浅析模块化课程设计在成人护理教育中的应用

旨在探索在职护理教育中课程设置与设计如何适应21世纪护理事业对高等实用型人才的培养要求。结合电大护理专业学生的知识结构、能力结构、工作特点及国内外大专护理教育毕业后医学教育课程体系特点。分析在职护理教育中课程设置的弊端。结果表明：模块化课程设计结合开放式自主择课是电大培养高等实用型护理人才的有效途径之一。     

Focus on dementia care: Continuing education preferences,challenges, and catalysts among rural home care providers

ABSTRACT

Home care staff who provide housekeeping and personal care to individuals with dementia generally have lower levels of dementia care training compared with other health care providers. The study's purposes were to determine whether the professional role of home care staff in a predominantly rural region was associated with preferences for delivery formats of dementia-specific continuing education (CE) programs, and challenges and catalysts to attending CE on any topic. From January through March, 2014, 82 of 111 eligible home care staff in one Saskatchewan health region completed a cross-sectional postal survey (73.9% response rate). The survey included 41 nurses/case managers (client care coordinators, assessors, and team managers) and 41 continuing care aides (home health aides). Nurses/case managers and aides were equally likely to report moderate to high interest in locally delivered CE and low interest in Internet-based and computer-based CE. Compared with nurses/case managers, aides were more likely to report challenges to CE attendance due to CE not being a requirement of their position or relevant to their work. Low staffing levels were the top challenge regardless of professional role. Nurses/case managers and aides were equally likely to identify locally offered programs and paid time off as the top two catalysts of CE attendance. Given the growing number of individuals with dementia receiving home care services, the current study suggests that continuing education should be offered locally and included in rural staff’s paid time in order to encourage attendance.     

整体护理理念在护理专业学生课堂教学与临床带教中的应用现状研究

整体护理是一种护理行为的指导思想或护理理念,是根据护理对象的生理、心理、社会、文化、精神等各个方面的需要,提供适合个体的最佳护理。医院开展整体护理工作已经十余年了,目前学校对护理专业学生的培养应与当今医院的护理实践相适应。     

心理护理对接受IVF—ET治疗患者的重要性

目的：通过心理护理减轻接受IVF—ET治疗患者的心理压力。方法：通过对接受ⅣF—ET治疗患者心理压力的各种因素探讨,注重心理指导,帮助患者树立信心;重视与患者家属的沟通;进行耐心细致的健康教育;建立完善的社会保障体系;手术前后的温情护理,达到减轻接受IVF—ET治疗患者的心理压力。结果：通过临床、实验室、护理三方面密切配合,特别是心理护理,能减轻接受IVF—ET治疗患者的心理压力,可以提高助孕的成功率。     

The effect of industrial training on ethical awareness of final year students in a Malaysian public university

Studies (for example, Dellaportas in Making a difference with a discrete course on accounting ethics. J Bus Ethics 65(4):391–404, 2006; Saat in An investigation of the effects of a moral education program on the ethical development of Malaysian future accountants, 2010) on final year accounting students show that industrial training has a positive impact on the ethical development in a way that students improved in their ethical judgement after attending a 6-month training. Thus, this research aims to evaluate the influence of industrial training in the development of ethical awareness among final year students from a Malaysian public university. These students were from multiple academic backgrounds—engineering, science and social science. A pre and post study was adopted in order to achieve the objectives. A set of survey was distributed to students before and after they have attended industrial training. In assessing students’ ethical awareness, 15 business-related and workplace ethical situations were given and students had to rate their acceptance on these situations from not acceptable (1) to most acceptable (7). From the findings, it can be observed that although the level of ethical awareness among students is fairly good, industrial training has minimal impact in improving or developing students’ ethical awareness. The impact is such because students who undergone industrial training may have observed certain behaviour that they thought are acceptable in a workplace; this may have changed the way students perceived their acceptance on the situations.     

