Chang-Xu Kan,Yong-Chao He,Hong-Xu Ren,Xiao-Yu Liu,Liang-Chen Sun

1The Affiliated Yantai Yuhuangding Hospital of Qingdao University,Yantai 264000,China. 2The Affiliated Children’s Hospital of Shandong University,Jinan 250022,China. 3Zouping Municipal People's Hospital,Binzhou 256216,China.

Abstract Objective: To explore the application effect of constructing professional teaching staff in low‐level training in operating room, so as to further optimize the teaching strength of operating room in our hospital and improve the training effect of junior nurses. Methods:Thirty‐eight low‐level nurses in the operating room of a third‐class hospital in Yantai were selected for half a year's nurse training. With theoretical scores, overall nursing performance, nurses' self‐awareness evaluation system and nurses' satisfaction with tutors as evaluation criteria, and based on the selection of high‐quality teachers, various evaluation indexes before and after the training of low‐level nurses in the operating room were compared and evaluated through the cultivation of practical teaching teachers' ability and the application of a series of teaching methods based on the change of competence‐based education (CBE) teaching mode, the application of guided learning interactive canadian education (BOPPPS) teaching model and problem‐based learning (PBL) teaching method.Results: After the training, the examination scores of low‐level nurses were significantly improved (P ＜0.05), the teaching quality was highly recognized by low‐level nurses, the quality of low‐level nurses was improved, and patients' satisfaction with nurses was improved. Conclusion: It is of great significance to assist the construction of professional teachers in evidence‐based medicine. Through the training of practical teaching teachers'ability and the application of a series of teaching methods based on the change of CBE teaching model, the application of BOPPPS teaching model and PBL teaching method, the training results of nurses have been significantly improved and improved, which is worthy of clinical reference and promotion.

Keywords: training of‐level nurses; construction of teachers; operating room;competence‐based education; guided learning interactive canadian education;problem‐based learning

Background

Strengthening the construction of operating room nursing teachers is an important guarantee to improve the teaching level of the operating room, and the construction of professional teachers plays a pivotal role in the training of nurses in the operating room. With the continuous development of the health industry, the society has also put forward higher requirements for nursing services, to further strengthen the construction of the clinical nurse team, to improve the service ability of clinical nurses, and to vigorously cultivate clinical practical talents [1]. In today's society, people have higher standards for nursing work and higher standards. Improving the quality of clinical nursing and developing a nursing career is the most fundamental to improve the level of nursing education, and the key lies in the effect of clinical nursing teaching. Strengthen the construction of teachers in the operating room of our hospital,promote the development of the discipline construction of the operating room, and cultivate high‐quality specialized talents [2]. The continuous reform and improvement of the teaching methods of the operating room teachers in our hospital.Through the effect analysis of the clinical teaching results of the samples (low‐level operating room nurses), the evaluation indicators of the nurses before and after the training have been significantly improved, and the discipline construction of the operating room of our hospital has achieved good results.

General information

Study subjects

The study subjects selected 38 low‐level nurses in the operating room of a third‐class hospital in Yantai, and the low‐level nurses were included in the standard: (1) no operating room practical experience in the hospital; (2) fresh graduates or length of service ＜1 year; (3)the study subjects were less different and had not received professional training. Exclusion criteria: those who voluntarily quit for any reason.There are 76 subjects in this study,including 64 males and 12 males, aged from 18 to 23 years, with an average age of (20.26±1.37) years.

Study methods

This study combines literature and evidence‐based nursing, trained low‐level nurses by building high‐level teachers, and compared the assessment scores of low‐level nurses before and after the training.Traditional teaching model was applied in the control group. The key parts and difficult parts of the textbook are explained to the students in the form of indoctrination. Students in the experimental group used the teaching method after the teaching reform to compare the teaching results.

The evaluation system of nurses includes theoretical performance and overall nursing performance, students' evaluation and cognitive system of the tutor's teaching concept, and nurses' satisfaction with the tutor's teaching. All data were analyzed by the statistical software package SPSS 26.0. Counting data were compared using a chi‐square test, expressed in (± s), t‐test for test levelα= 0.05, andP＜0.05 for statistical data. Statistical significance.

Construction of high-level teaching staff

Selection of nursing care tutors

To ensure the quality of nursing training, the selection, training and assessment of clinical teaching teachers are the key [3]. Teaching tutor requires high clinical teaching ability, professional and above professional titles, and can guide low‐level nurses to carry out theoretical and practical operation, and have high professional quality. The selection criteria for teaching tutors are as follows:

Tutors require a solid and skilled business foundation, good learning, expression, communication and coordination ability, serious,responsible work and quick response[4].

