基于TPSN模型优化CBL-RISE教学模式及其在新疆地区ICU专科护士培训中的非随机对照研究

张霞; 张莉; 侯芳; 宋蓓; 黄颖

doi:10.3760/cma.j.cn116021-20251015-02256

您当前的位置：

首页 >

文章列表页 >

基于TPSN模型优化CBL-RISE教学模式及其在新疆地区ICU专科护士培训中的非随机对照研究

更新时间：2026-04-27

- 基于TPSN模型优化CBL-RISE教学模式及其在新疆地区ICU专科护士培训中的非随机对照研究
- Optimization of CBL-RISE teaching mode based on TPSN model and a non-randomized controlled study on its application in training intensive care unit specialist nurses in Xinjiang region
- 中华医学教育探索杂志 2026年页码：1-8
- 作者机构：
  
  1.新疆医科大学第一附属医院重症医学科，乌鲁木齐 830054
  2.新疆医科大学第一附属医院护理部，乌鲁木齐 830054
- 作者简介：
  
  张莉，Email：121449072@qq.com
- 基金信息：
  
  新疆医科大学第一附属医院暨第一临床医学院2022年度“青年科研起航”专项基金(2022YFY-QKHL-10);“天山英才”医药卫生高层次人才培养计划(TSYC202301A041)
- DOI：10.3760/cma.j.cn116021-20251015-02256
  中图分类号： R459.7
- 收稿：2025-10-15，
  
  网络首发：2026-04-27，
- 稿件说明：
移动端阅览
张霞, 张莉, 侯芳, 等. 基于TPSN模型优化CBL-RISE教学模式及其在新疆地区ICU专科护士培训中的非随机对照研究[J/OL]. 中华医学教育探索杂志, 2026,1-8.

Zhang Xia, Zhang Li, Hou Fang, et al. Optimization of CBL-RISE teaching mode based on TPSN model and a non-randomized controlled study on its application in training intensive care unit specialist nurses in Xinjiang region[J/OL]. Chinese Journal of Medical Education Research, 2026, 1-8.
张霞, 张莉, 侯芳, 等. 基于TPSN模型优化CBL-RISE教学模式及其在新疆地区ICU专科护士培训中的非随机对照研究[J/OL]. 中华医学教育探索杂志, 2026,1-8. DOI： 10.3760/cma.j.cn116021-20251015-02256.

Zhang Xia, Zhang Li, Hou Fang, et al. Optimization of CBL-RISE teaching mode based on TPSN model and a non-randomized controlled study on its application in training intensive care unit specialist nurses in Xinjiang region[J/OL]. Chinese Journal of Medical Education Research, 2026, 1-8. DOI： 10.3760/cma.j.cn116021-20251015-02256.

摘要

目的

探讨基于TPSN[教师（teacher）、病人（patient）、学生（student）、护士（nurse）]模型优化CBL联合文献为导向的自我学习（reference-induced self education，RISE）模式（即CBL-RISE模式）教学在新疆地区ICU专科护士培训中的应用效果。

方法

选取178名ICU专科护士，分为对照组（90名，CBL-RISE模式）和研究组（88名，TPSN优化CBL-RISE模式）。采用ICU护士核心能力量表、循证护理能力评定量表、学习兴趣问卷和学习倦怠量表评估教学效果。采用SPSS 23.0进行统计学分析。

结果

研究组理论成绩（91.02±3.56）、操作成绩（88.33±3.77）、临床实践成绩（85.47±2.97）均高于对照组（

=14.70、12.48、10.65；均

0.001）。培训后，研究组ICU护士核心能力量表评分[专业基础知识（62.80±8.35）、临床实践能力（78.40±7.16）、护理管理能力（52.92±5.66）、专业发展能力（

56.69±5.64）、临床判断思维（49.90±3.90）

]

和循证护理能力评定量表评分[证据检索及评价（22.52±2.50）、证据整合（16.90±1.58）、证据传播（9.07±1.47）、情境评估及证据应用（26.53±2.00）

]

均高于对照组（

=6.02、5.79、6.90、10.40、6.24、9.49、9.27、6.61、14.00；均

0.001）。研究组学习兴趣高于对照组（

=-3.15；

=0.002）。培训后，研究组学习倦怠量表评分[情绪低落（19.81±3.27）、行为不当（19.74±3.91）、成就感低（18.32±3.14）、对专业的认识及兴趣（10.43±1.96）、学习环境（10.42±2.13）

]

均低于对照组（

=12.97、8.47、10.25、12.53、14.98；均

0.001）。重复测量方差分析显示，2组各量表评分的时间主效应、组别主效应及交互作用差异均有统计学意义（

0.001）。

结论

基于TPSN模型优化CBL-RISE模式教学能够提高ICU专科护士的考核成绩、核心能力、循证护理能力和学习兴趣，并减轻学习倦怠。

Abstract

Objective

To explore the application effectiveness of the CBL-RISE (case-based learning combined with reference-induced self-education) teaching mode optimized based on the TPSN (teacher

patient

student

nurse) model in training intensive care unit (ICU) specialist nurses in Xinjiang region.