高职院校行业英语教学需求调查与分析——以护理专业为例

采取问卷调查的方式,了解高职护理专业学生对行业英语的学习需求,探讨适合高职护理专业行业英语教学的思路和方法。调查结果表明,护生对行业英语课程认同度较高,对自身的英语水平不太满意,希望在学完基础英语后（第二学期后）能够继续学习针对护理行业的专门英语,并重点加强职场环境下听说交际能力的训练。     

Clinical Office Safety: Strategies to Enhance the Safety of Staff and Clients

Mental health practitioners' exposure to threats and acts of nonfatal violence are among the highest of all professions. Implementing a comprehensive workplace violence prevention program specific to the clinical setting is paramount to decreasing these risks. However, generic security recommendations at times come in conflict with the professional, legal, ethical, and budgetary constraints unique to the clinical environment. This article discusses how the various types of security surveys, policy considerations and practical training applications can be implemented with sensitivity to those challenges and still enhance the safety of staff and clients alike.     

Geriatric Training Needs of Nursing-Home Physicians

Medical care in nursing homes is not provided by board-licensed geriatricians; it mainly comes from physicians in need of educational programs in the field of geriatrics. Such programs, based on curriculum guidelines, should be developed. The purpose of this study was to seek input from nursing home physicians on their perceived needs for training in geriatrics. A mail questionnaire survey was sent to nursing home physicians regarding their opinion on the most needed subjects and preferred training methods. Of the 210 surveys mailed, 132 (63%) were returned. More than a quarter of the respondents had not had any kind of geriatric medical education. A desire for geriatric training was evident, preferably in the form of courses and periodic seminars. Use of medications, infectious diseases, depression, dementia and cardiac disorders were the most important topics indicated by the respondents. These data can be of help in preparing the curriculum for a continuous medical education program in geriatrics, preferably in the form of courses and periodic seminars.     

Vergleichsarbeiten und schulische Personalentwicklung – Ausmaß und Voraussetzungen der Datennutzung

The introduction of comparative tests in a low-stakes system was carried out in the expectation that the data feedback to schools would act as a stimulus for the development of the schools and the standard of classroom teaching. By contrast with the use of data to develop teaching, the use of data for personnel development has not yet been studied in Germany. On the basis of an on-line survey of head teachers and a paper-and-pencil survey of teaching staff, the study examines for the first time the extent to which comparative test data is used by head teachers for personnel development and as a means to plan in-service training in subject conferences, and what factors influence whether the data is used in this way. Of the head teacher characteristics which were studied (attitude in relation to the perceived usefulness of the data, qualifications, organisation and age of the head teacher), usefulness is the only characteristic which has a positive effect on the use of the data. The use of comparative test data to plan in-service training in subject conferences is positively influenced by data-wise leadership by the head teacher and by collaborative evaluation.     

Ethical Practices in the Provision of Guidance by Further Education Health Care Tutors who hold a Nursing,Midwifery or Health Visiting Qualification

This paper seeks to establish what constitutes ethical practice in the provision of guidance by Further Education health care tutors who hold a nursing, midwifery or health visiting qualification and are therefore bound by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) Code of Professional Conduct. It considers potential ethical dilemmas which such tutors may encounter during guidance activities, in the context of the UKCC standards and the five key ethical principles of autonomy, beneficence, non-maleficence, justice and veracity. Whilst these professional standards and principles may appear to provide a comprehensive foundation for ethical guidance practice, in reality they fail to offer clear support in the resolution of many of the ethical dilemmas that face health care tutors undertaking guidance work. Since guidance provided by such tutors may not be fully impartial, the importance of 'ethical sensitivity' and ethical decision-making skills are also highlighted.     

Evidence-based health promotion in nursing homes: A pilot intervention to improve oral health

ABSTRACT

Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts’ nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an intervention targeting Certified Nurses’ Aides (CNAs) was developed and tested. We hypothesized that following the training, CNAs would have increased knowledge and self-efficacy toward providing oral health care to the residents in their charge.

This pilot study used a one-group pretest-posttest design to test the effectiveness of a psycho-educational training intervention. Utilizing the constructs of knowledge and self-efficacy from the Theory of Planned Behavior and the Social Cognitive Theory, we framed the content of a training intervention and administered a 21-item instrument. The survey was distributed to the CNA staff of a single midsize nursing home immediately prior to and after the intervention. The 1-hour training intervention was empirically supported by formative data and delivered by dental faculty researchers.

