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Article(id=1322168339250663678, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322167871413796899, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.03.026, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1744128000000, receivedDateStr=2025-04-09, revisedDate=1767715200000, revisedDateStr=2026-01-07, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159096777, onlineDateStr=2026-10-28, pubDate=1770652800000, pubDateStr=2026-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159096777, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159096777, creator=13701087609, updateTime=1793159096777, updator=13701087609, issue=Issue{id=1322167871413796899, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='3', pageStart='353', pageEnd='528', issueExtLink='null', onlineDate='null', pubDate='1770652800000', pubDateStr='2026-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793158985236, creator='13701087609', updateTime=1793158985236, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=524, endPage=528, ext={EN=ArticleExt(id=1322168341037437185, articleId=1322168339250663678, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Innovative practice and development trend of simulation-based nursing education from the perspective of competency-based education, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

By exploring the theoretical synergy mechanism between simulation-based nursing education and competency-based education,combined with international typical practice cases and cutting-edge technology applications,this paper analyzed the teaching effectiveness of the integration,and explored the practical path,challenges,and future development trends of simulation-based nursing education under the framework of competency-based education.The aim was to provide theoretical support and practical reference for the digital transformation of nursing education.

, authors=Lanxin OUYANG, Yudi DU, Shaowen PU, Yin LIN, Di LIU, authorsList=Lanxin OUYANG, Yudi DU, Shaowen PU, Yin LIN, Di LIU, authorCompany=null, correspAuthors=Di LIU, authorNote=null, correspAuthorsNote=
LIU Di, E-mail:
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通过探讨护理模拟教学与能力本位教育的理论协同机制，结合国际典型实践案例与前沿技术应用，分析二者融合的教学效能，并探讨护理模拟教学在能力本位教育框架下的实践路径、面临的挑战及未来发展趋势，以期为护理教育的数智化转型提供理论支撑和实践参考。

, authors=欧阳兰欣, 杜玉迪, 浦绍文, 林印, 刘迪*, *, *, authorsList=欧阳兰欣, 杜玉迪, 浦绍文, 林印, 刘迪, authorCompany=null, correspAuthors=刘迪, authorNote=

欧阳兰欣，护师，硕士研究生

, correspAuthorsNote=
刘迪，E-mail：
LIU Di, E-mail:
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欧阳兰欣，护师，硕士研究生

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层级学习目标护理模拟教学实践能力本位教育对应原则
0级基础知识获取（如氧疗设备类型）通过虚拟模块或自动化设备[如心肺复苏（CPR）模型]独立学习，依赖自动化反馈以学习者为中心，强调自主学习
1级基础技能训练（如插管）在技能实验室中无临床情景练习，教师即时指导直接观察技能，去时间化训练
2级情景化技能应用（如呼吸窘迫病人处理）在模拟临床环境中应用技能，采用嵌入式教练或暂停讨论能力的情景依赖性，反馈促进改进
3级跨专业团队协作与复杂病例管理跨专业团队在真实情景中协作，通过反思性汇报深化能力团队能力整合，以结果为导向
4级真实临床环境中的持续学习通过临床事件汇报（如真实呼吸急救案例）进行经验总结能力维护与持续改进
), ArticleFig(id=1322530272646643785, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168339250663678, language=CN, label=表1, caption=

阶梯式模拟课程设计模型的分级结构示例

, figureFileSmall=null, figureFileBig=null, tableContent=
层级学习目标护理模拟教学实践能力本位教育对应原则
0级基础知识获取（如氧疗设备类型）通过虚拟模块或自动化设备[如心肺复苏（CPR）模型]独立学习，依赖自动化反馈以学习者为中心，强调自主学习
1级基础技能训练（如插管）在技能实验室中无临床情景练习，教师即时指导直接观察技能，去时间化训练
2级情景化技能应用（如呼吸窘迫病人处理）在模拟临床环境中应用技能，采用嵌入式教练或暂停讨论能力的情景依赖性，反馈促进改进
3级跨专业团队协作与复杂病例管理跨专业团队在真实情景中协作，通过反思性汇报深化能力团队能力整合，以结果为导向
4级真实临床环境中的持续学习通过临床事件汇报（如真实呼吸急救案例）进行经验总结能力维护与持续改进
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能力本位教育视域下护理模拟教学的创新实践与发展趋势
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欧阳兰欣 , 杜玉迪 , 浦绍文 , 林印 , 刘迪 *, *, *
护理研究 | 科研综述 2026,40(3): 524-528
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护理研究 |科研综述 2026 , 40 (3) : 524 -528
能力本位教育视域下护理模拟教学的创新实践与发展趋势
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欧阳兰欣, 杜玉迪, 浦绍文, 林印, 刘迪*, *, *
作者信息
  • 1华中科技大学同济医学院附属武汉中心医院，湖北 430014
通讯作者:
刘迪，E-mail：
LIU Di, E-mail:
作者简介:

