As a core course in nursing, Obstetric and Gynecologic Nursing consists of 48 hours of theory classes and 12 hours of laboratory classes. In this course, we selected chapters with moderate difficulty, student interest, and strong social applicability for teaching reform, such as postpartum hemorrhage. The experimental group implemented the TPKCEE compound teaching model based on narrative nursing for the ideological and political education, while the control group received traditional obstetric and gynecologic teaching. Both groups used the same textbooks, lecturers, and reference materials.
2.3.1 Experimental Group
(1) Design of TPKCEE Blended Learning Model in Obstetric and Gynecologic Nursing Education
The experimental group employs the TPKCEE integrated teaching model in the design of obstetric and gynecological nursing education. This model includes the following components: T (Thinking)[15], P (Problem), K (Keypoints), C (Case) [16], E (Experiment)[17], and E (Expansion). Figure 1 provides an overview of the research.
(2) Integration of Narrative Nursing Cases and Clinical Nursing Cases
The case is integrated with narrative nursing cases in the fixed mode of chief complaint, present illness, physical examination, laboratory examination, and diagnosis. The case is presented to students in the form of storytelling. The way of storytelling can be in the form of reading diaries. The diary can be from the nurse's perspective, such as "Today, a 35-year-old pregnant woman came to the department..."; it can also be from the patient's perspective, such as "I'm 35 years old this year and a mother of one child. Yesterday, I found out..."; it can also be in the form of documentaries, films, or TV drama fragments. The story should describe in detail the communication between the nurse and the patient, analyze in detail the process of narrative nursing and the nursing outcome during the communication. At the end of the course, students are required to record narrative nursing dramas based on the cases provided by the teacher to observe students' understanding of narrative nursing.
The design of the cases not only ensures their scientific nature, but also pays attention to the infiltration of medical ethics, ethics, and patriotism education.
(3) Teaching Methods
Pre-class teaching preparation: 1)Write narrative nursing clinical cases and TPCKEE teaching plans. 2)Require completion of a mind map of the chapter's knowledge points after completing the MOOC (Massive Open Online Course) learning. 3)Send the narrative nursing clinical cases to student study groups and set 4–6 questions for students based on teaching objectives and key points. Four questions guide students to learn and discuss the knowledge points that need to be mastered in this chapter and connect them to other relevant courses. One or two questions are related to ideological and political aspects, such as how nurses feel when communicating with patients and how they deconstruct and externalize the story.
In class: a multimedia format is utilized to reintroduce the narrative nursing clinical case and deconstruct it into two parts: 1) By using the occurrence, development, and changes of the disease as the main focus, students are constantly asked questions to induce recall of the pre-lesson content and to summarize the key and difficult points of the Chap. 2)The nurse's perception of the patient's psychological state and identification of possible difficulties that the patient may face are analyzed from the patient's narrative. Additionally, the nurse's approach to helping the patient recognize and solve problems during the development of the patient's psychological experience is discussed.
After-class: review and expansion: Push post-class review materials to expand new concepts, technologies, and methods related to nursing and treatment in this chapter.
Taking the postpartum hemorrhage chapter as an example, the TPCKEE teaching model based on narrative nursing is used in the design of obstetric nursing education, as shown in Fig. 2.
3.3.2 Control Group
Teaching is conducted using a traditional instructional approach, which primarily includes the following components: (1)Pre-class: Assigning pre-reading tasks and requiring completion of MOOC studies as per the given instructions. (2)In-class: Reviewing the main points covered in the previous class, followed by teaching the key and challenging aspects of the current chapter. This includes clinical presentations, etiology, nursing diagnosis, and nursing interventions. During practical sessions, the teacher provides explanations and demonstrations of nursing procedures, after which students practice in groups while receiving guidance from the teacher. (3)Post-class: Assigning homework based on the key and challenging aspects of the chapter.