Findings indicate increases in two areas of oral health knowledge: toothbrush position and frequency of brushing. Self-efficacy, however, did not significantly change. Although the results marginally supported our hypothesis, this pilot study demonstrates the feasibility of delivering interventions to CNAs who have direct responsibility for promoting the oral health of long-term care facility residents.     

THE ROLE OF EDUCATION AND HEALTH CARE DELIVERY STRUCTURE IN QUALITY OF NURSING CARE FOR MENTALLY ILL PATIENTS IN NURSING HOMES

A study of nursing home staff found that nurses generally are not knowledgeable about psychiatric symptoms and do not seek out psychiatric intervention for their patients who need it. Even when nurses are knowledgeable about psychiatric symptoms and have had special training in mental health care it is found that they nonetheless rarely seek psychiatric intervention for their patients. The problem to be redressed lies not merely in increased education alone. It also resides in the organizational character of health care delivery in nursing homes, which makes adequate nursing response to mental illnesses impossible.     

在职护士分层次培训实践探索

护理人员在职培训是护理专业技术人员不断进行知识技能的补充、更新、拓宽和提高的一种继续教育。为了适应医学科学发展需要,为患者提供更安全、高效的护理,建立一支业务素质高、结构合理的护理专业技术队伍非常重要。因此必须加强不同层次在职护士培训。结合临床实际建立完善的在职护士分层次培训方案;加强分层培训管理、确保培训计划的执行落实;选择成人学习为特点的培训,保证培训效果是关键。在职护士分层培训使护士既快又安全地获得专业训练,提高了综合素质,降低了职业风险,同时利于不同层次的护士向着护士成长规范化、专业化方向发展。     

Task Characteristics and Learning Potentials—Empirical Results of Three Diary Studies on Workplace Learning

Most learning in the workplace occurs while pursuing working rather than learning goals. The studies at hand aimed to identify task characteristics that foster learning in the workplace. Task characteristics are supposed to exert a major effect on the learning potential. However, the fact that learning is more often than not a rather unconscious by-product of working poses methodological challenges because respondents might not be capable of accurately recalling daily work experiences. Diaries were applied in order to bring measurement closer to the processes. Three diary studies were conducted in the field of office work within vocational education and training, with trainees requested to record particular work tasks several times a day. Each diary record, i.e., each work task, required a rating of ten standardized items relating to task characteristics including the perceived learning potential of the present task. Eighteen trainees aiming to become retail salespersons recorded 488 work tasks, 10 trainees aiming to become bank clerks recorded 1,113 work tasks, and 20 trainees aiming to become industrial clerks recorded 573 work tasks. The aim of these studies was to explain the variance in the perceived learning potentials from further task characteristics using regression analyses. The extent of the explained variance ranged from 46.6 % in study 1 to 77.8 % in study 3. Interestingness, novelty, assistance from others, and feedback turned out to be the best predictors, whereas scope of action even showed negative influences. Practical implications for workplace learning as well as methodological recommendations for using diary methods in the workplace are discussed.     

Dementia-related work activities of home care nurses and aides: Frequency,perceived competence,and continuing education priorities

ABSTRACT

An understanding of the specific dementia learning needs of home care staff is needed to plan relevant continuing education (CE) programs and supports. The study’s objective was to examine frequency and perceived competence in performing 20 dementia-related work activities, and identify CE priorities among home care staff. A cross-sectional survey of all home care staff in a primarily rural health region was used to gather data. Of 111 eligible staff, 82 participated (41 nursing aides, 41 nurses/case managers). To explore the relationship between activity frequency (F) and competence (C), the proportion of nurses and aides in four quadrants for each activity was examined: (1) low F-low C, (2) low F-high C, (3) high F-low C, and (4) high F-high C. Nurses/case managers were significantly more likely than aides to regularly perform 11 activities and to report high competence in 9 activities (p < .05); aides were more likely to assist with two activities (personal care and daily living activities). Thus, nurses/case managers performed a broader range of activities and reported higher competence overall. The top CE topic for both groups was recognizing differences between dementia subtypes, but rankings for most activities varied by group. Aides’ CE priorities indicated a desire to develop competence in low frequency-low competence activities, suggesting an expanded role in supporting dementia patients and their families. Nurses’ CE priority topics were in the high F-high C quadrant, indicating a need to further develop competence in these activities. Findings have implications for planning CE programming for home care providers.     

