Abstract目的： 了解情景模拟教学对高职大专护理专业学生学习效果的作用，研究情景模拟教学对高职大专护理专业学生学习成绩和学生核心能力的影响。 方法： 本研究应用目的抽样法抽取高职大专护理专业2012级4个班，共178名学生作为研究对象，采用随机分组，组间对比研究设计。将178名学生分为10个学习小组，应用抽签法，随机抽取其中5个学习小组为试验组，剩余5个学习小组为对照组。试验组共91人，对照组共87人。在学生入学后第二学年第4学期进行研究，为期18周，试验组学生运用情景模拟教学，对照组沿用传统教学。分别让两组学生填写自制的情景教学效果评价问卷，中国注册护士核心能力量表（CIRN），同时统一进行理论闭卷考试。将学生学习效果的评价问卷调查结果和闭卷理论考试成绩、实践考核操作成绩进行组间对比，将CIRN量表调查评分的结果进行对比。178名研究对象全程参与，并完成问卷填写和理论考试，资料全部回收。数据整理以后，用SPSS17.0统计软件进行处理，统计学计算均数与标准差，用t检验进行组间对比分析。 结果： 1）教学效果评价： 对两组护理学生在实践教学、学习促进和能力提高等问卷评分结果进行对比，除了时间合理性项目、技能掌握程度的评分传统教学法比情景模拟教学法高，创新能力项目的评分两组间对比没有统计学差异外，其它的项目评分情景模拟教学法均较传统教学法高，且差异有显著性。 2）考试成绩评价 （1）理论考核成绩，采用标准化试题类型包含A1、A2、A3、A4型题，A1、A2型题考查的主要是学生基础理论知识点，A3、A4型题是病例分析题型考查学生分析问题解决问题的能力，结果显示，试验组（47.96±4.38）与对照组（45.31±5.35）的理论成绩A3、A4型题得分高于A1、A2型题，差异有统计学意义（t= 2.12 ，P＜0.05 ）。 （2）实践考核成绩 两组学生的实践总成绩、护患沟通成绩、实践操作技能成绩呈正态分布。再将数据进行描述统计与独立样本t检验，结果显示试验组学生实践考核总成绩（78.31±9.04，）高于对照组（74.92±9.16），差异有统计学意义（t=2.48，P＜0.05）。试验组的护患沟通部分得分（14.56±3.40），高于对照组（12.51±4.66），差异有统计学意义（t=3.37，P＜0.05）。 3）CIRN量表调查评分的结果： CIRN量表测评得分发现，试验组学生平均总分大于280分，对照组学生平均总分小与280分。对两组学生得分进行描述统计与独立样本t检验，结果显示试验组学生CIRN量表总评分（291.70士16.95）高于对照组（278.72士20.95），差异有统计学意义（P<0.05）。在七个分量表中，有四个分量表试验组得分与对照组差异有统计学意义，分别是临床护理试验组（40.91士5.98），对照组（38.57士7.81），（t=2.11，P<0.05）；人际关系试验组（41.87士5.22），对照组（39.35士6.86），（t=2.58，p<0.05）；评判性思维和科研试验组（43.86士5.49），对照组（41.24士5.99），（t=2.85，p<0.05）；领导能力试验组（40.05士5.89），对照组（39.89士6.29），（t=3.15，p<0.00）。其余三个分量表两组学生得分差异无统计学意义，分别是专业发展试验组（40.95士6.02），对照组（9.92士6.12），（t=0.17，P>0.05）；法律和伦理实践试验组（43.35士4.70），对照组(40.59士6.13），（t=1.06，P>0.05）；教育和咨询试验组（40.78士6.15），对照组（39.15士6.94），（t=1.56，P>0.05）。 结论： 情景模拟教学与传统教学相比对高职大专护理专业学生学习效果的作用显著，主要体现在以下三个方面： 1）情景模拟教学可提高学生学习效果，主要表现在： （1）通过促进学生主动性参与、加强学生与教师之间交流、增强了观察应变能力等方面，提高课堂教学效果。 （2）通过加强学生自主性学习、课前预习、收集资料、巩固理解知识、各学科间相互联系提高教学质量。 2）情景模拟教学可促进学生理论考试成绩的提高，尤其在病例综合性分析问题的解答中较传统教学法突出。 3）情景模拟教学通过促进学生评判性思维能力、评估能力、沟通能力、和技术操作能力等方面，培养并提高高职大专护理专业学生核心能力。
Objective: To understand the role of situational simulation teaching in learning out come of higher vocational college nursing students, and explore the learning out come of situational simulation teaching on academic achievement and core competence of vocational college nursing students. Methods: The comparative research design between groups is adopted. It adopts the purposive sampling method to sample 178 students from four classes in Grade 2012 of higher vocational college nursing major, divided the 178 students into 10 learning groups randomly, and ask the 10 group leaders to draw lots, 5 learning groups as the experiment groups, the remaining five groups as the control groups. There are a total of 91 students in experiment groups and 87 students in control groups. The research was conducted in the 4th semester (18 weeks), at the second academic year situational simulation teaching is adopted for experiment group, while traditional learning method is adopted for control group. The two groups of students fill in self-developed situational simulation teaching outcome evaluation questionnaires and competency inventory for registered nurse (CIRN), and close-book theory exam is made for the students. Then make comparison about evaluation questionnaire survey results, close-book theory exam results and practical Skill evaluation results as well as CIRN questionnaire survey scoring results between the two groups. The 178 research objects are in whole-course involvement, and complete the questionnaire filling and theory exam, the relevant data are taken back for analysis. After data sorting, SPSS17.0 statistical software is used for handling, statistics is used for calculation of average value and standard deviation, and t-test is used for comparison and analysis between groups. Results: 1) Evaluation on teaching out comes Based on survey results about teaching out comes in two groups of students and comparison about practical teaching, study promotion, capacity improving and questionnaire scoring results, the scoring of time allocation reasonability and skill mastery degree for traditional teaching method is higher than that of situational simulation teaching, innovative capacity scoring features no statistical difference between the two groups, for other items, scoring for situational simulation teaching is apparently higher than that of traditional teaching method. 