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Research on teaching reform of rehabilitation nursing major based on modern apprenticeship system

   | Aug 18, 2021

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Hierarchical mentoring model.

Level Duty and task
Teaching officer in charge of nursing department Put the teaching guarantee mechanism in place
Select nursing teachers
Make internship rotation plan
Clinical department nursing teacher Train nursing teachers
Establish the basic framework for the completion of the internship
Ward nursing teacher Monitor teaching quality
Evaluate teaching performance
Bedside nursing teacher Teach students according to the internship requirements
Give feedback to students regularly
School teacher Formulate professional personnel training programs negotiated with medical institution
Build a professional curriculum system
Formulate talent training assessment and evaluation system
Pair up with external tutors to teach students
Conduct teaching evaluation and assessment

The Delphi method expert basic information.

Classification Number of persons
Job Dean of nursing school 3
Leader of nursing teaching group 6
Nursing teacher 6
Director of nursing department 2
Nursing department teaching officer 1
Head nurse of rehabilitation department 6
Clinical nursing teacher of rehabilitation department 4
Rehabilitation nursing specialist 2
Age (the average is 42.83 years old) ≥50 years old 6
40–49 years old 12
30–39 years old 12
Year of working (the average is 20.23 years) ≥25 years 8
20–24 years 7
15–19 years 10
10–14 years 5
Professional title Senior 9
Sub-senior 8
Intermediate 13
Education background Doctor 10
Master 9
Bachelor 11

Indicators of nursing students’ competence in rehabilitation nursing posts.