After the consent of the nursing department, the teaching tutor underwent systematic training, and finally passed the final assessment by the nursing department and the head nurse. The establishment of a one‐to‐one tutorial system can enable newly graduated nurses to adapt to the role change from students to professionals as soon as possible,improve their theoretical level and practical ability of surgical care,and improve the management ability and responsibility of teaching[5].

Volunteer to participate in clinical teaching work, full of work enthusiasm,willing to contribute.

Cultivation of teachers'practical ability

Practical teaching is an important method to test the teaching level,and an important link for low seniority nurses to integrate the knowledge learned into the actual work. It is an important period for low seniority nurses to understand the operating room initially. At this stage, the guiding role of teachers is particularly important. In the past, most teaching teachers lacked systematic and standardized training, and the practical teaching ability of teaching teachers was lacking [6]. To further strengthen the construction of operating room nursing teachers and improve their comprehensive ability, phased methods were adopted to train their practical teaching ability.

Operating room nursing staff are the main practitioners of nursing practice teaching tasks, and play a vital role in teaching, effectively promoting the organic integration of theory and practice among low‐seniority nurses [7]. Therefore, the quality of nursing tutors play a very critical role in the training of the nursing team. The training of practical ability of nursing tutors is divided into the following three parts:

(1) Pre‐job training stage. In view of the theoretical knowledge preparation of low‐level nurses, pre‐job training, familiar with the basic rules and regulations of the hospital, job responsibilities and basic procedures, the core system of the operating room and the relevant knowledge of the hospital sense.

(2) Practical training stage. According to the pre‐job theoretical knowledge storage and allocation and skills learning, combined with clinical reexplanation, deepen the understanding of theoretical knowledge, and the preliminary explanation of surgical knowledge to low‐level nurses, which was gradually explained and deepened from easy to difficult [8].

(3) Specialty and management training stage. When the low‐level nurses have a certain theoretical foundation, they began systematic surgical teaching, a couple to one area teaching assessment, explain surgery related knowledge, and give full play to the role of practical teaching.

Through the three stages of training, the learning ability and learning subjective initiative of the lower‐level nurses have made signficant progress, and the students' teaching satisfaction with the tutors has been further improved, and a systematic clinical operating room thinking ability has been established. Moreover, through the further cultivation of tutors' practical teaching ability, the teaching practice ability of teaching tutors has been significantly improved,and the students'satisfaction has also been improved accordingly.

Teaching method based on PBL(Problem-Based Learning)

PBL teaching method (Problem‐Based Learning) is a problem‐oriented learning method [9]. In the process of learning, middle school students are the main thinking of learning, and teachers are only as the learning guide, play an auxiliary role, and play an auxiliary role.At the same time, group learning units help students master the knowledge points faster. In the traditional teaching mode, most teachers combine the critical content and difficult content in the teaching material to explain the students' knowledge and cram teaching, resulting in the teaching effect is always not ideal [10]. The emergence of the PBL teaching mode has effectively solved this problem. Students themselves learn each operation with problems.Each operation is based not only on the simple and superficial surgical cooperation, but also on the nature of surgical cooperation. It stimulates the students' learning motivation and is more conducive to the tutor's teaching work.

The PBL teaching mode is mainly based on problems,student‐centered, and teachers as the guiding role. In PBL teaching mode, with the teacher through finishing real case problem, students through access to literature, information, and according to the data exchange, discussion, demonstration and then solve the problem,with the teacher by guiding students to summarize, not only can improve the ability of self thinking, and through the real case problem to make students better understand and master professional knowledge [11].

The application of PBL teaching method not only improves students'knowledge, but also significantly improves the subjectivity of learning, and the atmosphere of learning is also much more active than before. Let each student can have their own ideas, rather than blindly follow the crowd, each student to closely follow the teaching plan of the department, to adapt to the needs of the operating room nursing development.

Before class, the department WeChat contact group was set up. The tutor sent the teaching PPT to the group. Students would listen to the teaching theory with problems through learning in advance. The tutor collects feedback on the questions before the class, and gives targeted lectures according to the questions.

In the class, the tutor introduced the PBL cases to guide the students to rethink the problem according to the teaching content, and can discuss each other between groups to deepen their understanding of the problem. Finally, the tutor made comments and supplemented and guided the problem.

After class, according to the class situation, the tutor makes a course summary and posts it in the WeChat group for students to learn and supervise each other.

Teaching reform based on the CBE model

Continuous change in medical mode, health concept, accelerate the process of population aging, brought tremendous changes in the nursing work mode. At the same time, the rapid development of medical field enriched the nursing knowledge system, leading to explain knowledge and operation as the main purpose of traditional nursing education mode is facing great challenges. In 2004 and 2005,the American Nursing Alliance called for the reform in American nursing education to be innovative, to make a radical transformation,and proposed "Competence‐based education (CBE) " [12].

