目的 探究专业教育与护理本科生职业认同的关联路径及作用机制,为未来教育改革提供参考依据。方法 以全国21个省、市、自治区的43所高校2645名大学四年级护理本科生为研究对象,采用护理学专业学生职业认同量表及护理本科专业教育情况调查问卷收集数据,通过回归分析、结构方程模型等进行统计分析。结果 护理本科生的职业认同总体水平为(3.597±0.635)分,职业反思水平为(3.693±0.708)分。护理本科专业教育中,教师角色榜样为(3.951±0.606)分,情境化教学为(3.601±0.438)分,激励型互动为(3.608±0.627)分。专业教育各因素均是护理本科生职业认同的主要影响因素(均P<0.01)。专业教育与护理本科生职业认同存在2条显著的链式路径:专职教师角色榜样→同伴认可度→情境化实验教学→职业认同,临床教师角色榜样→临床实习→患者与家属激励→职业认同,其间接作用分别为0.071和0.160,专职教师角色榜样和临床教师角色榜样总作用分别为0.503和0.284。专业教育标准化直接作用0.894。结论 专业教育与护理本科生职业认同的关联以直接作用为主,临床教育路径的关联作用大于学校教育路径,护理教育者可通过针对性改革提高学生的职业认同。

Objective To explore the association path and mechanisms of professional education with professional identity among nursing undergraduates,so as to provide a reference for the reform of nursing professional education. Methods A total of 2645 senior nursing undergraduates were recruited from 43 universities across 21 provinces,municipalities directly under the central government and autonomous regions in China.Data were collected using the professional identity scale for nursing students and a self-designed questionnaire on professional education of nursing undergraduates.Regression analysis and structural equation modeling were applied for statistical analysis.Results The overall score of professional identity among nursing undergraduates was 3.597±0.635,and the score of career reflection was 3.693±0.708.In terms of professional education,the scores of teacher role model,situational teaching and motivational interaction were 3.951±0.606,3.601±0.438 and 3.608±0.627,respectively.All dimensions of professional education were major influencing factors of professional identity among nursing undergraduates (all P<0.01).Two obivous chain mediating paths were identified: full-time teacher role model→peer recognition→situational experimental teaching→professional identity; clinical teacher role model→clinical practice→patient and family encouragement→professional identity.The indirect effects of the two paths were 0.071 and 0.160,while the total effects of full-time teacher role model and clinical teacher role model were 0.503 and 0.284 respectively.The standardized direct effect of professional education was 0.894.Conclusions The association of professional education with professional identity among nursing undergraduates is dominated by direct effect.The associating effect of the clinical education path is stronger than that of the university education path.Nursing educators can effectively promote students' professional identity by implementing targeted educational optimization and reform.

R47