BACKGROUND:Increased professional commitment is essential for relieving the nursing workforce shortage, which is exacerbated by the COVID-19 pandemic. The professional commitment of graduating nursing students is a powerful predictor of their work commitment. However, limited information is available regarding graduating nursing students' professional commitment. Existing studies investigating nursing students' professional commitment are limited by their lack of theoretical foundation. OBJECTIVES:To investigate the level of graduating nursing students' professional commitment and its multilevel influencing factors from the perspective of the Ecological Systems Theory in the early days following the COVID-19 outbreak. DESIGN:A descriptive cross-sectional study. SETTING:Three educational institutions in Shanghai, China. PARTICIPANTS:513 nursing students who were graduating with an associate or bachelor's degree. METHODS:The independent variables were measured by a self-designed questionnaire. The dependent variable professional commitment was measured by the Nursing Professional Commitment Scale. Hierarchical regression analyses, which allowed the independent variables entered in order, were performed to identify the significant predictor variables of the professional commitment and its dimensions. RESULTS:The level of professional commitment was 100.15 ± 20.35 (score ranged between 34 and 136). The individual factors (degree, whether had received a scholarship during the past academic years, ΔR2 = 0.142), family factors (parents and siblings' attitudes towards one's majoring in nursing, ΔR2 = 0.153), educational factors (academic faculty's belief in nursing profession, leaders' emphasis on nursing profession, satisfaction with clinical instructors' role modeling, ΔR2 = 0.097), and social factors (reason for majoring in nursing, perceived nurse-patient relationship, ΔR2 = 0.153) were significant predictors of the graduating nursing students' professional commitment (R2 = 47.6 %, F = 32.277, p < 0.001). CONCLUSIONS:The graduating nursing students had a moderate level of professional commitment, which needed to be improved. Nursing educators should comprehensively consider various factors to understand the relationship between individuals and environmental systems, and implement targeted interventions to shape the positive professional values of nursing students.

Objective:To examine the influence of professional commitment and significant others on occupation choices in graduating nurse students.Methods:From February to April 2020, 477 graduating nursing students from four medical colleges or universities located in Shanghai were involved in the survey. The questionnaire items included general personal information, nursing professional commitment scale, significant others and occupation choices. Multinomial logistic regression analysis was used to identify influencing factors of nursing students' occupation choices.Results:The significant others for nursing students' employment choices were their parents [70.6% (337/477)], teachers [12.2% (58/477)], peers [9.4% (45/477)] and others [7.8% (37/477)], respectively. The results showed that the score of professional commitment of nursing students was (100.53±20.71); the most significant others influencing nursing students' occupation choice were their parents and school teachers. The proportion of nursing students choosing "hospital nurse" as their occupation choice is 67.9%(324/477); the graduating nursing students with higher score of professional commitment are less likely to choose continuing their education as graduate students( OR=0.961, 95% CI=0.938~0.984) or other unrelated occupations( OR=0.916, 95% CI=0.886~0.948). The graduating nursing students who has higher satisfaction with their clinical teachers during the internship ( OR=0.164, 95% CI=0.030~0.894; OR=0.371, 95% CI=0.144~0.959) were less likely to choose other unrelated occupations. Academic teachers ( OR=2.896, 95% CI=1.212~6.920) may be significant others to graduating nursing students who prefer to continue their education as graduates. Conclusions:Professional commitment is a key factor affecting occupation choices of graduating nursing students, and teachers have a significant influence on nursing students' choosing occupation.

目的:了解护理本科生毕业课题实施中的困难,为改进相关管理提供参考;方法:对本校2013～2015级护理本科生开展调查,采用方差分析、t检验、相关分析比较不同阶段困难程度或分析一般资料对困难总分的影响;结果:共收到106份有效问卷;困难总分均值为(9.69±3.39)分,困难程度平均为[(36.01±18.75)％].不同年级、选题来源、课题类型、研究场所、导师职称、导师单位等6项的学生困难总分差异无统计学意义,P>0.05;选题阶段、开题阶段、调研实施阶段、统计分析阶段、论文撰写与答辩阶段困难程度分别为(42.61±18.56、37.26±15.86、31.76±17.51、38.30±25.35、30.15±11.09),F=8.17,P<0.01;选题阶段、开题阶段、统计分析阶段困难程度显著高于另外两个阶段;研究基础与困难总分的相关系数为-0.269,P<0.01.结论:护理本科生毕业课题研究困难有普遍性且个体差异较大;确定选题、科研设计、统计分析依然是护理本科生毕业课题实施的难点,需引起教育管理者重视并设法改进;本科生在开始毕业设计之前的学习阶段参加科研或社会实践有助于提升其完成毕业课题的能力.

Objective To explore domestic research status of nursing clinical competence assessment. Methods Relevant literatures on nursing clinical competence assessment published before July 2012 were retrieved from the databases of CNKI,Wanfang and CMB,and analyzed. Results Literatures on nursing clinical competence assessment debuted in 1994.A wide range of assessment objects were covered,with 59.7% of the literature focusing on undergraduate students;83.1% of the literature were research studies,which mainly focus on assessment system(55.8%) and practice(22.1%).Methods used in assessment included questionnaire surveys,OSCE and other forms,with some terms being used inconsistently.Research institutes of these literature showed some central trend. Conclusion Domestic research on nursing clinical competence assessment is still in its infancy.Use of the concepts should be standardized,assessment system should be developed according to different training goals of objects.Methods of assessment need further exploration.