Personal Digital Assistants as Point-of-Care Tools in Long-Term Care Facilities: A Pilot Study

This study used both survey and interview questionnaires. It was designed to assess the feasibility, usability, and utility of two point-of-care tools especially prepared with information relevant for dementia care by staff nurses in a small, a medium-sized, and a large nursing home in Florida. Twenty-five LPN or RN nurses were recruited for the study of their use of one of the tools—either a set of pocket cards (used by the control group) or a pocket PC (used by the experimental group). The findings of our study indicate that personal digital assistants (PDAs) can potentially improve long-term care clinicians' effectiveness and efficiency at work, resulting in better patient care for nursing home residents.     

Competencies in Geriatric Nursing: Empirical Evidence from a Computer-Based Large-Scale Assessment Calibration Study

Valid and reliable standardized assessment of nursing competencies is needed to monitor the quality of vocational education and training (VET) in nursing and evaluate learning outcomes for care work trainees with increasingly heterogeneous learning backgrounds. To date, however, the modeling of professional competencies has not yet evolved into procedures that would meet large-scale assessment (LSA) standards in VET. To empirically test a proposed structural model for client-directed nursing competence and to estimate psychometric properties of a newly developed video- and computer-based test (CBT) to inform subsequent LSA in nursing VET, 402 final-year nursing students from 24 German schools responded to a 77 item CBT. Multi-dimensional IRT modeling was employed to test the subdomain structure and estimate students’ competencies in geriatric nursing. The standardized CBT measures nursing students’ client-directed care competence with acceptable precision (WLE?=?0.76) and does so across the whole range of observed proficiency levels. Structural validity was supported by substantive contributions of test items from all proposed process-oriented subdomains, practice field scenarios, as well as items with and without reference to emotional demands. However, it was not possible to empirically separate the diagnostic, practical or communicative subdomains, probably reflecting parallel, recursive and hierarchical care processes in complex care situations. On average, students in our sample attained 45 % of the maximum test score so it is a demanding assessment of nursing competence. An extensively piloted, valid and reliable CBT is suggested to assess nursing students’ client-directed care competencies at the end of the third year of the VET program.     

互联网视角下的教师培训:效益、挑战和对策

互联网技术对于扩大教师培训规模、提高培训效益具有巨大推动作用。新互联网技术的应用在教师培训中能够解决多少问题、发挥多大效益以及可能给教师培训带来多大挑战,都是具有很强政策研究价值的问题。我国教育发展目标和教师培训的现实需求要求教师培训升级换代,虽然互联网技术能在很大程度上优化教师在职培训的过程和效益,但仍然面临全员覆盖与全员参与之间的差距、成本效益的体现和确保未充分解决等挑战。因此,互联网时代做大做强教师培训要在理念、规范引导、经费资源拓展以及专家保障等方面做出努力。     

The (in)convenience of care in preschool education: examining staff views on educare

It is generally accepted that Early Childhood Education and Care should adopt a holistic view on education, in which education and care are inseparable concepts. Perspectives of staff members themselves are, however, often absent in these educare debates. We conducted six video-elicited focus groups with various preschool staff members (n = 69) in Flanders (Belgium), which is well known for its split system in which children between two and a half and four years old are confronted with the pivotal transition from an informal or formal caring environment (home or childcare service) to a formal learning environment (preschool). With Maurice Hamington’s theory of embodied and performative care as a theoretical lens for this empirical study, we propose a new direction for pre- and in-service training, in which the use of emotions, embodied exchange and social responsibility has a central place.