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Abstract：
BACKGROUND: In the last decade, nursing education has begun to reform to competency-based education worldwide, including in low-and middle-income countries. Case-Based Learning (CBL), an approach to delivering competency-based education, contributes to acquiring critical thinking competency, problem-solving, higher knowledge, professional value and attitude. However, it needs to be taught in a culturally appropriate manner. In Cambodia, CBL was initiated in a classroom and clinical practicum by faculty and preceptors who graduated from the upgrading course. This study examined the factors associated with the competency level of nursing students, explored the practice and perceptions of teaching-learning activities among students, faculty members and preceptors and assessed the coherence of qualitative and quantitative findings.
METHODS: This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6-8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4-7 members were conducted to elicit the teaching-learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays.
RESULTS: First, the quantitative and qualitative findings confirmed each other \'s CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students\' academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students\' academic satisfaction with the programme.
CONCLUSIONS: The finding of CBL experiences in a group and students\' satisfaction with faculty members\' and preceptors\' teaching improved nursing students\' competency development. Meanwhile, students\' satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.
METHODS: This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6-8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4-7 members were conducted to elicit the teaching-learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays.
RESULTS: First, the quantitative and qualitative findings confirmed each other \'s CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students\' academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students\' academic satisfaction with the programme.
CONCLUSIONS: The finding of CBL experiences in a group and students\' satisfaction with faculty members\' and preceptors\' teaching improved nursing students\' competency development. Meanwhile, students\' satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.
摘要：
背景：在过去的十年中，护理教育已经开始在全球范围内改革为基于能力的教育，包括中低收入国家。基于案例的学习(CBL)一种提供基于能力的教育的方法，有助于获得批判性思维能力，解决问题,更高的知识，职业价值和态度。然而,它需要以文化上适当的方式教授。在柬埔寨,CBL是由从升级课程毕业的教师和导师在课堂和临床实习中发起的。这项研究调查了与护生能力水平相关的因素，探索学生教学活动的实践和看法，教职员工和导师，并评估定性和定量结果的一致性。
方法：这是一种收敛，混合方法研究。从八家教育机构收集数据进行定量和定性研究，从七家医院收集数据进行定性研究。2019年6月至9月，对三年制课程第三年的护生进行了横断面调查（n=719），与6-8名成员进行了8次焦点小组讨论(FGD;n=55),与教师(n=38)进行了15次FGD,与4-7名成员进行了临床导师(n=37),以引出教学经验和看法.进行多元线性回归以调查与学生能力相关的因素。此外，本研究对定性数据进行了主题内容分析。综合分析呈现为并排关节显示。
结果：首先，定量和定性的发现证实了彼此的CBL学习经验。如果学生有CBL经验，他们的护理能力水平更高，在课堂和临床实习中，两者都是以团体的方式。接下来,定量和定性的发现补充了学生对教师和导师教学的学术满意度。最后,扩大了定量和定性发现，以解释学生对该计划的学术满意度。
结论：在小组中发现CBL经验，学生“对教职员工的满意度”和“导师”教学改善了护生的能力发展。同时,学生对教育计划的设计和交付的满意度为政策层面缩小中低收入国家的理论和实践差距提供了启示。
方法：这是一种收敛，混合方法研究。从八家教育机构收集数据进行定量和定性研究，从七家医院收集数据进行定性研究。2019年6月至9月，对三年制课程第三年的护生进行了横断面调查（n=719），与6-8名成员进行了8次焦点小组讨论(FGD;n=55),与教师(n=38)进行了15次FGD,与4-7名成员进行了临床导师(n=37),以引出教学经验和看法.进行多元线性回归以调查与学生能力相关的因素。此外，本研究对定性数据进行了主题内容分析。综合分析呈现为并排关节显示。
结果：首先，定量和定性的发现证实了彼此的CBL学习经验。如果学生有CBL经验，他们的护理能力水平更高，在课堂和临床实习中，两者都是以团体的方式。接下来,定量和定性的发现补充了学生对教师和导师教学的学术满意度。最后,扩大了定量和定性发现，以解释学生对该计划的学术满意度。
结论：在小组中发现CBL经验，学生“对教职员工的满意度”和“导师”教学改善了护生的能力发展。同时,学生对教育计划的设计和交付的满意度为政策层面缩小中低收入国家的理论和实践差距提供了启示。
