Exploration and Practice of Training for Management Cadres of Standardized Nurse Training ()
1. Introduction
The implementation of standardized nurse training is an important way to consolidate the basic skills and improve the professional core abilities of clinical nurses, and also a critical link to promote the steady growth of these nurses. To better adapt to the reform and development of medical career, continuously improve the medical care service quality, and meet the increasing health demand of the public, the standardized nurse training, which is carried out uniformly all around Chongqing as the first pilot city of social standardized nurse training in China, has a history of 8 years since the launch in 2014, completing the training of 7642 qualified nurses accumulatively for Chongqing and its neighboring cities. In order to actively practice the spirits of Notification of National Health Commission of the People’s Republic of China on “studying and implementing General Secretary Xi Jinping’s important instructions and further strengthening the construction of nurse team” [1] and Master plan for Chengdu-Chongqing economic circle [2] issued by the Communist Party of China Central Committee, create a new situation of “14th five-year” nursing career development, improve the training center and Chongqing Special Nursing Quality Control Center depending on Chengdu-Chongqing nursing management capabilities, persist in the development philosophy of “create a new situation, promote the development1, and strive for excellence”, make full use of backbones, and comprehensively promote the development of Chongqing nurse training teaching work, and based on the knowledge that the nursing management cadres are the core strength for the implementation of standardized nurse training work, a bridge and bond to practice various requirements, and a key to guarantee the training effect [3], the First Affiliated Hospital of Chongqing Medical University, under the commission and guidance of Chongqing Health Commission, implemented the positive exploration on a new training mode for management cadres of standardized nurse training in the whole city. There was a 3-day (May 13-15, 2021) training class with 3-part course setting of “management”, “training” and “practice”.
2. Basic Information of Trainees
Totally 100 management cadres from 28 standardized nurse training bases in Chongqing participated in this training, including 3 males and 97 females, with an age of 34.93 ± 5.80 years. There were 3 chief nurses, 14 co-chief nurses, 52 supervisor nurses, and 31 senior nurses.
3. Configuration of Training Teachers
3.1. Theory Training
There was an abundant strength of teachers, including Vice Director Gong Shu from Nursing Department of West China Hospital of Sichuan University, Professor Zhu Jingci from Army Medical University School of Nursing, Director Lin Yuyun from Nursing Department of the Fifth People’s Hospital of Chongqing, as well as Xiong Fangfang, Training Officer and Clinically excellent Standardized Training Teacher Representative from Nursing Department of the First Affiliated Hospital of Chongqing Medical University.
3.2. Clinical Practice
There were head nurses and training teachers from totally 8 clinically excellent standardized training departments, including Emergency Department, Department of Critical Care Medicine, Department of Cardiothoracic Surgery, Department of Hepatobiliary Surgery, Department of Hematology, Department of Neurology, Department of Gynecology, and Department of Obstetrics in the First Affiliated Hospital of Chongqing Medical University.
4. Setting of Courses
In the prophase of class opening, a training demand questionnaire survey was conducted for management cadres from 28 bases who participated in the training. On the basis of survey, the training contents were designed by combining the actual work implementation of standardized nurse training, and the courses were composed by three parts of “management”, “training” and “practice”, specifically including management experience, course design, teaching methods, clinical practice, and so on. In these three parts, “management” involved two-level management practice sharing of standardized nurse training, wherein “two-level” meant Chengdu-Chongqing, base-base in Chongqing, and base-hospital/department; “training” contained the clinical training design and teaching method presentation of standardized nurse training; “practice” referred to implementing the teaching management, demonstrating and observing the specific teaching projects in various clinical departments.