欧阳兰欣，护师，硕士研究生

Innovative practice and development trend of simulation-based nursing education from the perspective of competency-based education
Lanxin OUYANG, Yudi DU, Shaowen PU, Yin LIN, Di LIU
Affiliations
  • 1The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology， Hubei 430014 China
    • Corresponding Author:
    LIU Di, E-mail:
出版时间: 2026-02-10 doi: 10.12102/j.issn.1009-6493.2026.03.026
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摘要
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通过探讨护理模拟教学与能力本位教育的理论协同机制，结合国际典型实践案例与前沿技术应用，分析二者融合的教学效能，并探讨护理模拟教学在能力本位教育框架下的实践路径、面临的挑战及未来发展趋势，以期为护理教育的数智化转型提供理论支撑和实践参考。

能力本位教育  /  模拟教学  /  胜任力  /  护理教育  /  综述

By exploring the theoretical synergy mechanism between simulation-based nursing education and competency-based education,combined with international typical practice cases and cutting-edge technology applications,this paper analyzed the teaching effectiveness of the integration,and explored the practical path,challenges,and future development trends of simulation-based nursing education under the framework of competency-based education.The aim was to provide theoretical support and practical reference for the digital transformation of nursing education.

competency-based education  /  simulation-based education  /  competency  /  nursing education  /  review
欧阳兰欣, 杜玉迪, 浦绍文, 林印, 刘迪. 能力本位教育视域下护理模拟教学的创新实践与发展趋势. 护理研究, 2026 , 40 (3) : 524 -528 . DOI: 10.12102/j.issn.1009-6493.2026.03.026
Lanxin OUYANG, Yudi DU, Shaowen PU, Yin LIN, Di LIU. Innovative practice and development trend of simulation-based nursing education from the perspective of competency-based education[J]. Chinese Nursing Research, 2026 , 40 (3) : 524 -528 . DOI: 10.12102/j.issn.1009-6493.2026.03.026
正文
