Establishment of a clinical decision-making ability indicator system for pediatric nursing interns based on evidence-based practice
10.3760/cma.j.cn116021-20250102-02116
- VernacularTitle:基于循证实践的儿科护理实习生临床决策能力指标体系的建立
- Author:
Jie CHANG
1
;
Qiong XIANG
;
Xiaoyu ZHOU
;
Min ZHANG
;
Juan WEI
;
Feng GUO
;
Rui PAN
Author Information
1. 空军军医大学第一附属医院/西京医院儿科，西安 710032
- Publication Type:Journal Article
- Keywords:
Evidence-based practice;
Pediatric nursing;
Intern;
Clinical decision-making ability;
Indicator system
- From:
Chinese Journal of Medical Education Research
2025;24(10):1393-1399
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct a clinical decision-making ability indicator system based on evidence-based practice for pediatric nursing interns, and to provide a scientific basis for clinical teaching and evaluation.Methods:A method combining literature analysis, Delphi expert consultation, and empirical research was used. Firstly, a systematic search of Chinese and English databases (2018-2023) was conducted. Literature was screened based on the PICO framework and evidence-based data were extracted, resulting in a preliminary system consisting of 4 primary indicators, 12 secondary indicators, and 39 tertiary indicators. Subsequently, the indicators were revised through two rounds of Delphi expert consultation (25 experts with 19-27 years of work experience). The expert authority coefficients (Cr) were 0.898-0.907 and the Kendall's concordance coefficients were 0.351-0.420 ( P<0.001). Finally, the analytic hierarchy process was used to determine the weights, and the reliability and validity were verified through a questionnaire survey (sample size: 30 participants in preliminary survey and 58 participants in formal survey). Results:The constructed indicator system included 4 primary indicators (weights), 13 secondary indicators, and 42 tertiary indicators. The weights of the primary indicators were as follows: knowledge integration ability (0.300), evidence-based practice ability (0.250), clinical judgment ability (0.280), and ethical decision-making ability (0.170). The importance scores of all items exceeded 4.0 points (out of 5 points), and the coefficients of variation were less than 0.20. The reliability and validity tests showed that the Cronbach's α of the overall scale was 0.89, and the intraclass correlation coefficient was 0.88. The cumulative variance contribution rate of exploratory factor analysis was 69.30%. The confirmatory factor analysis demonstrated a good model fit with a comparative fit index of 0.93 and a root mean square error of approximation of 0.05. Conclusions:This indicator system has high scientificity and practicality, and can provide a reference for the standardized cultivation and evaluation of clinical decision-making ability of pediatric nursing interns. In the future, it is necessary to strengthen advanced evidence-based skills training and long-term application effectiveness tracking.