Work area Work task Competence
Rehabilitation assessment Physical function assessment Can assess muscle strength by using the manual muscle strength assessment scale
Can assess muscle tone by using the improved Ashworth spasmodic evaluation scale
Can select the appropriate protractor according to different joint positions to evaluate the range of motion of the joint
Can distinguish various basic abnormal gait
Can measure the step width, step length and step length
Can describe and analyze the balance function of human body
Can carry on the shallow feeling, the deep feeling, the compound feeling carries on the evaluation
Can use conscious fatigue grade to evaluate the cardiac function
Know the technique of evaluation of cardiac function by moving plate test and two-step test
Know lung volume and lung ventilation function measurement techniques
Speech function assessment Can describe the procedures of the Boston aphasia diagnostic test and the Western aphasia test and analyze the significance of the results
Can describe the operation steps of the Frenchay dysarthria assessment method and analyze the clinical significance of the results
Understand the significance of sound spectrum analysis and aerodynamics inspection
Understand the method of non-verbal function assessment of aphasia
Cognitive function assessment Can score on the Glasgow coma scale
Can describe the evaluation methods and significance of MMSE, Montreal cognitive scale, bell drawing test
Can describe the operation and significance of the Wechsler memory scale and daily memory questionnaire
Can describe commonly used intelligence test scales
Can describe common tests for disqualification and apraxia
Swallowing function assessment Can guide the patients to carry out the trial of drinking water
Can describe the operation steps of esophageal acid drop test and esophageal pressure measurement
Understand the significance of barium swallow esophagogram examination, endoscopic swallowing examination and ultrasonic swallowing examination
Can use the bedside swallowing assessment scale
Can grade the degree of dysphagia
Bladder function assessment Can check bladder fullness
Can measure residual urine
Can cooperate with the preparation and body position before urine flow mechanics examination
Understand the clinical significance of urine flow rate
Can describe the procedure of bladder pressure volume measurement and analyze the results
Can describe the procedure of bladder pressure volume measurement and analyze the results to understand the significance of urethral dynamic measurement and electromyography to measure the electrical activity of anal sphincter
Intestinal function evaluation Can evaluate intestinal function by asking and observing the patient’s appetite, eating style and defecation
Can assess for abdominal bowel sounds, abdominal tenderness and stiffness
Can observe the morphology of the external sphincter of anus
Can perform perianal skin reflex examination
Can carry out touch and needling sensation examination of perianal skin
Social function assessment Can describe the meaning of social life ability measurement
Can use the social function activity questionnaire to evaluate the ability of social life
Can describe the use of social function defect screening, social ability rating scale, and social interaction measurement table
Understand the social situation of the elderly questionnaire and children’s social life skills measurement table of significance
Psychosocial assessment Can describe the basic contents and methods of psychological evaluation
Can use the anxiety and depression self - rating scale
Daily life function assessment Can describe the content of daily life ability measurement
Can use Barthel index rating scale to evaluate daily life function
Can describe procedures for functional independence assessment and analyze the clinical significance of the results
Understand the meaning of Katz index and PULSES measurement
Rehabilitation and nursing technology Put position Can carry on the hemiplegia patient’s anti-convulsive body position
Can position patients with spinal cord injury
Can put the patient of bone joint disease anti-convulsion position
Master the method of turning the axis, and assist patients to turn the axis
Shift position Can instruct patients with spinal cord injury and hemiplegia to carry out roll training and sit up training
Can instruct patients with spinal cord injury and hemiplegia to carry out sitting training in bed and standing up training in sitting position
Can assist patients with spinal cord injury, hemiplegia patients with bed-chair metastasis
Prevent and take care of pressure ulcers Can assess the patient’s skin condition
Can identify the risk factors for pressure ulcers
Can provide preventive measures for patients with high risk of pressure ulcer
Can take care of patients with pressure ulcers
Train daily living ability Can guide patients to dress, drink water, eat, go to the toilet, grooming, bathing, control defecation and other daily activities
Can understand the use of AIDS to daily living
Practice breathing Be familiar with respiratory function training, including labial breathing training, abdominal breathing training and respiratory muscle training
Master effective cough methods and guide patients
Can perform the lung percussion
Can use a sputum meter
Can carry on the suction sputum nursing care after gas cutting
Postural drainage Can tell the indications and contraindications of postural drainage
Can carry on the body position drainage operation
Care intestinal and bladder functions Master indications and contraindications of intermittent catheterization
Can develop a drinking plan for patients with intermittent catheterization
Can carry on the patient intermittent catheterization nursing
Master the matters needing attention of patients with intermittent catheterization
Master neurogenic bladder training techniques
Understand the method of bladder volume measurement
Be familiar with the method of inducing defecation
Be familiar with stomatostomy and wound care
Care dysphagia Can instruct patients with dysphagia to carry out indirect feeding training
Can instruct patients with dysphagia to carry out direct feeding training and compensatory training
Can carry out health education for patients and their families to prevent aspiration and observe matters needing attention during eating
Guide to injured limbs and orthotics Master the application guidance technology of artificial limbs, orthopedic devices and auxiliary devices
Understand the use of walking aid
Be familiar with wheelchair selection
Master the proper use of the wheelchair
Can understand the prosthetic application guidance training
Understand the guidance and training of orthotics
Be familiar with muscle strength and endurance training
Physical therapy Know the indications and precautions of common therapeutic devices
Can operate common therapeutic devices
Traditional Chinese medicine fumigation Know ear pressing beans
Know Chinese herbal fumigation and washing
Understand acupoint application
Traction Can tell the indications and contraindications of traction technology
Be familiar with the operation method of traction technology
Inform patients and their families of traction technology matters needing attention
Rehabilitation and nursing of common diseases Nervous system rehabilitation nursing Be familiar with the clinical treatment of stroke
Be familiar with the rehabilitation evaluation of stroke
Can carry on the hemiplegia patients soft paralysis, spasm, recovery period of rehabilitation training