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全球医疗体系的快速变革对护理人才的能力结构提出了新的要求，护理人员不仅需要扎实的专业知识，还需具备临床决策、团队协作、人文关怀等综合胜任力[1]。传统护理教育模式仍以知识传授为主，实践教学资源有限，导致学员在应对复杂临床情景时往往缺乏有效的能力训练，理论与实践脱节的问题尤为突出[2]。能力本位教育（competency-based education，CBE）作为现代护理教育的重要改革方向，以胜任力培养为核心，通过明确的能力标准、个性化学习路径和动态评估体系，提升学员的实际工作能力[3]。与此同时，护理模拟教学（simulation-based education，SBE）借助高仿真模拟器、虚拟现实（virtual reality，VR）、增强现实（augmented reality，AR）等技术，为学员提供安全、可重复的临床训练环境，使能力培养摆脱传统教学的资源限制[4-5]。能力本位教育与护理模拟教学在理念上高度契合，前者提供能力培养的目标框架，后者则通过情景化训练实现能力建构，二者的深度融合正推动护理教育迈向精准化、胜任力导向的新阶段[6]。本研究旨在探讨能力本位教育与护理模拟教学的协同机制，分析其在护理核心能力培养中的作用，并结合国际典型实践案例，分析护理模拟教学在能力本位教育框架下的应用现状、挑战与发展趋势，以期为护理教育的胜任力培养提供理论支撑与实践参考。
1　能力本位教育与护理模拟教学的理论协同机制
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能力本位教育与护理模拟教学在护理教育中的协同作用源于二者在能力培养目标上的高度契合。能力本位教育强调基于胜任力的系统化培养，其核心在于构建能力—评估—反馈闭环，以动态适配学习者发展需求[7]。相较于传统依赖学时的教学模式，能力本位教育更加注重能力达成，课程设计围绕岗位需求展开，并通过多样化的学习活动（如案例分析、模拟实训）促进能力螺旋式提升[8]。护理模拟教学则提供高仿真、低风险的实践环境，使学员能够在接近临床实际的模拟场景中强化能力。其核心特征包括情景真实性、错误容忍性和反思闭环性[9]。学员可在模拟前预习（pre-briefing）、模拟中实践（scenario）、模拟后汇报（debriefing）的学习循环下，进行重复训练和即时反馈，以促进知识向实践迁移[10]。
能力本位教育与护理模拟教学的这种协同关系还可以从多个理论层面加以解释。经验学习理论指出，能力发展需要经历经验、反思、抽象、实践的循环，而护理模拟教学正是能力本位教育这一学习路径的理想载体，使学员能够在模拟实践中积累经验，并通过反思与反馈深化能力构建[11-12]。认知负荷理论进一步指出，复杂技能的学习需要合理的任务分级，以优化学习者的认知资源分配[13]。护理模拟教学通过从低保真到高保真的分层设计，使学员在适应性挑战中逐步提升能力，从而合理控制认知负荷，减少无关认知超载，并提高能力迁移效率[14]。建构主义学习理论认为，知识和能力的生成在很大程度上受到社会互动与实践探索的促进[15]。能力本位教育与护理模拟教学的结合通过团队模拟、互动反馈、情景化训练等方式，使学员能够在团队协作与实际应用过程中积极建构自身知识体系，提升临床决策和问题解决能力。
综上所述，能力本位教育提供了护理胜任力培养的理论框架，而护理模拟教学则通过情景化模拟优化实践路径。二者的结合在学习机制上形成互补，使护理教育更加契合临床需求，为高水平护理人才的培育奠定理论基础。
2　护理模拟教学在能力本位教育框架下的实践应用
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护理模拟教学在能力本位教育框架下的应用，核心应在于构建围绕胜任力培养展开的教学流程，使学员能够在真实或近似真实的情景中发展和评估护理能力[10]。
2.1　能力本位教育框架下的护理模拟教学模式
2.1.1　基于情景的任务驱动教学
任务驱动的模拟教学模式以临床真实情景为依托，强调学员在完成具体任务的过程中建构核心能力，并确保训练内容与岗位需求的无缝对接[16]。该模式通常结合案例设计、任务分解与动态反馈，以提升教学的针对性和实效性。例如在针对急性心肌梗死病人的护理模拟中，教学内容不再局限于单一技能训练，而是通过完整的案例模拟，包括病情评估、紧急处理和家属沟通，使护士在任务执行中培养决策能力与团队协作能力[17]。研究表明，该模式能显著增强学员的自主学习意愿，提升复杂病例管理中的临床思维和应变能力[18]。此外，该模式通过模拟后的复盘，结合教师点评与学员自评，帮助学员优化任务执行策略，从而促进能力迁移至真实临床环境[19]。
2.1.2　模块化渐进式训练
在能力本位教育框架下，护理能力的发展具有阶段性特征，需要遵循从基础技能到复杂情景处理的递进式训练原则[7]。护理模拟教学可通过模块化设计，使学员的能力培养符合这一渐进式发展规律，即先掌握核心技能，再逐步过渡到综合应用，最终提升高阶临床胜任力。一项多中心研究表明，阶梯式模拟课程设计模型（SimSteps）在医学教育中展现出较高的适用性，其系统化、分阶段的课程开发流程能够确保教学目标与临床需求的高度契合[20]。沙特卫生专业委员会在模拟课程开发中应用阶梯式模拟课程设计模型，将其划分为需求整合阶段（通过国际与机构层面的需求分析，明确课程目标与技能缺口）、能力建构阶段（设计教学目标、分解技术与非技术技能、开发客观评估工具，并融入熟练度递进训练）、验证实施阶段[通过多层级课程评估（如柯氏模型）和资源协调，确保课程可持续落地]三大阶段[21]。调查显示，该模型在提升学员技能掌握度的同时，也促进了非技术能力的发展，如团队协作和沟通能力[20]。模块化设计结合实证框架，显著提升了课程的科学性与跨专业适用性，为多情景临床决策能力培养提供了标准化路径。
