目的 开发虚拟病人护理问诊教学系统并评价其应用效果。方法 基于功能性健康型态构建护理问诊虚拟病例设计框架,包括17个项目,以此设计21个虚拟病例,在试运行后优化为最终的虚拟病人护理问诊教学系统。选择某医院2017年7月—12月的46名实习生为对照组,按照常规实习计划进行实习;2018年7月—12月的44名实习生为试验组,在常规实习的基础上使用该系统进行问诊练习。评价学生的问诊能力和评判性思维能力,调查试验组对该系统的评价。结果 教学前后两组问诊自评得分、评判性思维得分的差值比较均有统计学意义（Z=-4.234,P<0.001;Z=-2.588,P=0.010）。90.9%的实习生认为该系统的虚拟病例符合临床真实病例,93.2%的实习生认为该系统能够提高其对护理问诊的兴趣和积极性,并有助于尽快适应临床实习。结论 虚拟病人护理问诊教学系统能够有效提高学生的护理问诊和评判性思维能力,具有较好的可行性。

Objective To develop a Virtual Patient Nursing Inquiry Teaching System and evaluate its effects. Methods Based on the Functional Health Pattern,the framework of virtual case design in nursing consultation was constructed,including 17 projects. Twenty-one virtual cases were designed and optimized to establish the final Virtual Patient Nursing Inquiry Teaching System. A total of 46 nursing students from July to December 2017 in a hospital were recruited as the control group and routine practice schedule was used in this group. Another 44 nursing students from July to December 2018 were assigned to the experimental group. Besides routine practice schedule,the Virtual Patient Nursing Inquiry Teaching System was also used in the experimental group. Students’ ability of inquiry and critical thinking,and the experiences of students in the experimental group were all collected. Results There were statistically significant differences in ability of inquiry scores and critical thinking scores between the two groups（Z=-4.234,P<0.001;Z=-2.588,P=0.010）. 90.9% of the nursing students thought that the virtual cases of the system were consistent with the real clinical scenarios,and 93.2% of nursing students thought that the system could improve their interest and enthusiasm in nursing inquiry and help them adapt to clinical practice as soon as possible. Conclusion The Virtual Patient Nursing Inquiry Teaching System can effectively improve students’ nursing inquiry and critical thinking ability,and has a good feasibility.