Methods

A total of 178 ICU specialist nurses were selected and divided into a control group (

=90

receiving the CBL-RISE mode) and a study group (

=88

receiving the TPSN-optimized CBL-RISE mode). Teaching effectiveness was evaluated using the ICU Nurse Core Competency Scale

the Evidence-Based Nursing Competency Scale

a Learning Interest Questionnaire

and a Learning Burnout Scale. Statistical analysis was conducted using SPSS 23.0.

Results

The study group achieved significantly higher scores in theoretical knowledge (91.02±3.56)

operational skills (88.33±3.77)

and clinical practice (85.47±2.97) compared to the control group (

=14.70

12.48

10.65; all

0.001). After the training

the study group showed significantly higher scores relative to the control group across all dimensions of the ICU Nurse Core Competency Scale [professional basic knowledge (

62.80±8.35)

clinical practice ability (78.40±7.16)

nursing management ability (52.92±5.66)

professional development ability (56.69±5.64)

clinical judgment thinking (49.90±3.90)

]

and the Evidence-Based Nursing Competency Scale [evidence retrieval and evaluation (22.52±2.50)

evidence integration (16.90±1.58)

evidence dissemination (9.07±1.47)

situational assessment and evidence application (26.53±2.00)

]

(

=6.02

5.79

6.90

10.40

6.24

9.49

9.27

6.61

14.00; all

0.001). Learning interest was also significantly higher in the study group than that in the control group (

=-3.15;

=0.002). After training

the study group reported significantly lower scores on the Learning Burnout Scale [depression (19.81±3.27)

inappropriate behavior (19.74±3.91)

low sense of achievement (18.32±3.14)

understanding and interest in the profession (10.43±1.96)

learning environment (10.42±2.13)

]

than those in the control group (

=12.97

8.47

10.25

12.53

14.98; all

0.001). Repeated measures analysis of variance revealed significant differences in the main effect of time

main effect of group

the interaction between time and group on all scale scores between the two groups (

0.001).

Conclusions

The CBL-RISE teaching mode optimized by the TPSN model enhanced examination performance

core competencies

evidence-based nursing abilities

and learning interest

while reducing learning burnout among ICU specialist nurses.

关键词

Keywords

references

Jarding EK , Flynn Makic MB . Central line care and management: adopting evidence-based nursing interventions [J ] . J Perianesth Nurs , 2021 , 36 ( 4 ): 328 - 333 . DOI: 10.1016/j.jopan.2020.10.010 http://dx.doi.org/10.1016/j.jopan.2020.10.010 .

Badparva B , Ghanbari A , Karkhah S , et al . Prevention of central line-associated bloodstream infections: ICU nurses' knowledge and barriers [J ] . Nurs Crit Care , 2023 , 28 ( 3 ): 419 - 426 . DOI: 10.1111/nicc.12757 http://dx.doi.org/10.1111/nicc.12757 .

郭诗畅，薛孟奇，吴巧媚，等 . 以循证思维为导向的微课程联合CBL教学法在ICU规培护士临床思维能力培养中的应用 [J ] . 现代临床护理， 2024 ， 23 （ 7 ）： 39 - 45 . DOI: 10.3969/j.issn.1671-8283.2024.07.006 http://dx.doi.org/10.3969/j.issn.1671-8283.2024.07.006 .

郑丹，王晓倩，王苏平 . 病案引导联合以文献为导向的自我学习在传染病护理教学的应用 [J ] . 护理学杂志， 2020 ， 35 （ 8 ）： 67 - 70 . DOI: 10.3870/j.issn.1001-4152.2020.08.067 http://dx.doi.org/10.3870/j.issn.1001-4152.2020.08.067 .

