Two-way Evaluation and Analysis of Student-centered Clinical Teaching

Clinical observation is an important means to cooperate with clinical teaching, and it is a special stage of transition from theoretical study to clinical practice. How to make students apply their theoretical knowledge to clinical practice as soon as possible and improve their ability to analyze and solve problems is a subject that must be studied in nursing teaching. Establish Two-way evaluation system and apply it to clinical nursing teaching management. Teachers' evaluation form and interns' evaluation form were developed, which were applied to 186 students and teachers of this year. the results show that the scores of the Two-way evaluation results are obviously improved, and the practice teaching management is becoming more standardized. It is beneficial to improve the quality of clinical nursing teaching by finding out the problems in nursing teaching through Twoway evaluation and taking corresponding countermeasures.


Introduction
Comprehensive ability of clinical nursing is the basic ability necessary for clinical treatment, health education, communication and other nursing work to solve patients' problems in clinical practice [1]. In traditional teaching, the improvement of comprehensive ability of clinical nursing often depends on clinical practice, but the expansion of nursing enrollment, the improvement of patients' awareness of rights protection and the enhancement of people's ethical awareness has greatly restricted students' practical learning directly on patients' bodies [2][3]. At present, the teachercentered probation teaching mode is often used in clinic, which is not conducive to the initiative of nursing students and the cultivation of clinical thinking of nursing students. "Problem solving" teaching is a kind of teaching mode which is Student-centered and trains effective problem solvers [4].
Teaching evaluation is a means of modern teaching management. Traditional clinical nursing teaching evaluation is mainly accomplished by teachers' assessment of students' theory and operation. This one-way evaluation of students is subjective and one-sided, and cannot fully reflect the effect and quality of clinical teaching [5]. In order to improve the quality of teaching and the effect of learning in clinical teaching, through Two-way evaluation of clinical nursing teaching, our hospital learned the satisfaction of nursing students with teaching and the evaluation of teaching teachers on learning, and discussed the existing problems and solutions, which achieved certain results. It is reported as follows.

Object
There are 186 internship students in our college, including 104 junior college students and 82 undergraduate students from 5 different schools.

Method
According to the problems existing in clinical teaching, the improvement measures of link management were taken pertinently, and the key links of management were included in the evaluation content, and the self-made evaluation table was made. The nursing students distributed the Evaluation Table of Teaching Management and Teaching Quality to nursing students at the mid-term of practice and before the end of practice, and the nursing students evaluated the teachers in the completed practice departments one by one. Teachers' evaluation of nursing students not only includes the examination of leaving school, but also fills in the Evaluation Form of Nursing Students' Practice. The evaluation criteria are divided into four grades: excellent, good, fair and poor. In an anonymous form, the investigators will directly send the form to the respondents, and take it back after filling it out. Incomplete forms will be discarded.

Statistical Method
SPSS 15.0 was used to establish a database for statistical analysis, and χ2 test was used for counting data, and T test was used for measuring data. P < 0.05 indicated that the difference was statistically significant.

Evaluation of Teachers
A total of 188 copies of "Evaluation Form of Nursing Students for Teaching Teachers" were distributed, and 180 copies were recovered, with a recovery rate of 96%. 376 copies of "Clinical Practice Evaluation Form for Nursing Students" were distributed, and 368 copies were recovered, with a recovery rate of 98.%. See table 1 for the evaluation of nursing students on teaching teachers.

Evaluation of Clinical Practice of Nursing Students
Evaluation of clinical practice of nursing students Table 2.

Effect of Two-way Evaluation System
(1) Teacher's sense of responsibility increases Through Two-way evaluation of clinical teachers, the teaching consciousness and sense of responsibility are enhanced, self-restraint and competition consciousness are enhanced, and efforts are made to overcome their own shortcomings and learn from the teaching experience of excellent teachers, thus forming a good teaching atmosphere.
(2) Feedback is timely and effective The Two-way evaluation system strengthens the communication between teaching and learning, and the information feedback between teaching and learning is timely. If the students' timeliness evaluation reflects that the scheduling of a department is unreasonable when they leave the department, we will immediately contact the head nurse and teachers of the department to adjust the internship arrangement of the students in a timely manner. If the teacher finds that the students' thoughts fluctuate due to the influence of employment in the mid-term internship, we will hold the internship alumni association of the whole hospital in time to guide them on how to write letters of recommendation, how to apply for documents, and how to deal with interviews and examinations. The Two-way evaluation system enables teachers and students' problems to be found and solved in time.
(3) Train qualified talents The internship nursing students in our hospital come from the regular schools at the provincial and municipal levels, including college enrollment, self-funded students in vocational schools and students in adult classes. Their level is uneven and their acceptance ability is different. Therefore, according to the actual situation, clinical teachers flexibly use teaching methods, combine the characteristics of undergraduate courses, arrange internships and pay attention to improving the quality of nursing students. In teaching, we should also pay attention to using modern nursing concept to guide teaching, and resolutely overcome the traditional work style of only seeing illness but not seeing people. Two-way evaluation is a management method that teachers and nursing students are willing to accept and welcome.