<正>研讨会(seminar),是学生为研究某一问题而与教师、专家共同讨论的一种教学或学术交流形式。seminar的特点是互动性,有助于激发师生的创造潜能,有助于构建民主、平等的现代师生关系,有助于培养合作精神。护理个案seminar在组织形式上融合了传统病例讨论课和seminar的特点:①非正式性。护理个案seminar被定位为课余的补充学习形式,是学生之间的同辈交流平台,在没有考核压力的情况下,学生们的参与更为轻松自如,更容易体现seminar的互动特色。②突出学生的主体性。而护理个案seminar的研讨内容由

Objective To explore the effects of case seminar in the training of graduate nursing students' clinical practice competence and comprehensive ability. Methods The care cases were prepared by the professional-degree nursing graduates, and were discussed in groups by all nursing graduates supervised by the tutors. The students ' evaluation on the seminar was collected by questionnaires. Results The students gave high appraisal on the preparation of cases(93.2%),devotion(77.3%) and interest(61.4%) to the seminar and the discussion atmosphere(61.4%). Moreover,they agreed that the seminar could increase professional knowledge(63.6%),improve clinical thinking(70.5%),promote communications between students and teachers(65.9%), and strengthen team spirit(79.5%). Conclusion Case seminar can mobilize the graduates ' interest in clinical problems, contributes to the development of clinical-thinking and clinical practice competence,as well as the comprehensive abilities.

Objective To clarify people′ s cognition about the connotation of clinical competence through appraising the existing evidence.Methods To clear up the existing evidence concerning the connotation of clinical competence,we retrieved related literature,screened out the research objects,selected the representative concepts,extracted independent connotation,and appraised the contents,etc.Results Seven independent connotations of clinical competence,four connotations of nursing clinical competence or nurse′ s clinical competence were extracted,four of which gave generalized or narrow sense to clinical competence rationally.Limits of the existing interpretion include:inappropriate description of the essence of competence;failure to correctly interpret the essence of clinical;inappropriate interpretion of ways and factors of clinical competence;limited or inappropriate definition of the principal part of clinical competence;syntax or logical errors in descriptions;tautology:using words containing clinical to interpret the connotation of clinical competence.ConclusionIt is suggested that the generalized connotation of clinical competence is the capability that medical staffs possess to provide medical or nur-sing service to the objects in medical or nursing facilities,and the narrow sense of it is the necessary capability that medical staffs possess to be engaged in such activities as diagnosis,treatment and nursing care.

目的:通过考核了解护理硕士专业学位研究生的临床能力状况;方法:床旁护理查房、操作考核、病史记录检查、带教老师访谈等;结果:护理硕士专业学位研究生的专业思想评价良好,护理病历书写欠规范,护理查房主要存在以下问题:(1)收集资料和沟通能力较欠缺;(2)体格检查能力薄弱;(3)病例分析能力不足;结论:护理硕士专业学位研究生的临床能力培养模式有待进一步完善。

Objective To explore problems in cultivation and assessment of clinical competence of professional-degree nursing postgraduates(PNP).Methods Holistic nursing ward round,operational examination,nursing records and rotation records checking,and clinical instructors interview were adopted.Results Career thoughts of PNP are favorable,while skills and capability on nursing records and holistic nursing seemed relatively weak.Conclusion Cultivation of clinical competence of PNP need to be strengthened;incentive mechanism should be made to inspire the enthusiasm of tutors and clinical instructors in cultivation of the PNP;assessment system of clinical competence for PNP should be developed and improved constantly,and so does the assessment-results-disposal system.

Objective To investigate the status of self-directed learning in nursing students and to analyze the influencing factors.Methods Totally,624 nursing students were evaluated by using a self-designed demographic information form and the Self-Rating Scale of Self-Directed Learning.Results The total score of self-directed learning was 223.58±29.86,with total scores and scores of all dimensions being greater than 70% of the expected scores.However,95.83% of the students knew little about the term of self-directed learning.In comparison of the total score,the score of girls was higher than that of boys;freshmen higher than sophomore and diploma students higher than undergraduate students(P<0.05,P<0.01).The availability of learning resources,learning motivation,team work and learning habits were particularly important predictors of self-directed learning(P<0.01 for all).Conclusion Self-directed learning of nursing students is fairly good.However,some differences in self-directed learning are seen in students with different genders,school years and educational levels.In order to improve students′ capability of self-directed learning,nursing educators should help students identify their motives,direct them to harness all available resources efficiently,and cultivate good learning habits and team work spirit.

老年髋部骨折是指发生在65岁以上老年人的股骨颈和股骨粗隆间骨折.流行病学调查表明,亚洲国家的老年髋部骨折发生率较欧美国家低.但是随着老龄化的加速发展,我国65岁以上老年人越来越多(2000年已达1.1亿,占总人口的8.5%),老年人髋部骨折的发生率也逐年增加(目前估计为每年30多万例).

总结了老年病房意外伤害的影响因素,包括环境因素、患者自身因素、照护者因素、管理制度等,并提出了预防措施,如改善环境,加强对患者和照护者的管理等。认为应改善老年病房环境,加强对患者和照护者的管理,健全管理体系。

创伤急救护理技能涵盖了对伤情的判断及处理,如止血、包扎、固定、搬运.以往传统教学方法往往以单项技能为轴心训练,这种教学方法能使学生熟练掌握单项急救技术,但是比较枯燥乏味,在实际应用中,不利于学生将创伤急救理论和技能实践有序结合,当学生面对突发紧急情景时,往往会手足无措.情景教学是在教学过程中,教师有目的地激发学生的学习兴趣,创设与教学内容相符的生动具体场景,将理论知识演化为直观内容,引导学生对所学专业知识进行自我的追求和探索,从而帮助学生加深对教材的理解[1].我院教师在总结往年急救护理学教学实践经验,结合学院课程建设的基础上,在创伤急救护理技能教学中运用情景教学法,以激发学生的学习兴趣,帮助学生在创伤急救理论和实践中架起一座桥梁.现介绍如下.