有效沟通在儿科护理学体验式教学中的应用

儿科护理学是一门生命科学，是实践性很强的应用学科，由于面临护理对象的特殊性，要求学生除具有丰富的基础知识，较强的操作技能，尤其要具备良好有效沟通能力。

在校护生缺乏社会经验，在临床见习或实习操作过程中不能满足患儿及家长的需求。

当前我国4-2-1的家庭模式，家长对患儿过度关注，学生在临床岗位，面对患儿及家长时就会胆怯、紧张、易产生交流障碍，在临床护理过程中经常出现患儿家长不配合护理人员现象，严重影响护理质量。

本研究的目的在于把有效沟通应用在儿科护理体验式教学中，让学生在实际体验式学习中强调“说中学”“做中学”，转变教师的教学方式，实现学生学习方式转变，激发、调整、升华学生的知、情、意、行等方面素质和潜能。

成为效力更持久的学习方式。

同时，学生在创设情境模式内学会如何有效沟通，加强与临床工作联系，通过角色体验，体会到患儿及家长的心情，了解患儿及家长的心理需求，学会换位思考和人文关怀。

一、对象与方法以2013级普通护理专业69名学生为研究对象。

将该班分为试验班（33人）和对照班（36人），每班分为5个组，一组6～7人，设组长1名，负责教学任务的组内分配。

由同一名教师进行讲授，使用相同教材。

试验班与对照班均实施体验式教学模式，其步骤包括：创设情境，根据教学单元设置编写病例，由于护生尚未接触临床，课前护生负责收集病历，课下通过网络平台师生交流，在教师指导下进行整理，确定病例后模拟临床场景，让护生自主学习，合作探究，研究分析感悟体验，制定处理对策，并系统实施。

试验班增加角色互换，在每个病例中设置医生1人，护士2人，患儿1人，患者家属2～3人，由护生模仿医护患三方，每次变换不同角色，引进标准化病人的同时，针对儿科护理对象特殊性，引进标准化病人家属，不同家属代表不同性格、不同年龄，学生自由发挥，侧重护生与家属沟通。

课程全部结束期末考试，并向学生发放调查问卷。

二、结果本研究中所有数据结果应用SPSS软件进行统计分析，采用t检验，P<0.05为有统计学差异。

1.考试成绩。

期末考试成绩分为三部分：理论基础知识，包括A型选择题、填空题、名词解释题、简答题，共50分;病例分析题20分，考核学生整体护理能力;实验30分，主要考核学生动手能力与整体思维。

实验考试与理论基础知识、病例分析部分阅卷由同一名教师完成。

实验班、对照班理论基础分别为41.72±5.63和42.15±3.12，病例分析分别为13.71±3.73和14.12±4.21，实验分别为24.28±4.22和20.15±3.09，两个班级的理论基础、病例分析、实验的P值分别为0.125、0.072、0.013。

两班在理论基础知识部分、病例分析P值均大于0.05，不具有明显统计学差异，因此两班在理论基础知识、病例分析部分成绩没有明显区别。

实验成绩P值0.013<0.05，具有明显统计学差异，试验班的实验成绩高于对照班。

2.调查问卷。

调查问卷为三点记分制选择题。

发放调查问卷69份，回收有效问卷67份，有效回收率为97.1%。

问卷调查结果为：情景设置有趣实验班、对照班分别得分2.15±0.62和2.13±0.57，P值为0.125;课堂演练针对性强、贴近实际实验班、对照班分别得分2.22±0.52和2.21±0.27，P值为0.157;提高分析问题、解决问题能力实验班、对照班分别得分1.71±0.64和1.74±0.27，P值为0.103;提高课堂学习效率实验班、对照班分别得分2.13±0.56和2.16±0.66，P值为0.097;提高人际沟通能力实验班、对照班分别得分2.23±0.52和2.02±0.47，P值为0.015。

调查结果看出，两班在情景设置有趣、课堂演练针对性强、贴近实际、提高分析问题和解决问题能力、提高课堂学习效率等方面没有明显统计学差异;在课堂教学气氛和效果明显改善、激发学习兴趣、理解患儿及家属感受、注意保护患儿隐私、提高人际沟通能力等方面有统计学差异，说明应用有效沟通的体验式教学有助于这些方面的提高。