Existing Problems
(1) Lack of teaching ability of teachers The lack of teachers' teaching ability is mainly reflected in giving nursing students opportunities and guidance. Nursing students think that in addition to the clinical practice guidance of nursing students, teachers are also in charge of patients, and undertake a lot of clinical nursing work every day. The guidance for nursing students often only stays at the traditional stage of "teachers and believers", lacking systematic and planned guidance, and teachers will no longer give guidance after teaching. Because of the busy clinical nursing work and the lack of nurses, some operations cannot be carried out according to the operating rules, which leads nursing students to think that theory is separated from clinical practice.
(2) Nursing students have poor problem-solving ability Investigation shows that nursing students' ability to analyze and solve problems is poor, which is related to their weak basic cultural knowledge and weak mastery of professional knowledge. At work, most nursing students can't apply the knowledge they have learned in school to clinical practice, and remember the rescue measures firmly, but they are at a loss when they meet critical patients. Not good at accumulating and summing up experience; I don't know how to communicate with patients with different cultural level, economy, family, status and belief background. Do not use simple and BCP Education & Psychology

EED 2021
Volume 3 (2021) 143 popular language to educate patients about relevant knowledge; Psychological coping ability is weak, and it is easy to produce nervous and fearful psychology.

Counter-measure
(1) Reasonably arrange internship tasks Most nursing students hold a positive attitude towards the internship arrangement, but 18.9% of nursing students think it is average and 2.8% think it is unreasonable. After a detailed understanding, we know that nursing students who think that the internship arrangement is average or poor think that the purpose of their internship is mainly to achieve a smooth transition from theory to practice, and the internship content is therapeutic operation, while the ward has arranged some contents unrelated to nursing technical operation, such as patient's life nursing and sending emergency specimens, etc., and thinks that this arrangement is to treat them as nurses, not as those who are taught nursing skills.
In this regard, we believe that the content of the internship should be comprehensive and involve all the affairs they must deal with after taking up their posts. Their opinions are not absolutely correct, but they also give us how to better arrange the learning content in the future, so that they can master substantive nursing skills more and faster and make overall arrangements [6].
(2) Strengthen the combination of theory and practice Nursing students learn basic nursing theories and related knowledge in school, and the ultimate goal of learning is to master a service skill on the basis of solid theory. For example, if students have no solid theoretical foundation, their mastery of skills lacks theoretical guidance, so they cannot learn by analogy [7]. However, their school study is like a castle in the air without foundation, because they only have good academic performance and neglect the training and mastery of skills. It can be said that theory and skills interact.
Therefore, we require clinical teachers to take the combination of nursing theory and nursing skills as the cutting point and combination point of study, and carry out practical small lectures, nursing teaching rounds and nursing medical records evaluation in combination with clinical practice, so that nursing students can organically combine these two aspects and make up for the defects in any one aspect.
(3) Cultivate nursing students' ability to get along with others The completion of nursing work requires collective strength, cooperation and cooperation with doctors and clinical auxiliary departments, etc. Whether they can get along well with others in the work of collective cooperation determines the success or failure of their future work. It was found that 8.7% of nursing students had poor ability to get along with others. And the process of teaching is also a process of how to make them integrate into the collective harmoniously as soon as possible, which requires teachers who teach to consciously train nursing students to respect teachers, colleagues and all those who give them help and support in their work, so that they can regard themselves as a section in a chain rather than an independent nail in the process of studying their careers.
(4) Strengthen organizational management and training of clinical nursing teachers Implement the three-level responsibility system of nursing department, head nurse and teaching teacher, and the nursing students will be specially assigned to teach. Teachers must have a college degree or a nurse's title or above. They should be selected through competitive recruitment, and should be employed once a year, with regular assessment. To strengthen the systematic training of teachers and improve the overall level of teachers, our hospital has adopted various channels, such as encouraging nurses to participate in undergraduate nursing study, actively sending nurses to study abroad, and organizing teaching rounds and exchanging experiences in the whole hospital by the nursing department. These measures have played a positive role in improving the quality of clinical teaching.

Summary
Clinical teaching and learning of nursing are a process of interaction between teachers and students. In this process, as teachers, first, correct teaching methods should be combined with the attitude of educating people; Second, both knowledge renewal and ability growth should be emphasized. Student-centered problem-solving teaching can improve students' theoretical achievements. Academic achievement is an important index reflecting students' learning effect. We try to use the flow chart to evaluate the application of factual and conceptual knowledge in the stages of analysis and evaluation, and use the students' self-rating scale and self-summary after class to analyze and evaluate metacognitive knowledge. In the future, we should strengthen the research and development of Two-way evaluation tools for clinical teaching to ensure that situational teaching method can be properly and effectively applied in the teaching process.