2) Evaluation of exam results (1) As for the theory exam results, the standardized test question type consists of A1, A2, A3 and A4, A1 and A2 mainly aims at basic theory knowledge, while A3 and A4 belong to case analysis type which can check the students’ comprehensive capacity in solving problems, results indicate that theory achievement for A3 and A4 is higher than that of A1 and A2, its difference is statistically significant (experimental group scores are 47.96±4.38，contrast group scores are 45.31±5.35). （t=2.12, P＜0.05） (2) Practice evaluation scores Practice evaluation scores show that the practice scores, nurse-patient communication scores and practice skill scores present a normal distribution. The descriptive statistics and t-test of independent samples on the data show that the practice evaluation scoring for experiment group is higher than that of control group, and its difference is statistically significant (experimental group scores are 78.31±9.04，contrast group scores are 74.92±9.16，t=2.48, P＜0.05）. The nurse-patient communication scoring for experiment group is higher than that of control group, and its difference is statistically significant（experimental group scores are 14.56±3.40，contrast group scores are 12.51±4.66，t=3.37, P＜0.05）, the difference in the scores of practice operation technology between two groups is not statistically significant . 3) CIRN questionnaire survey scoring results: CIRN questionnaire evaluation scores show the average total scores for experiment group are above 280, while average total scores for control group is below 280. The descriptive statistics and t-test of independent samples on scores of two group of students show that CIRN questionnaire evaluation scores for experiment group are higher than those of control group, the difference is statically significant (t=4.29，P<0.05）. In the seven sub questionnaires, difference between scores of experiment group and scores of control group in four sub questionnaires is statistically significant, clinical nursing （experimental group scores are 40.91士5.98，contrast group scores are 38.57士7.81，t=2.11，P<0.05）; interpersonal relationship （experimental group scores are 41.87士5.22，contrast group scores are 39.35士6.86，t=2.58，p<0.05）; critical thinking and research （experimental group scores are 43.86士5.49，contrast group scores are 41.24士5.99，t=2.85，p<0.05）; leadership (experimental group scores are 40.05士5.89，contrast group scores are 39.89士6.29,t=3.15，p<0.00). For the other three sub questionnaires, the difference in scores between two group is not statistically significant, respectively professional development (experimental group scores are 40.95士6.02, contrast group scores are 39.92士6.12，t=0.17，P>0.05); legal and ethical practices (experimental group scores are 43.35士4.70，contrast group scores are 40.59士6.13，t=1.06，P>0.05); education and consulting (experimental group scores are 40.78士6.15，contrast group scores are 39.15士6.94，t=1.56，P>0.05). Conclusions: Compared to the traditional teaching, the role of situational simulation teaching in learning out comes of higher vocational college nursing students is apparent, mainly embodied in the following three aspects: 1) The situational simulation teaching can enhance the teaching out comes, as shown in the following: (1) Enhance the teaching out comes by boosting active participation of students, enhancing the communication between students and teachers and reinforcing capacity in observation and adaptability to changes. (2) Improve the teaching quality by enhancing the students’ learning autonomy, review and preview before class, data evaluation, knowledge grasp and interrelation of disciplines. 2) The situational simulation teaching can boost the theory exam scores of students, especially, its comprehensive analysis about examples is more excellent than traditional teaching. 3) The situational simulation teaching can train and enhance the core competence of higher vocational college nursing students by boosting students’ critical thinking capacity, evaluation capacity, communication capacity, technical operation capacity and other aspects.