三、讨论护理专业不仅仅是一门医学专业，更是一门人文专业，要求学生必须以人为前提，关心人，理解人。

儿科护理学作为特殊护理专业，小儿自身特点及现代家庭对小儿患病的重视，要求护理专业学生做到以患儿及其家庭为中心，在临床工作中做好沟通工作。

1.有效沟通对于在体验式教学中提高护生学习成绩的影响。

加入有效沟通的体验式教学相较于传统体验式教学，在理论知识与案例分析方面并未显示明显优势，但在实验方面显示出明显的优势，说明加入有效沟通的方式不仅锻炼护生的沟通能力，在与患儿及患儿家属交流过程中强化了技能的操作，规范了相关的技能操作标准。

2.有效沟通对在体验式教学中激发护生的学习热情的影响。

调查问卷结果显示，加入有效沟通的体验式教学相较于传统体验式教学在改善课堂教学气氛和效果、激发学习兴趣方面有明显优势。

分析其原因，传统体验式教学由于每次情景的设定的类似，学生容易产生疲倦心理，而有效沟通的加入，让情景再现既相似又不同，吸引了护生注意力，增加护生对该环节的期待值，情景模拟平台中学生可以充分展示自己，护生不同的沟通方法，这样能激发护生的兴趣，进一步提高了护生的学习热情。

