【作者】 朱修文；

【导师】 王薇；

【作者基本信息】 浙江大学 ， 护理学， 2010， 硕士

【摘要】 研究目的了解高职高专护理学生评判性思维能力现况,比较不同年级、不同类型护理学生评判性思维能力的特点和差异。据此提出教学对策,在“3+2”高职护生《护理综合》课程中运用PBL教学法并对效果进行评价,以探索提高高职高专护理学生评判性思维能力的有效教学策略。研究方法第一部分采用问卷调查法,使用中文版评判性思维能力测量表(CTDI-CV)对某高职高专院校3个年级460名大专护理学生和2个年级705名高职护理学生进行问卷调查,了解高职高专护理学生整体评判性思维能力现况,以及不同年级、不同类型护理学生评判性思维能力的特点和差异。第二部分采用干预研究的方法,将311名高职护理学生分为实验班和对照班,在《护理综合》课程中实验班运用PBL教学法而对照班运用传统教学法。学生在课程前、后填写中文版评判性思维能力测量表(CTDI-CV),课程结束后进行理论及实验考试并对结果进行比较分析。研究结果1、高职高专护理学生CTDI-CV总分为285.09±29.55分,评判性思维能力强的比例为1.63%。七个维度得分由低到高依次是：寻找真相(36.25±6.41分)、系统化能力(37.61±6.55分)、评判性思维的自信心(39.90±6.55分)、认知成熟度(41.12±6.53分)、开放思想(41.28±5.92分)、分析能力(43.94±5.37分)和求知欲(44.98±6.82分)。2、大专三个年级护理学生在CTDI-CV总分以及寻找真相、开放思想、系统化能力、求知欲和认知成熟度五个维度得分上的差异均有统计学意义(P<0.05)。两两比较的结果显示三年级护理学生在CTDI-CV总分以及以上五个维度得分上高于二年级(P<0.05)；在CTDI-CV总分以及系统化能力、求知欲、认知成熟度三个维度得分上高于一年级(P<0.05)。一年级护理学生在寻找真相维度得分上高于二年级(P<0.05)。高职两个年级护理学生在CTDI-CV总分以及所有七个维度得分上差异均有统计学意义(P<0.05),二年级得分高于一年级。3、一年级大专护理学生和高职护理学生在CTDI-CV总分以及寻找真相、开放思想、分析能力、求知欲和认知成熟度五个维度得分上的差异均有统计学意义(P<0.05)。大专护生高于高职护生。4、《护理综合》课程前,高职实验班和对照班护理学生在CTDI-CV得分和成绩测评上差异无统计学意义(P<0.05)。课程结束后实验班在理论和实验考试成绩上优于对照班,在CTDI-CV总分及寻找真相、开放思想、分析能力、求知欲四个维度得分上高于对照班,差异有统计学意义(P<0.05)；实验班课后CTDI-CV总分及所有七个维度得分均高于课前,差异有统计学意义(P<0.05)。研究结论1、高职高专护理学生评判性思维能力总体虽然达到正性水平,但是接近于正性下限(280分)。评判性思维能力强的学生比例很小。护生寻找真相和系统化能力欠缺,评判性思维的自信心不高。2、在校学习的二年级大专学生与一年级学生相比,评判性思维能力不升反降。进入临床实习的学生评判性思维能力得到普遍提升。说明学校前期教学在发展护理学生评判性思维能力方面可能存在一定缺陷。临床实习能有效提高护理学生的评判性思维能力。3、同一层次不同类型入学的护理学生(大专、高职)在评判性思维能力上具有差异和特点。教学中应该因材施教。4、在高职护理学生的《护理综合》课程中应用PBL教学法能有效提高评判性思维能力,同时促进理论知识和实践技能的掌握。更多还原

【Abstract】 Objective:To investigate the critical thinking ability and compare difference in different grades,different types of education of nursing students from higher vocational schools and colleges. Based on this,to put forward the teaching countermeasures,to explore the application and effects of PBL in integrated nursing course of higher vocational nursing students.Methods:Questionnaire method was adopted in Part 1.The Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV) was used to investigate 460 college nursing students from 3 grades and 705 higher vocational nursing students from 2 grades. Intervention study was adopted in Part 2.311 higher vocational nursing students were randomly divided into two groups, the experimental group and the control group. PBL was applied to the experimental group while traditional method was applied to the control group during the integrated nursing course. All the students fulfilled the CTDI-CV before and after the course. Theory and practical examinations were administrated after the course.Results:1.The total score of CTDI-CV of all students was 285.09±29.55.1.63% students characterized strong ability.The subscale scores were listed as follows:Truth-seeking(36.25±6.41),Systematicity(37.61±6.55),Critical thinking self-confidence (39.90±6.55),Cognitive maturity(41.12±6.53),Open-mindedness(41.28±5.92),Analyticity(43.94±5.37),Inquisitiveness(44.98±6.82). 2.There were significant differences in total score and some subscale scores of CTDI-CV among the college nursing students from 3 grades.3.There was significant difference in total score and some subscale scores of CTDI-CV between college nursing students and higher vocational nursing students of grade 1.4.There was significant difference in the scores of theory and practical examinations between the two groups of higher vocational nursing students. There was significant difference in total score and some subscale scores of CTDI-CV between the two groups after the integrated nursing course, and also between the beginning and the end for the experimental group.Conclusions:1.The total score of CTDI-CV of Nursing Students from Higher Vocational Schools and Colleges showed positive,but a few students characterized strong ability.Nursing students were deficient in the ability of Truth-seeking, Systematicity and Critical thinking self-confidence.2.The college nursing student’s critical thinking ability of grade 2 was below than grade 1,which indicats shortage in current nursing education in promoting critical thinking ability. The critical thinking ability was improved in student practical nurses,which indicates the clinical practice can effectively improve the critical thinking ability of nursing students.3.Nursing students of different types of education shows different characteristics in critical thinking ability,we must teach students according to their aptitude.4.The application of PBL in integrated nursing course can effectively improve the critical thinking ability, and can promote the mastery of knowledge and skills.更多还原