4.1. Management
Vice Director Gong Shu from Nursing Department of West China Hospital of Sichuan University was responsible for“Practice sharing of standardized nurse training mode in West China Hospital”, with the following contents: post-based competency in West China Hospital; construction of a pyramidal nursing talent cultivation system; stratified, sorted, phased, targeted management; obedience to the education tenet of “delicacy, supreme and elite”; improvement to the comprehensive capabilities of trainees in the standardized training. With “Construct a new practice mode of standardized nurse training through human culture-mechanism interaction” as a title, “emphasize the culture, build the system, and strengthen the management” as a mainline, and the cultural construction of “five-heart care” and “patient safety” as a cornerstone,Training Officer Xiong Fangfang from Nursing Department of the First Affiliated Hospital of Chongqing Medical University introduced her hospital’s some specific implementation measures in the standardized nurse training, which related the construction of training system and the reinforcement of personal management, quality management and security management [1]. Director Lin Yuyun from Nursing Department of the Fifth People’s Hospital of Chongqing provided the experience sharing of “training effect-orientated nurse training management practice”, and specifically introduced the training management experience and characterized teaching on the basis of good training effect at the current base. Yang Jie, Pang Jiani, Luo Xiaoqing and Zeng Yuhan, excellent standardized training teacher representatives from the First Affiliated Hospital of Chongqing Medical University, completed the clinical departments’ standardized training teaching management sharing of “any achievement depends on the rules, and the cultivation aims to perfection”. Firstly, Teacher Yang Jie from Department of Hepatobiliary Surgery shared her department’s nurse training teaching experience, and she pointed out to set the teaching objectives as detailed as possible, master the learning, living and mental states of trainees, and keep trainees in the heart to improve their belonging sense. Secondly, Teacher Pang Jiani from Department of Hematology shared the teaching management practice that the head nurse participated in the whole nurse training work, and how the department carried out the standardized training teaching using PDCA management tool. Teacher Luo Xiaoqing from Emergency Department set the advanced training objectives and “diversified” training contents by combining her department’s specialty features. Finally, Teacher Zeng Yuhan, by combining the existing issues in the nurse training teaching of Department of Critical Care Medicine, presented how to carry out the exploration and innovation based teaching practice with humanistic care as a magnetic field, student demand as an orientation, and nursing safety as a baseline.
4.2. Teaching
Combining the clinical cases, Professor Zhu Jingci from Army Medical University School of Nursing offered an issue-oriented lecture about how to guide students to implement PBL teaching and broaden the students’ horizons, and she also put forward higher requirements for nurse training teaching work. Training Officer Xiong Fangfang from Nursing Department of the First Affiliated Hospital of Chongqing Medical University explained the basic steps of making a training plan and the whole-process management of training in details starting from “design and management of clinical training” and with the basic principles of clinical training as a basis [2].
4.3. Clinical Practice Activities
Based on the prophase survey and special investigation on the observation demands of management cadres for clinical practice, the specific practice observations (e.g., teaching ward round, discussion on intractable cases, mini-lecture, and management of training materials) were performed by group in totally 8 clinically excellent standardized training departments, including Emergency Department, Department of Critical Care Medicine, Department of Cardiothoracic Surgery, Department of Hepatobiliary Surgery, Department of Hematology, Department of Neurology, Department of Gynecology, and Department of Obstetrics.
5. Training Effect and Effect Analysis
5.1. Training Effect
To investigate the training effect and thus provide a direction for improvement in the future training, a sojump survey (https://www.wjx.cn/) of trainees was conducted at the end of training, involving 87 management cadres as responders, with a survey rate of 87.00%.
Basic Information of Survey Participants
In 87 management cadres participating in the survey, there were 3 males and 84 females, with an age of 34.99 ± 5.84 years; 96.576% management cadres had the education of ≥Bachelor, and 81.17% management cadres had the standardized training teaching experience. The details are shown in Table 1.
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Table 1. Basic information of 87 management cadres.
5.2. Effect Analysis
93.10% management cadres made an overall evaluation of “excellent” on the training class. 93.10% management cadres thought that they got great help of teaching practice from this training class, learned new teaching methods and broadened their thoughts. 95.40% management cadres believed that the arrangement of teaching time for courses was reasonable. The top 3 most popular courses of management cadres in this training were PBL teaching method (87.36%), practice sharing of standardized nurse training mode in West China Hospital (77.01%), and clinical practice observation of standardized nurse training management mode (72.41%), which indicated that the trainees had higher study demands for teaching methods, clinical management methods, and practice. The detailed analysis is shown in Table 2.
5.3. Comments and Suggestions
Based on the sojump survey (https://www.wjx.cn/) data and combining the scale-based effect analysis, some thoughts and suggestions are proposed for the configuration of teachers, the setting of courses, and the clinical practice.