3.有效沟通对在体验式教学中培养护生职业素养的影响。

在临床工作中，护士需要理解患者感受，注意保护患者的隐私，护士的每一次工作都是使患者身心达到完美状态的道德观念实践。

通过有效沟通在体验式教学中的应用，可以帮助护生在理解患儿及家属感受、注意保护患儿隐私、提高人际沟通能力等方面有所提高。

护生作为不同的角色来看待护理工作，如果没有真实的情感，没有人文关怀的意识是无法真正做到在实际工作中与患儿及家属建立起理解信任。

因此，此种教学方法能够提高护生的职业素养，增强其人文关怀意识。

四、结语将有效沟通融入到体验式教学中，能够改变护生的学习过程，提高学生的学习成效，提高护生职业素养，使护士更好地适应未来护理工作需要。

Pediatric nursing is a life science, is a practical subject and the application of facing the particularity of nursing object, asked the students in addition to have rich knowledge, strong operation skills, especially must have good ability to communicate effectively. College nursingstudents lack of social experience, in the process of clinical practice or internship operation can't meet the needs of children and their parents. Current our country the 4-2-1 family pattern, parents of children with excessive attention, students in the clinical work, the face of children and their parents will shy, nervous, easy to produce communication disorders, often appear in the process of clinical nursing parents don't cooperate with nursing staff phenomenon, seriously affect the quality of care.The purpose of this study is to apply effective communication in pediatric nursing experience type teaching, let students in actual experiential learning emphasizes the "high school", "said high school" transformation of the mode of teachers' teaching and students learning style changes, inspire, adjustment, sublimation of the students' cognition, emotion, meaning and line quality and potential. Become a more lasting learning style. At the same time, students learn how to communicate effectively within the establishment situation pattern, strengthen the contact with clinical work, in the role of experience, and experience the mood of children and their parents, children and parents of psychological understanding demand, learn empathy and humanistic care.A, objects and methodsTo level 2013 ordinary nursing specialty, 69 students as the research object. The class is divided into experimental class (33) and that in comparative classes (36), each class into five groups, a group of 6 to 7 people, a group leader 1, responsible for the teaching task allocation in the group. Taught by the same teacher, using the same materials. Experimental class and that in comparative classes are implementing experience type teaching mode, its steps include: the establishment situation, according to the teaching unit set up the writing case, because of clinical nursing students have not been contact, nursing students before class is responsible for the collection of records, communication between teachers and students of class through the network platform, in under the guidance of teachers, determine the cases after simulating clinical scenarios, let students autonomous learning, cooperation, study feeling experience, countermeasures to deal with, and system implementation. Experimental class increase the roles were reversed, in each case set 1 doctor, nurse 2 people, 1 children, family members of patients with 2 ~ 3 people, by the nursing students to imitate the medical risk of three parties, each different roles, the introduction of standardized patient at the same time, in view of the pediatric nursing object particularity, the introduction of standardized patients' families, families represent different personality, different age, students, focusing on the nursing students to communicate with their families. Course all over the final exam, and questionnaires to the students.Second, the resultsAll data results in this study carried out a statistical analysis on the application of SPSS software, using t test, P < 0.05 for statistically significant.1. The examination results. The final exam is divided into three parts: theoretical foundation knowledge, including A type choice, fills up the topic, nouns explain topic, the short answer, A total of 50 points; Case analysis problem with 20 points, assessment students overall nursing ability; Experimental 30 points, the main assessment of the student beginning ability and the overall thinking. The experiment test and theory of knowledge, case analysis part marking performed by the same teacher. Experimental classes, the theoretical basis that in comparative classes were 41.72 + / - 5.63 and 42.153.12 mm, case analysis were 13.71 + / - 3.73 and 14.12 4.21 mm, the experiment was 24.28 + / - 4.22 and 20.15 + / - 3.09 respectively, two classes oftheoretical basis, case analysis, experimental P values were 0.125, 0.072, 0.013, respectively.Class two basic knowledge in the theory part, case analysis P values were greater than 0.05, no significant statistical difference, so both classes in basic knowledge of theory, case analysis result there was no significant difference. Experiment results P values < 0.013, 0.013 has significant statistical difference, experiment results of experimental class is higher than that in comparative classes.2. The questionnaire. Questionnaire for three marking system choice. Questionnaires of 69 copies, recycling effective questionnaire 67, effective recovery rate was 97.1%. Questionnaire survey results for: scene set interesting experimental classes, and that in comparative classes scored 2.15 + / - 0.62 and 2.13 + / - 0.57 respectively, P value is 0.125; Classroom exercises are pointed, close to the actual experimental classes, that in comparative classes scored 2.22 + / - 0.52 and 2.21 + / - 0.27 respectively, P value is 0.157; Improve the ability to analyze and solve problems experimental classes, and that in comparative classes scored 1.71 + / - 0.64 and 1.74 + / - 0.27 respectively, P value is 0.103; Improve the efficiency of classroom learning experimental classes, and that in comparative classes scored 2.13 + / - 0.56 and 2.16 + / - 0.66 respectively, P value is 0.097; Improve interpersonal communication experimental classes, and that in comparative classes scored 2.23 + / - 0.52 and 2.02 + / - 0.47 respectively, P value is 0.015.The results of the survey, two classes in the scene setting interesting, pointed, close to the actual classroom practice, improve the ability to analyze and solve problems, improve the efficiency of classroom learning etc. There was no significant statistical difference; In classroom teaching atmosphere and the effect is improved obviously, stimulate interest in learning, understanding of children and their families feeling, pay attention to protect children's privacy, improve interpersonal communication ability, etc have statistically, illustrate the application of effective communication helps to improve these aspects of the experience type teaching.Third, discussNursing is not only a medical professional, but also a humanities courses, students must be people-oriented, caring, understanding person. As a special nursing, pediatric nursing pediatric characteristics and the modern family, to the attention of the children fell ill for nursing students do on children and families, to do a good job of communication in the clinical work.1. Effective communication in the experience type teaching to improve the effect of nursing students Join the effective communication of experiential teaching compared with traditional experiential teaching, in the aspect of theory and case analysis did not show obvious advantage, but in the aspect of experiment shows obvious advantages, add effective communication way that not only exercise nursing students communication skills, in the process of communicate with children and families of children with strengthened the skills of operating, skills relevant to the regulated standard operation.2. Effective communication to stimulate in the experience type teaching nursing students' learning enthusiasm. Effectively communicate, according to the results of the questionnaire to join the experience type teaching compared with traditional experience type teaching in improving classroom teaching atmosphere and the effect has obvious advantages, stimulate interest in learning. To analyze its reason, the traditional experiential teaching since each set of similar scenes, students easy to produce fatigue, and effective communication, let the scene reappearance both similar and different, attracted attention of nursing students, increasing expectations on the part of nursing students, scene simulation platform for middle schoolstudents can fully display their, nursing students of different communication methods, it can stimulate the interest of nursing students, to further improve the nursing students enthusiasm of learning.3. Effectively communicate to the cultivation of nursing students in the experience type teaching professionalism. In clinical work, nurses need to understand the patient feeling, pay attention to protect the privacy of patients, nurses in every job is to make the perfect state of body and mind in patients with moral practice. Through effective communication in the application of experiential teaching, can help nursing students in understanding the children and their families feeling, pay attention to protect children's privacy, improve interpersonal skills have improved. Nursing students as a different look at the role of nursing work, if there is no true feelings, can not be truly without humanistic care consciousness in the practical work with children and their families understand trust. Therefore, this kind of teaching method can improve the professional quality of nursing students, enhance their humanistic care consciousness.Four, conclusionTo communicate effectively integrated into the experience type teaching, can change the nursing students in the learning process, improve the students' learning, improve the professional quality of nursing students to better adapt to the future nursing work needs.。