventory. Int J Nurs Stud,2002,39(2): 123-132.
    [36]姚利民.国外对教学促进大学生批判性思维发展的研究及启示.高等理科教育,2001,(5):18-24.
    [37]张国芳,余晓平,金仁康.浙江省高职毕业生就业情况调查.教育与职业,2006,(4):70.
    [38]李丹,张琳,蔡小红,等.高职护理专业护生评判性思维的测量及相关因素分析.中华护理杂志,2007,42(1):68-70.
    [39]施翠芬,巫向前.护理专业学生批判性思维气质与技能的相关性研究.护理学杂志,2009,24(12):78-81.
    [40]张艳,杨培常,张涵,等.河南省高职护生评判性思维倾向现状研究.中国实用护理杂志,2009,25(12B):28-30.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700