2.1.3　反馈闭环与自适应学习
在能力本位教育框架下，护理模拟教学不仅关注学员在某一时点的能力达成，更强调基于反馈的动态优化，以确保能力发展符合个性化培养路径。护理模拟教学作为实践导向的教学方式，天然适用于形成性评价，其核心在于构建以即时反馈、多维数据评估与自适应学习为支撑的能力发展闭环。即时反馈是护理模拟教学的重要环节，教师通过结构化讨论，引导学员回顾训练过程，分析操作优势与不足，并结合同行反馈，促进临床思维能力的发展[9]。此外，学员可以通过反思性学习日志记录自身表现、识别能力短板，并制定改进策略，以强化自主调节能力[22]。这种基于自我认知的反馈机制，使学习者在反思中不断优化能力表现。在能力评估方面，研究探索基于数据驱动的动态评价模式，突破传统的单次考核方式，使评估更符合能力本位教育的胜任力培养理念。客观结构化临床考试（objective structured clinical examination，OSCE）作为护理教育中的常见考核方式，主要用于总结性评价，但难以持续追踪学员能力发展。而结合基于护理模拟教学的过程性评估，教师可以通过模拟训练数据、学员互动记录、任务完成度等多维指标，建立个体化能力发展轨迹，使评估更加科学化和系统化[23]。基于动态评估的自适应学习机制，教师能够精准识别学员的个性化学习需求，并动态调整训练难度与内容。土耳其一项研究提出“学生分类率（student classification rate，SCR）”的方法，通过综合分析学习行为、课堂参与度、作业提交情况等数据，精准识别学生的学习风格，并成功实现了个体学习进度的动态监测[24]。这一思路可用于护理模拟教学，通过模拟训练数据分析构建智能能力评估模型，从而动态调整教学方案。
2.2　能力本位教育框架下的护理模拟教学课程设计工具
在能力本位教育框架下，护理模拟教学课程设计已发展出多种模式，以优化能力培养路径并确保学习成果符合临床胜任力要求。其中阶梯式模拟课程设计模型作为一种成功的教学框架，为护理模拟教学提供了清晰的进阶路径，并能够动态调整教学内容，以匹配学员的能力发展需求。阶梯式模拟课程设计模型通过5个层级（0~4）明确能力培养路径，并动态调整教学内容，已被广泛应用于临床技能培训、团队协作演练及跨专业教育[25]。阶梯式模拟课程设计模型各层级的学习目标、护理模拟教学实践模式及能力本位教育对应原则见表1。阶梯式模拟课程设计模型提供了一条标准化、层次化、情景化的护理模拟教学课程规划路径，使能力培养更具系统性。作为能力本位教育框架下的教学工具，其能够精准匹配不同阶段学员的学习需求，并有效促进模拟教学与临床实践的衔接。
3　发展趋势与前沿探索
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随着数智化转型的加速，前沿技术正在推动护理教育在能力本位教育和护理模拟教学领域的深度创新。例如，虚拟现实创伤急救模拟系统能够重现心搏骤停等紧急场景，让学员在高压环境下反复训练决策能力[26]，已被证明比传统教学模式提高了学员的临床决策准确性。与此同时，混合现实（mixed reality，MR）技术突破了空间限制，如HoloLens设备使得跨地域学员能够同步参与高仿真模拟，促进了远程护理教育的互动性和标准化[27]。人工智能技术的应用也为个性化学习路径提供了新的契机。人工智能导师系统通过自然语言处理技术，实时分析学员在模拟护患沟通中的语言模式，给予反馈和改进建议，从而有效提升非技术性技能的达标率[28]。此外，生物传感技术通过量化学员的生理数据（如心率）优化模拟教学策略，增强了学习效果[29]。区块链技术也逐步在护理教育中得到应用，用于存储和验证学员的能力成长档案，确保跨机构的能力认证和学分互认[30]。
随着能力本位教育与护理模拟教学的深度融合，评估体系也正经历变革，尤其是在智能化和动态化的趋势下。数据驱动的评估模式通过大数据分析学员的训练表现，构建精准的能力预测模型，从而帮助制定个性化的学习路径[31]。例如，智能学习管理系统（learning management system，LMS）能够自动识别学员在模拟训练中的不足，并根据其错误模式生成针对性的补强计划，极大提高了技能迁移的效率[32]。另外，结合可委托专业活动（entrustable professional activities，EPAs）框架与工作场所评估（workplace-based assessment，WBA）系统，可使评估结果更具临床应用价值[33]。