Vosoughi MN , Zamanzadeh V , Valizadeh L , et al . An introduction to the TPSN model: a comprehensive approach to reducing the theory-practice gap in nursing [J ] . BMC Nurs , 2022 , 21 ( 1 ): 261 . DOI: 10.1186/s12912-022-01030-w http://dx.doi.org/10.1186/s12912-022-01030-w .

盛芬 . ICU护士核心能力评价指标体系的构建与初步应用 [D ] . 济南：山东大学， 2020 . DOI: 10.27272/d.cnki.gshdu.2020.005028 http://dx.doi.org/10.27272/d.cnki.gshdu.2020.005028 .

王旖磊，胡雁，周英凤，等 . 循证护理能力评定量表的建立与信效度研究 [J ] . 护理学杂志， 2017 ， 32 （ 2 ）： 49 - 52， 59 . DOI: 10.3870/j.issn.1001-4152.2017.02.049 http://dx.doi.org/10.3870/j.issn.1001-4152.2017.02.049 .

张颖，崔美玲，于思琪，等 . 不同年级本科护生自我效能感与学习倦怠情况调查与分析 [J ] . 护士进修杂志， 2016 ， 31 （ 4 ）： 322 - 324 . DOI: 10.16821/j.cnki.hsjx.2016.04.013 http://dx.doi.org/10.16821/j.cnki.hsjx.2016.04.013 .

Fukuda T , Sakurai H , Kashiwagi M . Efforts to reduce the length of stay in a low-intensity ICU: Changes in the ICU brought about by collaboration between certified Nurse Specialists as head nurses and intensivists [J ] . PLoS One , 2020 , 15 ( 6 ): e0234879 . DOI: 10.1371/journal.pone.0234879 http://dx.doi.org/10.1371/journal.pone.0234879 .

Yang F , Ji M , Wu Y , et al . Delirium screening for patients in the intensive care unit: a prospective validation study of the iCAM-ICU by nurse researchers and bedside nurses in routine practice [J ] . Int J Nurs Stud , 2021 , 117 : 103886 . DOI: 10.1016/j.ijnurstu.2021.103886 http://dx.doi.org/10.1016/j.ijnurstu.2021.103886 .

Saifan A , Devadas B , Daradkeh F , et al . Solutions to bridge the theory-practice gap in nursing education in the UAE: a qualitative study [J ] . BMC Med Educ , 2021 , 21 ( 1 ): 490 . DOI: 10.1186/s12909-021-02919-x http://dx.doi.org/10.1186/s12909-021-02919-x .

Saifan A , Devadas B , Mekkawi M , et al . Managing the theory-practice gap in nursing education and practice: hearing the voices of nursing students in the United Arab Emirates [J ] . J Nurs Manag , 2021 , 29 ( 6 ): 1869 - 1879 . DOI: 10.1111/jonm.13407 http://dx.doi.org/10.1111/jonm.13407 .

Zamanzadeh V , Valizadeh L , Ghahramanian A , et al . Nursing students' experiences from clinical education using the TPSN model [J ] . BMC Nurs , 2024 , 23 ( 1 ): 155 . DOI: 10.1186/s12912-024-01810-6 http://dx.doi.org/10.1186/s12912-024-01810-6 .

刘娜，柳琴，张立华，等 . 学业自我效能感在军校医学生调节模式与学习倦怠、学习投入间的中介作用 [J ] . 联勤军事医学， 2024 ， 38 （ 2 ）： 165 - 170 . DOI: 10.13730/j.issn.2097-2148.2024.02.016 http://dx.doi.org/10.13730/j.issn.2097-2148.2024.02.016 .

朱泉熔，刘梦荃，贾金忠，等 . 导师指导与临床医学硕士专业学位研究生个人能力关系研究：学习投入和学习倦怠的作用 [J ] . 中华医学教育探索杂志， 2024 ， 23 （ 9 ）： 1161 - 1168 . DOI: 10.3760/cma.j.cn116021-20231226-01834 http://dx.doi.org/10.3760/cma.j.cn116021-20231226-01834 .

Lee T , Lee SJ , Yoon YS , et al . Personal factors and clinical learning environment as predictors of nursing students' readiness for practice: a structural equation modeling analysis [J ] . Asian Nurs Res (Korean Soc Nurs Sci) , 2023 , 17 ( 1 ): 44 - 52 . DOI: 10.1016/j.anr.2023.01.003 http://dx.doi.org/10.1016/j.anr.2023.01.003 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

导师指导与临床医学硕士专业学位研究生个人能力关系研究：学习投入和学习倦怠的作用

医学检验技术专业实习生的学习倦怠与社会支持相关性分析与对策