CBE is a new education model oriented by career needs, which emphasizes the overall educational concept of integrating theoretical teaching, cultivating practical workability and improving comprehensive quality, which is conducive to comprehensively cultivating students'various abilities [13].

The scientific teaching method is an important link of competency‐standard education. The Colorado College of Nursing applying Lenburg's COPA model advocates the use of multiple advanced teaching methods[14]. Including:①Collaborative Learning(Collaborative learning): emphasizing various forms of unity and cooperation between students, students and teachers; ②Interactive Learning (Interactive learning): Role exchange in class, two‐way communication between teachers and students, Creation and application of Multimedia interactive learning environment; ③Scenario simulation teaching: simulation teaching of various common clinical scenarios; ④ Case teaching: Tutor teaches by collecting clinical case analysis. It can exercise students' independent analysis ability and comprehensive knowledge application ability is often used in the classroom. Teachers need to carefully design cases according to the teaching objectives for students to conduct systematic analysis and learning. It can exercise students' comprehensive knowledge ability and theoretical application ability.

Nursing is a subject, and nursing is not only stuck in simple and repeated operations, cultivate students to understand and understand the true meaning of nursing, cultivate students' inner desire and love for nursing, to fundamentally let students learn with responsibility and goal, to cultivate own nursing competence as the orientation and goal. In teaching, through various learning methods, students can quickly integrate into the knowledge system, build teaching models,so that students can learn knowledge in effective teaching.

Application of BOPPPS teaching model

Guided Learning Interactive Canadian Education (BOPPPS) is a student‐centered teaching model [15]. It is a teaching method created and implemented by British Columbia Tech, Canada. This teaching method divides the course teaching process into an introduction(bridge‐in): attracting students' interest in learning; Objective(objective): students understand the purpose of learning, to participate in learning voluntarily; Pre‐test (pre‐assessment): a preliminary understanding of students'mastery of knowledge; Participant Learning(participatory learning): students study actively. Participate in the learning process rather than passive acceptance; Post‐test(post‐assessment): to understand the students' grasp; Summary(summary): review 6 parts of omission filling. The BOPPPS teaching model is used for short [16]. Its core has two points: one is to emphasize that nursing learning is the process of personal experience,not a simple recitation of learning; the second is to timely obtain students' problems in nursing learning, to adjust the learning direction. Attract students' interest, with interest to guide teaching,tutor set learning goals, tutor through interaction with students to understand the basis of students'grasp,tutor through explanation with teaching let students experience surgery, after teaching tutor through test students understand the situation, continuous summary review to achieve the corresponding teaching objectives.

Results

There are two kinds of assessment, including theoretical performance assessment and nursing operation assessment. Nursing operation assessment includes overall nursing operation cooperation and nursing operation (random draw a nursing operation), total score superposition included in Table 1, the comparison group students is significantly better than the experimental group, and the difference has statistical significance (P＜0.05).

On the students' cognition of the evaluation of the tutor's teaching philosophy,from Table 2,we can see that,except for the cultivation of team spirit,the individual students believe that the effect is small, and most students have approved the teaching philosophy of the other project tutors.

Student satisfaction with the tutor

From Table 3, we can see that the students' satisfaction with the tutor has been greatly improved after the reform of the teaching methods.

Table 1 Results of the experimental and control groups

Comparison with pre‐training,P＜0.05.

Table 2 Student assessment of students' teaching concepts

Table 3 Evaluation of student teaching satisfaction with tutors

Discussion

Nursing training is an effective means to improve the overall quality of nursing practitioners, and the construction of nursing teachers is particularly important. As the training guide, the nursing tutor's personal comprehensive quality, professional knowledge, skills and ability level are the key factors affecting the training effect [17]. The risk of nursing work in operating room is high, technically demanding operators and the risk degree of nursing operation is high. As a professional tutor in the operating room, he should have skilled theoretical knowledge and professional skills, and shoulder the responsibility and obligation to train a new generation of nurses.Through this discussion, it is not difficult to find that after the training, the assessment scores of low‐level nurses have been significantly improved (P＜0.05), the teaching quality has been highly recognized by low‐level nurses, the quality of low‐level nurses has been improved, and patients' satisfaction with nurses has been improved. In auxiliary evidence‐based medicine, we see the importance of professional teaching staff construction. From the training results, through the training of practical teaching teachers'ability and the application of a series of teaching methods based on the change of CBE teaching mode, the application of the BOPPPS teaching model and PBL teaching method, the training results of nurses have been significantly improved and improved.