4　挑战与对策
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4.1　挑战
护理教育中能力本位教育与护理模拟教学的深度融合虽展现出显著潜力，但仍面临多重现实挑战，需通过系统性策略实现突破。1）技术成本与教育公平的悖论成为首要障碍。高端模拟设备的购置与维护费用高昂，可能加剧资源分配的地域差异，导致欠发达地区院校难以平等享受技术创新红利。对此，构建开源分级模拟教学资源库是一条可行路径，可通过整合高、中、低保真度工具（如3D打印解剖模型、虚拟病例库、低成本标准化病人脚本），并共享虚拟现实模拟课程与结合本土化低成本模拟器（如手机端增强现实应用），为不同地区院校提供适配的教学资源，提升偏远地区学员的技能培养效果[34]。2）高保真模拟的应用需在提升真实性与保障心理安全之间寻求平衡。尽管高保真模拟能够增强沉浸感，但某些高度紧张的情景（如大量出血、濒死病人救治）可能引发学员过度焦虑，甚至产生心理负担，影响学习效果[35]。研究表明，适度压力有助于提升技能迁移能力，但若情景设计超出学员的承受范围，可能导致“学习停滞”或回避相关训练[36]。为此，需要建立分级模拟策略，根据学员经验水平调整情景复杂度，并通过循证研究明确不同保真度模拟对特定能力培养的实际效能，避免盲目追求高技术复杂性。此外，可引入情绪支持机制，如在训练后开展心理事后解说（psychological debriefing），帮助学员调适情绪，增强心理韧性，以确保模拟教学既能提升能力，又不对学习者造成过度心理压力[37]。3）教师角色转型的适应性挑战凸显了人力资本升级的紧迫性。传统护理教师普遍缺乏数字技术操作、数据分析与跨学科协作能力，难以有效驾驭能力本位教育与护理模拟教学融合教学模式。为此，构建模拟教师信息胜任力培训框架至关重要[38]。教师不仅需掌握模拟技术的操作方法，还需具备护理信息学素养，如数据驱动的教学决策、远程模拟指导及数字资源管理能力，以适应智能化教学环境的需求。
4.2　对策
未来需从多个层面协同发力，以推动能力本位教育与护理模拟教学的深度融合。1）在政策层面，鼓励院校与企业、科研机构合作，共享优质模拟资源，降低技术使用门槛；2）在教学实践层面，建立适应不同发展阶段的分级模拟体系，并完善教师培训支持体系，以提升教学效能；3）在心理支持层面，优化学员的情绪调适机制，确保沉浸式学习的同时维护心理安全。通过这些综合举措，护理模拟教学将更具可持续性，不仅提升技术应用的普及度和教学效能，更能促进基于胜任力的培养模式优化，助力护理教育向智能化、个性化和高质量方向发展。
5　小结
收起
在能力本位教育的框架下，护理模拟教学作为一种高效的实践教学模式已展现出助力护理胜任力培养的巨大潜力。二者的深度融合不仅优化了护理教育的教学模式，也有效弥补了传统教学中理论与实践脱节的问题。数智化技术的应用正在推动护理模拟教学向智能化、个性化方向发展，数据驱动的评估体系也在增强能力本位教育的精准度与适应性。然而，护理模拟教学的广泛应用仍面临资源配置不均、教师胜任力不足、学员心理安全保障等现实挑战。未来需要在政策支持、资源共享、教师培训和心理调适等方面协同推进，以构建更具可持续性、适应不同学员需求的能力本位教育与护理模拟教学融合教学体系。通过这些努力，护理教育将迈向更加智能化、高质量的发展阶段，为培养具备综合胜任力的护理专业人才奠定坚实基础。

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doi: 10.12102/j.issn.1009-6493.2026.03.026
  • 接收时间：2025-04-09
  • 首发时间：2026-10-28
  • 出版时间：2026-02-10
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  • 收稿日期：2025-04-09
  • 修回日期：2026-01-07
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    1华中科技大学同济医学院附属武汉中心医院，湖北 430014

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total species (%)		 属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
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