5.3.1. Configuration of Teachers
In the configuration of training teachers, it is suggested to strictly select the teachers on this consideration of both education and actual standardized training teaching experience. As seen from the composition of survey responders, there were 63 (74.12%) responders with a professional title of ≥supervisor nurse, 84 (96.576%) responders with the education of ≥Bachelor, and 59 (67.82%) responders with the standardized training teaching experience of ≥3 years. Therefore, there are higher requirements for teachers, and the selection of training teachers will be stricter in the future that needs a full evaluation on the teaching capability and representativeness of teachers.
5.3.2. Setting of Courses
In the setting of courses, it is suggested to add more courses of clinical practice experience and teaching methods. As shown by the analysis according to the theory of American educationist Malcolm. S. Knowles, the study contents of adults are associated with their social roles. In this training, totally 46 (46%) trainees were teaching team leaders or clinical backbone nurses, and they were the clinical teaching implementers and previously faced more clinical practice conditions. Therefore, the training of clinical teaching methods shall be more targeted and practical for trainees [4].
Meanwhile, it is also suggested to add the centralized scenario simulation of teaching ward rounds and case discussion. Due to the limited training time, the practice observation mode was to observe one teaching activity according to the prophase questionnaire survey, thus failing to meet several study demands of various trainees. It is thereby suggested to adopt the centralized scenario simulation teaching activities in the near future.
5.3.3. Clinical Practice
In clinical practice, it is suggested to add the clinical observation contents (e.g., medical record writing) and allow the participation in all observations other than one observation. The observation contents in this training only involved the management of teaching materials, teaching ward rounds, discussion on intractable cases, and mini-lecture of departments, but did not contain the medical record writing in the standardized training teaching requirements of the National Health Commission. In case of sufficient training time, the training can be set according to the observation contents, and the training teachers can be arranged for one-by-one observation and systematic & comprehensive study.
At the same time, it is also suggested to record a uniform and standard skills operating video, thus facilitating the operation teaching of standardized nurse training in Chongqing and promoting the harmonious development of teaching quality.
6. Improvement Measures
Based on the effect analysis of trainees and the comments & thoughts, some improvement measures are developed to promote the training effect for management cadres of standardized nurse training.
6.1. Reasonable Setting of Courses
In the prophase of class opening, the questionnaire survey will be continued in various bases, and then the training contents will be designed on the survey basis and by tightly combining the actual development of standardized nurse training. The sharing of clinical practice experience and teaching methods shall be added, and a uniform and standard skills operating video shall be recorded to meet the demand of homogeneous teaching for mutual learning and improvement.
6.2. Improvement of Training Methods
Such training methods as scenario simulation and case analysis shall be fully applied, and the centralized teaching ward rounds and medical record discussion shall be carried out, so that more management cadres participate in the training and get benefits from the training study, eventually improving the training effect.
6.3. Addition of Management Practice
The contents of observation courses shall be enriched, e.g., adding the practice observation course of medical record writing, and increasing the number of observation courses to meet the teaching demand of each management cadre as possible.
6.4. Assessment Mode
A process-dominated formative assessment mode shall be designed to focus on the actual troubleshooting capabilities of management cadres.
In conclusion, the management cadres at various standardized nurse training bases have management post training demands of standardized nurse training in different extents and different types. The targeted, practical, effective training requires continuous exploration on the setting of training courses, the selection of teachers, the application of training methods, and the effective assessment practice. Under the great support and guidance of Chongqing Health Commission and depending on Chongqing Special Nursing Quality Control Center, we will cultivate a batch of high-efficiency and high-quality management cadres, so as to solve more actual issues and issues urgently to be improved in the implementation process of standardized training management, with the final purpose of promoting the development of standardized nurse training in Chongqing and improving the overall training quality.
Fund Project
2018 Medical Research Projects of Chongqing Health Commission & Chongqing Science and Technology Bureau (2018, MSXM135).
NOTES
1Fund program: 2018 Medical Research Projects of Chongqing Health Commission & Chongqing Science and Technology Bureau (2018, MSXM135).