Can carry on the hemiplegia patients soft paralysis period pressure sore nursing and prevention, spasm period pain nursing, recovery period daily life nursing
Be familiar with the clinical manifestations and treatment points of craniocerebral injury
Be familiar with rehabilitation evaluation of craniocerebral injury
Can carry on the passive movement training to the craniocerebral injury patient
Be familiar with the clinical treatment of spinal cord injury
Be familiar with the rehabilitation evaluation of spinal cord injury
Can carry on the passive movement training to the spinal cord injury patient
Bone and joint system rehabilitation nursing Be familiar with the concept, clinical manifestation and diagnosis of fracture
Be familiar with the rehabilitation evaluation of fracture
Know the clinical treatment of fracture
Can guide the patients with fracture with functional exercise and prevention of complications
Can carry on the physical training to the fracture patient
Be familiar with joint replacement
Can provide guidance for functional exercise and prevention of complications for patients undergoing joint replacement
Can carry on the physical training to the joint replacement patient
Be familiar with the concept, clinical manifestation and diagnosis of arthritis
Be familiar with the rehabilitation evaluation of arthritis
Know the clinical treatment of arthritis
Can carry out traditional Chinese medicine rehabilitation for arthritis patients
Be familiar with the rehabilitation of amputation
Be familiar with the rehabilitation evaluation of amputation
Can carry on the rehabilitation training to the amputee patient
Cardiopulmonary disease rehabilitation nursing Be familiar with the rehabilitation evaluation of coronary heart disease
Know the clinical treatment of coronary heart disease
Can carry on the life instruction to the coronary heart disease patient
Be familiar with the rehabilitation evaluation of hypertension
Know the clinical treatment essentials of hypertension
Can guide the health of patients with hypertension
Be familiar with the rehabilitation evaluation of chronic obstructive emphysema
Know the clinical treatment essentials of chronic obstructive emphysema
Can carry on the respiratory training and the daily life instruction to the chronic obstructive emphysema patient
Tumor rehabilitation nursing Evaluate pain by visual analogy and McGill pain questionnaire
Can assess the edema of tumor patients
Can carry on the diet, the medicine and the life instruction to the tumor patient
Can evaluate the motor function of tumor patients
Can carry on the physical ability recovery and so on training to the tumor patient
Can assess the nutritional status of tumor patients
Can carry on the reasonable nutrition instruction to the tumor patient
Can carry on the daily life activity ability evaluation to the tumor patient
Can carry on the psychological nursing to the tumor patient
Emergency and intensive rehabilitation nursing Know the clinical nursing points of tracheotomy
Can carry on the health instruction and the tracheotomy rehabilitation training to the tracheotomy patient
Know the clinical nursing points of stoma and wound
Can conduct health guidance and rehabilitation training for patients with stoma and wound
Know the clinical nursing points of ventilator belt, off-line and extubation
Can carry on the health instruction and the off-line training to the ventilator patient, the breathing strengthens the training
Can assess the nutritional status of critically ill patients
Can carry on the reasonable nutrition instruction to the tumor patient
Other diseases rehabilitation nursing Be familiar with the rehabilitation assessment of burns
Know the clinical treatment of burns
Can carry on the joint range of motion training, the pain nursing, the daily life activity ability training to the burn patient
Be familiar with the etiology, clinical manifestation, classification and treatment of cerebral palsy in children
Be familiar with the rehabilitation evaluation of children with cerebral palsy
Can carry out sitting training, balance training and walking training for children with cerebral palsy
Be familiar with the rehabilitation evaluation of senile dementia
Know the clinical treatment essentials of senile dementia
Can carry on the memory training, exercise to boost intelligence, and understanding, and the expression ability training, the social adaptation ability training to the senile dementia patient
Know puerperal health care and postpartum rehabilitation
Be familiar with the knowledge of postpartum pelvic floor function measurement
Can give postpartum massage and reasonable dietary guidance
Be familiar with the knowledge of gynaecology (including menopause) health care and rehabilitation
Be familiar with the rehabilitation evaluation of gynecology (including menopause)
Can carry on the department of gynaecology (including menopause) rehabilitation guidance
Rehabilitation nursing management Rehabilitation psychological nursing Can assess the patient’s state of consciousness, cognitive activity, mood and personality through interviews, listening, and questioning
Can describe the principles and considerations of the psychological evaluation
Can tell the common psychological reaction stages and characteristics of patients
Can carry on the rehabilitation nursing to the patient common psychological problem
Can describe the matters needing attention of psychological rehabilitation nursing
Rehabilitation safety management Can tell the management process of pressure ulcer
Can assess risk factors for falls
Can take preventive measures for high-risk fall patients
Can inform patients and their families of the importance of preventing falls and precautions
Can deal with the emergency procedures when the patient falls down
Can assess risk factors for deep vein thrombosis in patients
Can take preventive nursing measures of deep vein thrombosis
Can observe and identify the clinical manifestations of deep vein thrombosis
Can handle emergency procedures after deep vein thrombosis
Be familiar with the management system of inpatients
Can accompany and inform the family members of patients with potential risk of loss
Can deal with the emergency procedure when the patient is lost
Can assess the patient’s risk factors for aspiration/asphyxia
Can perform emergency procedures in case of aspiration/asphyxia
Can identify the role of nurses in preventing nosocomial infections
Can follow the ward disinfection and isolation management system
Can perform hand hygiene in strict accordance with specifications
Be aware of the prevention and control of multiple drug resistant bacteria
Can protect nursing staff from occupational hazards
Can assess the risk factors for postural hypotension
Can guide the patient the correct way to get up
Can inform patients and their families of the prevention of postural hypotension nursing measures
Can handle emergency procedures when postural hypotension occurs
Can identify the clinical manifestations of alzheimer’s disease
Can determine the main dysfunction in patients with alzheimer’s disease
Can use the clinical dementia rating scale to grade the senile dementia patients
Can guide the elderly dementia patients to eat, live, dress and behavior, prevent burns, falls, injuries and other accidental injuries
Rehabilitation education Can use the text propaganda, the symposium, the exhibition, the audio-visual teaching material and so on various forms of health education carries on the education to the patient
Can correctly use the process of health education to implement health education

