基于里程碑理念构建护理硕士专业学位研究生临床能力评价体系
Developing a Clinical Competency Assessment System for the Master of Nursing Specialist Students Based on the Milestones Concept
摘要: 目的：以里程碑理念为基础构建护理硕士专业学位研究生临床能力评价体系。方法：采用德尔菲法对来自吉林、陕西、湖南、浙江等省共15名专家进行两轮函询，建立护理硕士专业学位研究生临床能力里程碑评价体系的各级指标。结果：最终确立了由5个能力等级、5个一级指标、18个二级指标以及43个三级指标构成的评价体系。两轮函询问卷有效回收率均为100%，肯德尔和谐系数分别为0.211和0.310 (均P < 0.05)，专家函询权威系数(Cr)分别为0.923和0.957。结论：专家意见的协调一致性好，权威程度和积极性较高，所形成的临床能力里程碑评价体系可为护理硕士专业学位研究生的培养和评价提供参考依据。
Abstract: Objective: To establish a clinical competency evaluation system for Master of Nursing Specialist Students (MNS) based on a milestone concept. Methods: A two-round Delphi survey was conducted with 15 experts from Jilin, Shaanxi, Hunan, Zhejiang, and other provinces to develop tiered indicators for the MSN clinical competency milestone evaluation system. Results: The final evaluation system comprised 5 competency levels, 5 first-level indicators, 18 second-level indicators, and 43 third-level indicators. Both rounds achieved a 100% valid response rate, with Kendall’s coefficient of concordance at 0.211 and 0.310 (both P < 0.05), and expert consultation authority coefficients (Cr) at 0.923 and 0.957. Conclusion: Expert opinions demonstrated high consistency, strong authority, and positive engagement. The resulting milestone evaluation system provides a reference framework for cultivating and assessing clinical competencies among Master of Nursing Specialist Students (MNS).
文章引用：赖金贵, 乔彦铭, 王雨晗, 李梦媛, 王璐, 袁娴雅, 张琳, 宋艳. 基于里程碑理念构建护理硕士专业学位研究生临床能力评价体系[J]. 教育进展, 2026, 16(7): 1483-1494. https://doi.org/10.12677/ae.2026.1671523

