反例视频结合情境模拟在手术室无菌操作临床教学中的应用

doi:10.3761/j.issn.1672-9234.2023.10.002

摘要/Abstract

摘要：

目的探讨反例视频结合情境模拟教学在手术室护理实习生无菌操作培训中的应用效果。方法通过收集整理、查阅资料，归纳实习生无菌操作易错点，并制作反例视频。选取2021年12月—2022年7月手术室74名护理实习生，分为对照组和试验组（各37名）。对照组给予理论授课、观看正向操作视频后再进行操作演示。试验组在对照组干预方法基础上进行情境模拟及观看反例视频。培训结束后评价两组无菌操作理论考核成绩、易错点发生率及教学效果评价，21 d后再次进行理论和临床实境考核。结果培训后，试验组、对照组无菌操作理论考核成绩分别为（90.11±3.94）（86.29±4.45），21 d后临床实境考核中，试验组、对照组无菌操作理论考核成绩分别为（94.11±1.83）（91.90±1.79），试验组2次理论考核成绩均高于对照组，差异具有统计学意义（t=3.847、5.133，P<0.05）。试验组在铺置无菌器械台、无菌持物钳使用、一次性取用无菌物品、取无菌溶液、穿全遮盖式无菌手术衣方面的易错点发生率均低于对照组（P<0.05）；试验组对实习教学效果评价得分高于对照组，差异具有统计学意义（P<0.001）。结论反例视频结合情境模拟教学能有效提高手术室护理实习生的无菌操作技术质量，提高其规范操作的依从性。

关键词: 手术室, 临床实习, 无菌术, 情境模拟, 反例视频

Abstract:

Objective To explore the application effect of counter-example video combined with scenario simulation teaching in the training of aseptic operation for nursing interns in the operating room. Methods The first step of the study was to collect，sort out the data，and summarize the easy mistakes of aseptic technique to make a counter example video. After that，74 nursing interns practiced in the operating room from December 2021 to July 2022 were selected as participants and divided into a control group and an experimental group（37 in each group）. The control group received theoretical lectures，watched positive operation videos，and then demonstrated the operation. On the basis of intervention in the control group，situational simulations and counter-example videos were implemented in the experimental group. After the training，the theoretical assessment results of aseptic technique，the occurrence rate of error prone points and the teaching effect of interns were compared. Besides，the clinical reality assessment was conducted again 21 days later. Results After teaching，the experimental group and the control group scored（90.11±3.94） points，and（86.29±4.45） points in the examination of aseptic technique respectively. In the second assessment of 21 days later，the experimental group and the control group achieved（94.11±1.83） points and（91.90±1.79） points in clinical reality examination respectively. The two examination results of the examination group were higher than that of the control group，with a statistically significant difference（t=3.847，5.133，P<0.05）. The incidence of error prone points in the experimental group was lower than that in the control group in laying sterile instrument tables，using sterile holding forceps，disposable sterile items，taking sterile solutions，and wearing fully covered sterile surgical gowns（P<0.05）. The experimental group scored higher in evaluating the effectiveness of internship teaching than the control group，with a statistically significant difference（P<0.001）. Conclusion Counter-example video combined with situational simulation teaching can effectively improve the technical quality of sterile operation of nursing interns practiced operating room，and helpful in improving the compliance of standardized operation.

Key words: Operating Rooms, Clinical Practice, Asepsis, Scenario simulation, Counter-example video

安晓燕, 李雪云, 吕晓凡, 刘佩玉. 反例视频结合情境模拟在手术室无菌操作临床教学中的应用[J]. 中华护理教育, 2023, 20(10): 1163-1168.

AN Xiaoyan, LI Xueyun, LÜ Xiaofan, LIU Peiyu. Application of counter-example video combined with scenario simulation in the training of aseptic operation for nursing interns in operating room[J]. Chinese Journal of Nursing Education, 2023, 20(10): 1163-1168.

图/表 2

参考文献 12

[1]	谭中华, 韩书军. CBL联合OSCE模式在手术室护理教学中的应用[J]. 中国继续医学教育, 2019, 11(31):57-60.
	Tan ZH, Han SJ. Application of case-based learning method combined with objectively structured clinical examination mode in operation room teaching[J]. China Continuing Med Educ, 2019, 11(31):57-60.
[2]	李会, 李艳荣, 王素娟, 等. 心理干预对手术室护生实习效果影响的研究[J]. 护士进修杂志, 2011, 26(20):1836-1837.
	Li H, Li YR, Wang SJ, et al. Study on the influence of psychological intervention on the practice effect of nursing students in operating room[J]. J Nurses Train, 2011, 26(20):1836-1837.
[3]	时丹, 吴荷玉, 胡娟娟, 等. 微课联合模拟手术室训练在本科护生教学中的应用[J]. 护理学杂志, 2018, 33(11):74-75.
	Shi D, Wu HY, Hu JJ, et al. Application of microteaching and simulation training in student nurses practicing in operating room[J]. J Nurs Sci, 2018, 33(11):74-75.
[4]	郭艳丽. 资源视角下的“错误”再审视与再利用[J]. 基础教育论坛, 2019(30):66-69.
[5]	邱华丽, 潘晓彦, 晋溶辰, 等. 缺陷式情境教学法在中医护理学本科教学中的应用研究[J]. 中华护理教育, 2014, 11(12):885-887.
	Qiu HL, Pan XY, Jin RC, et al. Application of the defect situational teaching method in the course of Traditional Chinese Medicine Nursing[J]. Chin J Nurs Educ, 2014, 11(12):885-887.
[6]	张淑利, 李胜云, 李玲, 等. 缺陷式情境教学法在手术室新入职护士培训中的应用[J]. 中华护理教育, 2020, 17(5):451-455.
[7]	张源慧, 唐琳, 唐龙, 等. 现场追踪式缺陷情境模拟教学对新入职护士批判性思维能力的影响[J]. 中华现代护理杂志, 2018, 24(13):1588-1591.
[8]	谭思源, 孙静, 陈艳, 等. 对手术室年轻护士进行情境模拟培训的实践研究[J]. 中华护理教育, 2014, 11(3):212-214.
	Tan SY, Sun J, Chen Y, et al. Practice of situational simulation training for junior nurses in operating rooms[J]. Chin J Nurs Educ, 2014, 11(3):212-214.
[9]	曾春燕, 姚静. “反例”小角色大作用:反例教学的重要性[J]. 首都师范大学学报(自然科学版), 2017, 38(4):18-23.
	Zeng CY, Yao J. Counterexample is small role but useful—the importance of counterexample teaching[J]. J Cap Norm Univ Nat Sci Ed, 2017, 38(4):18-23.
[10]	何善亮. 注意力曲线的内涵及其教学意蕴[J]. 教育科学研究, 2017(5):44-48.
[11]	肖泽梅, 吴婷, 邓雪英. 护生评判性思维培养的研究进展[J]. 护理学杂志, 2016, 31(16):98-101.
	Xiao ZM, Wu T, Deng XY. Training of critical thinking among nursing students:a literature review[J]. J Nurs Sci, 2016, 31(16):98-101.
[12]	凌陶, 金瑞华, 王金玄. 情境模拟教学法在护理本科生综合实训中的应用研究[J]. 中华护理教育, 2018, 15(9):655-660.
	Ling T, Jin RH, Wang JX. Application of situational simulation in comprehensive training for nursing undergraduates[J]. Chin J Nurs Educ, 2018, 15(9):655-660.

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