识别护理学生心肺复苏术表现的临床错误模式：一项混合方法的OSCE研究

IF 2.4 Q3 CRITICAL CARE MEDICINE

Resuscitation plus Pub Date : 2025-09-05 DOI:10.1016/j.resplu.2025.101089

Kheizaran Miri , Alireza Sardashti , Sajedeh Moradi , Arefeh Naseri , Amirhossein Mirzaei

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引用次数: 0

摘要

基本生命支持（BLS）能力对医疗保健专业人员至关重要，但在培训环境中存在持续的绩效差距。本研究旨在识别护生在客观结构化临床检查（oses）中心肺复苏（CPR）表现的错误模式，并通过利益相关者的见解，识别感知到的挑战并提出补救策略，以提高学习成果。方法采用顺序解释混合方法（2021-2024）对250名8学期护理专业学生进行研究。定量阶段使用以下方法分析欧安组织的绩效：1)经过验证的20项BLS知识测试，2)17项技能检查表，以及3)Laerdal QCPR®人体模型指标。定性阶段包括与25个利益相关者（学生、教师、考官）的访谈。数据分析采用描述性/推断性统计（SPSS v25）和专题分析（MAXQDA 2022）。结果发现了明显的缺陷：68%的患者未能达到指南要求的压缩深度（平均：40-50 mm，而推荐的50-60 mm）， 45%的患者表现出不正确的比率，只有18%的患者正确使用了AED垫。定性分析显示，压力（89%）和反馈不足（75%）是主要的绩效障碍。性别差异出现，女学生提供40%的浅按压（p < 0.05）。结论本研究揭示了护生在oses期间将BLS知识转化为合格CPR表现的能力持续存在差距。压缩质量、AED使用和决策方面的不足突出了当前培训模式的局限性。整合高保真仿真、实时反馈和压力缓解策略可以加强技能习得。需要进一步的多中心研究来建立基于证据的方法，以确保毕业生准备好提供高质量的复苏护理。临床试验号：不适用。

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Identifying clinical error patterns in nursing students’ CPR performance: a mixed-methods OSCE study

Background

Basic Life Support (BLS) competency is critical for healthcare professionals, yet persistent performance gaps exist in training settings. This study aimed to identify error patterns in nursing students’ cardiopulmonary resuscitation (CPR) performance during Objective Structured Clinical Examinations (OSCEs) and, through stakeholder insights, identify perceived challenges and suggest remediation strategies to improve learning outcomes.

Methods

A sequential explanatory mixed-methods study was conducted (2021–2024) with 250 eighth-semester nursing students. The quantitative phase analyzed OSCE performance using: 1) a validated 20-item BLS knowledge test, 2) a 17-item skills checklist, and 3) Laerdal QCPR® mannequin metrics. The qualitative phase included interviews with 25 stakeholders (students, instructors, examiners). Data were analyzed using descriptive/inferential statistics (SPSS v25) and thematic analysis (MAXQDA 2022).

Results

Significant deficiencies were identified: 68 % failed to achieve guideline-compliant compression depth (mean: 40–50 mm vs. recommended 50–60 mm), 45 % demonstrated incorrect rates, and only 18 % properly applied AED pads. Qualitative analysis revealed stress (89 % prevalence) and inadequate feedback (75 %) as key performance barriers. Gender disparities emerged, with female students delivering 40 % shallower compressions (p < 0.05).

Conclusion

This study reveals persistent gaps in nursing students’ ability to translate BLS knowledge into competent CPR performance during OSCEs. Deficiencies in compression quality, AED use, and decision-making highlight limitations of current training models. Integrating high-fidelity simulation, real-time feedback, and stress-mitigation strategies may strengthen skill acquisition. Further multicenter research is needed to establish evidence-based approaches that ensure graduates are prepared to deliver high-quality resuscitative care.

Clinical trial number: not applicable.

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