PDF(Pubmed)
Abstract：
High-fidelity patient simulation (HFPS) is widely used in professional training to enhance students\' competence in clinical management. A guideline for HFPS provides a systematic approach to direct students to learning during the simulation process. Problem-solving (PS) and clinical reasoning (CR) skills are essential to developing students\' professional competence in safe and effective care. These two skills should be initiated in the early training. A structured guideline was developed for HFPS. This study aimed to investigate the effects of the structured HFPS guideline on the development of PS and CR skills in junior nursing students. The students were required to go through four sessions, pre-briefing, simulation design, facilitation, and debriefing, for the HFPS; the study utilized the Problem-Solving Inventory (PSI) and the Nurses\' Clinical Reasoning Scale (NCRS) to measure PS and CR abilities before and after HFPS. Bivariate analysis, a one-sample t-test, and an independent t-test were performed to evaluate the performance of the PS and CR skills during the two study periods. A total of 189 students were recruited, with 92 in the intervention group and 97 in the control group. The research assistant was responsible for student recruitment through email invitations and allocating the students into the control group or the intervention group. A Wilcoxon analysis was performed and revealed significant differences in PS and CR between the two groups (p < 0.001). The analytic results showed that the PSI, particularly in domains of Problem-Solving Confidence (PSC) (p < 0.001) and overall PS (p < 0.001), and the CR (p < 0.001) had significant improvement after HFPS, particularly in the intervention group. The study concluded that the structured HFPS guideline significantly improved the students\' problem-solving and clinical reasoning abilities. Nurse educators play an important role in providing explicit learning instructions in a simulation guideline that directs and guides students to learn at each stage of HFPS. The students can be directed to be engaged in their learning through HFPS to enhance their competence in knowledge and skill development (PS and CR) for their personal and professional development.
摘要：
高保真患者模拟（HFPS）被广泛用于专业培训，以提高学生的临床管理能力。HFPS的指南提供了一种系统的方法来指导学生在模拟过程中进行学习。问题解决（PS）和临床推理（CR）技能对于培养学生在安全有效护理方面的专业能力至关重要。这两种技能应该在早期培训中开始。为HFPS制定了结构化指南。本研究旨在探讨结构化HFPS指南对低年级护生PS和CR技能发展的影响。学生们被要求通过四个课程，简报前,仿真设计,促进，和汇报,对于HFPS；该研究利用问题解决量表（PSI）和护士临床推理量表（NCRS）来测量HFPS前后的PS和CR能力。双变量分析，单样本t检验，并进行独立t检验以评估两个研究期间PS和CR技能的表现。共招收了189名学生,干预组92例，对照组97例。研究助理负责通过电子邮件邀请招募学生，并将学生分配到对照组或干预组。进行了Wilcoxon分析，揭示了两组之间PS和CR的显着差异（p<0.001）。分析结果表明，PSI，特别是在解决问题置信度(PSC)(p<0.001)和总体PS(p<0.001)领域，HFPS后CR(p<0.001)有显著改善，特别是在干预组中。该研究得出的结论是，结构化的HFPS指南显着提高了学生的解决问题和临床推理能力。护士教育者在模拟指南中提供明确的学习指导方面发挥着重要作用，该指南指导和指导学生在HFPS的每个阶段进行学习。学生可以通过HFPS进行学习，以提高他们在知识和技能发展（PS和CR）方面的能力，以促进个人和专业发展。