参考文献

[1] 关于印发金融硕士等19种硕士专业学位设置方案的通知[EB/OL]. 学位［2010］15号. 2010-03-18.
https://yz.chsi.com.cn/kyzx/zcdh/201005/20100513/89397230.html, 2026-01-25.
[2] 郭爱敏, 张倩倩, 唐玲, 等. 护理硕士专业学位毕业生核心能力量表的编制及信度、效度检验[J]. 中国护理管理, 2020, 20(11): 1643-1647.
[3] 李文君, 唐万珍, 曾毅文, 等. 双轨双控分阶段衔接模式用于护理硕士专业学位研究生规范化培训[J]. 护理学杂志, 2018, 33(21): 58-62.
[4] 李海潮. 第二代医学教育改革与胜任力导向医学教育的关系分析[J]. 中华医学教育杂志, 2019, 39(11): 801-806.
[5] Beresin, E.V., Balon, R. and Coverdale, J. (2014) The Psychiatry Milestones: New Developments and Challenges. Academic Psychiatry, 38, 249-252. [Google Scholar] [CrossRef] [PubMed]
[6] Eric, S., Holmboe, L.E. and Hamstra, S. (2017) The Milestones Guidebook.
http://www.acgme.org/Portals/0/PDFs/Milestones/MilestonesAnnualReport2016.pdf
[7] Green, M.L., Aagaard, E.M., Caverzagie, K.J., Chick, D.A., Holmboe, E., Kane, G., et al. (2009) Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training. Journal of Graduate Medical Education, 1, 5-20. [Google Scholar] [CrossRef] [PubMed]
[8] 中国精英教学医院联盟. 中国精英教学医院联盟住院医师核心胜任力里程碑评价体系[J]. 协和医学杂志, 2023, 14(5): 978-982.
[9] Edgar, L., Roberts, S. and Holmboe, E. (2018) Milestones 2.0: A Step Forward. Journal of Graduate Medical Education, 10, 367-369. [Google Scholar] [CrossRef] [PubMed]
[10] 胡明熙, 毕怀梅, 王涛, 等. 护理硕士专业学位研究生教育里程碑计划体系构建[J]. 护理研究, 2021, 35(8): 1488-1491.
[11] Sastre-Fullana, P., Morales-Asencio, J.M., Sesé-Abad, A., Bennasar-Veny, M., Fernández-Domínguez, J.C. and De Pedro-Gómez, J. (2017) Advanced Practice Nursing Competency Assessment Instrument (APNCAI): Clinimetric Validation. BMJ Open, 7, e013659. [Google Scholar] [CrossRef] [PubMed]
[12] Van Hecke, A., Decoene, E., Embo, M., Beeckman, D., Bergs, J., Courtens, A., et al. (2025) Development of a Competency Framework for Advanced Practice Nurses: A Co‐Design Process. Journal of Advanced Nursing, 81, 353-365. [Google Scholar] [CrossRef] [PubMed]
[13] Solberg, M.T., Pedersen, I., Mathisen, C., Finnstrøm, I.J., Lundin, P.K. and Nes, A.A.G. (2023) Professional Competence Required in Advanced Practice Nursing in Critical Care: An Exploratory Qualitative Study. Nursing Open, 10, 7839-7847. [Google Scholar] [CrossRef] [PubMed]
[14] Accreditation Council for Graduate Medical Education (2020) The Milestones Guidebook.
https://www.acgme.org/globalassets/milestonesguidebook.pdf
[15] Allen, S. (2014) Development of the Family Medicine Milestones. Journal of Graduate Medical Education, 6, 71-73. [Google Scholar] [CrossRef] [PubMed]
[16] 李玉乐, 焦静, 朱晨, 等. 我国护理硕士专业学位研究生临床培养研究进展[J]. 中国护理管理, 2019, 19(11): 1673-1677.
[17] 国务院学位委员会、教育部印发《专业学位研究生教育发展方案（2020—2025）》[EB/OL]. 2020-10-01.
http://www.moe.gov.cn/jyb_xwfb/s5147/202010/t20201009_493536.html, 2026-01-25.
[18] 孙慧群, 张培莉, 姚莉珮, 等. 我国护理硕士专业学位研究生临床能力评价体系的研究进展[J]. 中华护理教育, 2020, 17(4): 376-380.
[19] Ličen, S. and Plazar, N. (2019) Developing a Universal Nursing Competencies Framework for Registered Nurses: A Mixed‐Methods Approach. Journal of Nursing Scholarship, 51, 459-469. [Google Scholar] [CrossRef] [PubMed]
[20] 韩玉欣, 张宇, 王心慧, 等. 护理本硕博学生教育里程碑体系研究[J]. 昆明医科大学学报, 2025, 46(11): 160-171.
[21] 马壹, 王涛, 王心慧, 等. 基于里程碑计划的护理硕士专业学位研究生培养办法研究[J]. 科教文汇(中旬刊), 2021(8): 131-134.
[22] Huang, T.H., Liu, F., Chen, L.C., et al. (2021) The Acceptance and Impact of Google Classroom Integrating into a Clinical Pathology Course for Nursing Students: A Technology Acceptance Model Approach. PLOS ONE, 16, e0247819. [Google Scholar] [CrossRef] [PubMed]
[23] Azemian, A., Ebadi, A. and Afshar, L. (2021) Redefining the Concept of Professionalism in Nursing: An Integrative Review. Frontiers of Nursing, 8, 327-340. [Google Scholar] [CrossRef] 
[24] 程海丹, 管艳萌, 刘霞, 等. 16个省市患者参与患者安全实践及管理现状研究[J]. 护理管理杂志, 2023, 23(4): 290-294.
[25] 吴采倩, 吕程果, 米芊睿, 等. 数智融合驱动医学本科生科研能力培养模式初探[J]. 医学教育研究与实践, 2026, 34(2): 185-190.
[26] 吴凤萍, 高宁, 王媛, 等. 双轨合一模式下临床医学专业硕士科研能力薄弱成因与对策[J]. 医学教育研究与实践, 2026, 34(2): 222-228.
[27] Jokiniemi, K., Hølge‐Hazelton, B., Kristofersson, G.K., Frederiksen, K., Kilpatrick, K. and Mikkonen, S. (2021) Core Competencies of Clinical Nurse Specialists: A Comparison across Three Nordic Countries. Journal of Clinical Nursing, 30, 3601-3610. [Google Scholar] [CrossRef] [PubMed]

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