The score of the post competence of the nursing students in the experimental group and the control group before graduation (N = 88).

Work area Work task Competency indexes Full marks for competence Score of students in control group Score of students in experimental group χ2 values P values
Rehabilitation assessment Physical function assessment 10 50 20.33 ± 10.192 31.73 ± 14.183 68.698 0.000*
Speech function assessment 4 20 6.04 ± 4.412 9.58 ± 4.940 86.000 0.000*
Cognitive function assessment 4 20 14.28 ± 4.608 15.57 ± 3.757 16.608 0.055
Swallowing function assessment 5 25 5.85 ± 4.957 13.02 ± 8.298 79.692 0.000*
Bladder function assessment 6 30 11.74 ± 10.229 17.71 ± 9.840 35.658 0.000*
Intestinal function evaluation 6 30 12.87 ± 7.225 16.29 ± 7.325 30.777 0.058
Social function assessment 4 20 10.59 ± 5.459 12.80 ± 4.809 27.325 0.053
Psychosocial assessment 2 10 5.20 ± 2.267 6.07 ± 2.042 20.865 0.013*
Daily life function assessment 4 20 4.20 ± 1.655 10.43 ± 6.620 92.000 0.000*
Rehabilitation and nursing technology Put position 4 20 11.41 ± 4.198 13.39 ± 4.090 28.867 0.025*
Shift position 3 15 7.52 ± 3.811 9.24 ± 3.509 25.815 0.011*
Prevent and take care of pressure ulcers 4 20 8.76 ± 4.891 11.63 ± 4.950 34.829 0.002*
Train daily living ability 2 10 5.63 ± 1.665 6.05 ± 1.640 16.430 0.037*
Practice breathing 5 25 10.48 ± 5.307 13.04 ± 5.359 30.483 0.023*
Postural drainage 2 10 3.74 ± 1.652 5.03 ± 1.952 47.491 0.000*
Care intestinal and bladder functions 8 40 14.85 ± 7.610 18.25 ± 7.873 33.419 0.056
Care dysphagia 3 15 6.54 ± 2.738 8.03 ± 3.359 21.944 0.025*
Guide to injured limbs and orthotics 7 35 11.78 ± 7.399 16.46 ± 7.680 42.717 0.001*
Physical therapy 2 10 1.96 ± 1.712 4.48 ± 2.963 79.298 0.000*
Traditional Chinese medicine fumigation 3 15 6.13 ± 4.287 7.74 ± 4.337 18.973 0.089
Traction 3 15 6.74 ± 4.036 8.33 ± 3.561 26.323 0.015*
Rehabilitation and nursing of common diseases Nervous system rehabilitation nursing 10 50 18.87 ± 12.236 26.97 ± 12.646 49.169 0.027*
Bone and joint system rehabilitation nursing 15 75 19.15 ± 16.910 34.47 ± 22.243 57.051 0.001*
Cardiopulmonary disease rehabilitation nursing 9 45 16.00 ± 10.881 23.24 ± 12.594 47.451 0.012*
Tumor rehabilitation nursing 9 45 15.70 ± 10.641 22.55 ± 10.874 46.195 0.003*
Emergency and intensive rehabilitation nursing 8 40 16.48 ± 10.691 21.84 ± 9.979 33.181 0.044
Other diseases rehabilitation nursing 15 75 29.50 ± 22.798 43.07 ± 12.185 48.776 0.012*
Rehabilitation nursing management Rehabilitation psychological nursing 5 25 10.78 ± 6.599 13.47 ± 5.775 31.756 0.011*
Rehabilitation safety management 27 135 44.41 ± 35.830 66.73 ± 7.107 43.744 0.016*
Rehabilitation education 2 10 5.50 ± 1.859 6.17 ± 1.813 21.757 0.005*
eISSN:
2544-8994
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Assistive Professions, Nursing