目的：探讨临床教学中应用6W（what、where、when、who、why、how）理论联合情景模拟教学对于心血管专科操作并发症诊断和处理的效果。方法：将58名学生随机分为2组,每组29人,分别实施6W理论联合情景模拟教学法和传统教学法带教,教学完成时及3个月后对2组学生进行成绩考核,评估对不同专科操作并发症的诊断与处理能力,以比较2种教学方法的效果。结果：6W联合情景模拟教学组教学结束后理论考核成绩为（90.2±2.1）分,高于传统授课组（82.3±2.3）分;操作技能考核成绩为（98.2±4.2 ）分,高于传统授课组（92.6±3.3）分,2组间的考核成绩差异均有统计学意义（P<0.05）。3个月后对2组对象再次测试,6W联合模拟教学组理论考核成绩为（84.4±3.2）分,高于传统授课组（74.1±2.3）分;操作技能考核成绩为（95.5±3.2 ）分,高于传统授课组（88.6±5.4）分,2组间的考核成绩差异均有统计学意义（P<0.05）。结论：通过6W理论联合情景模拟教学对心血管专科新职工进行带教,可有效提升其对心血管专科操作并发症的诊断及实际处理能力,近期和远期教学效果均好于传统教学组。
Objective: To evaluate the application of 6 W (what, where, when, who, why and how) theory combined with scenario-based teaching on diagnosis and treatment of procedure-associated complications of cardiovascular diseases. Methods: A total of 58 newly-recruited (about two years) nurses were divided randomly into two groups with 29 students of each group: study group and control group. Students in the study group were trained by 6 W theory combined with scenario-based teaching and those in control group received traditional teaching. The capability of students for diagnosing and treating procedure-associated complications was assessed at the end of teaching and 3 months afterwards, and the differen-ces between the 2 groups were compared. Results: The scores for acquisition and assimilation of cognitive knowledge were significantly higher in the study group than those of the control group (90.2±2.1 vs. 82.3±2.3, P<0.05), and so was the assessment of operating skills (98.2±4.2 vs. 92.6±3.3, P<0.05) at the end of teaching. Moreover, three months after the end of teaching, scores of theoretical examination and practical performance were also remarkably higher in the study group than in control group（84.4±3.2 vs. 74.1±2.3, P<0.05; 95.5±3.2 vs. 88.6±5.4, P<0.05). Conclusions: The teaching program based on 6 W theory combined with scenario-based training is proved to be more effective than the traditional method for the acquisition of cognitive diagnostic knowledge as well as the practical performance both in short and long term.
[1] 秦小金, 丁抗宁, 王小芳, 等. 心内科护士规范化分层培训的应用与评价[J]. 中国医药导报,2015,12(9):153-156.
[2] 杨霞, 郭军, 董蔚, 等. 关于心内科实习生临床带教工作的体会及思考[J]. 中国心血管病研究,2017,15(11):1048-1050.
[3] 白凤仙, 刘志芳. 情境教学法应用于心内科低年资护士中的教学体会[J]. 中国药物与临床,2015,15(8):1205-1206.
[4] 周婉秋. 追溯中学生消费行为影响因素及引导——以首都师范大学附属育新学校中学生为例[J]. 校园英语,2017,33(33):114-115.
[5] 丁妍, 余健, 张柳燕, 等. 心血管内科专科护理质量指标的构建研究[J]. 护士进修杂志,2017,32(17):1561-1564.
[6] 吴焰, 何晓芳, 游莉. 心血管内科专科护理安全质量评价指标体系的初步构建[J]. 现代临床护理,2017,16(6):65-71.
[7] 胡经文, 阮慧琴, 郭燕, 等. 案例教学法在心内科临床护理教学和医德教育中的应用[J]. 中国医学伦理学,2016,29(4):603-605.
[8] Damp JB, Mendes LA, Goldman M, et al.ABIM/ACC competency-based education pilot in Internal Medicine and Cardiovascular Disease[J]. J Am Coll Cardiol,2017, 70(12):1534-1535.
[9] 胡司淦, 陈辉, 陈耀, 等. 问题导向学习教学法在心血管内科临床带教中的应用分析[J]. 中华全科医学,2016,14(9):1568-1570.
[10] 周艳丽, 史铁英, 陆靖, 等. PBL结合案例教学法在心内科护理本科生临床实践教学中的应用[J]. 重庆医学,2015,44(16):2291-2293.
[11] 王洪芳. 案例教学法在心血管内科护理教学中的应用[J]. 中国卫生产业,2017,14(17):11-12.
[12] Weinstock MB, Weingart S, Orth F, et al.Risk for Clinically Relevant Adverse Cardiac Events in Patients With Chest Pain at Hospital Admission[J]. JAMA Intern Med,2015,175(7):1207-1212.
[13] Dharod A, Soliman EZ, Dawood F, et al.Association of Asymptomatic Bradycardia With Incident Cardiovascular Disease and Mortality: The Multi-Ethnic Study of Atherosclerosis (MESA)[J]. JAMA Intern Med,2016,176(2):219-227.
[14] 孙静, 寇京莉, 郭京. 情景模拟教学在新入职护士规范化培训《症状护理》课程中的应用[J]. 中华现代护理杂志,2017,23(5):602-605.
[15] 李菊, 赵榕, 卢艳艳, 等. 以情景模拟为基础的刻意训练在护生护患沟通能力培养中的应用[J]. 护理研究,2017,31(26):3253-3256.
