摘要目的:探究护理学专业本科生在实景教学与模拟教学环境中的学习效果，并进行比较。方法:通过方便抽样法，选取北京市4所高校的193名护理学专业本科生为研究对象，采用临床学习环境比较调查表(clinical learning environment comparison survey，CLECS)对其进行问卷调查。采用Wilcoxon符号秩检验比较差异。结果:学生在实景教学环境下的CLECS总分为(80.5±15.3)分，高于模拟教学环境的(76.6±14.1)分，其差异具有统计学意义( Z＝－3.03， P＝0.002)。实景教学环境在沟通、整体观、评判性思维和教与学4个维度得分高于模拟教学环境，分别为(9.1±2.0)分比(7.5±2.3)分、(11.4±3.2)分比(10.3±3.4)分、(6.2±1.5)分比(5.5±1.6)分和(15.5±3.4)分比(15.1±3.1)分，其差异均具有统计学意义(均 P<0.05)；实景教学环境在自我效能维度得分为(10.9±2.5)分，低于模拟教学环境的(11.4±2.6)分，其差异具有统计学意义( Z＝－2.64， P＝0.008)。 结论:建议护理教师建立临床教学指导原则，将实景教学与模拟教学有机结合以达到最佳教学效果。

abstractsObjective:To explore undergraduate nursing students′ learning outcomes in actual and simulated learning environment and to compare them.Methods:A convenient sample of 193 undergraduate nursing students from 4 universities in Beijing completed clinical learning environment comparison survey (CLECS). Wilcoxon signed rank test was used to compare the differences.Results:The total CLECS score in actual learning environment (80.5±15.3) was higher than that in the simulated learning environment (76.6±14.1), and the difference was statistically significant ( Z=-3.03, P=0.002). The scores of the four dimensions including communication, holistic, critical thinking, and teaching-learning dyad in actual learning environment were higher than those in the simulated learning environment, with the scores being (9.1±2.0) vs. (7.5±2.3), (11.4±3.2) vs. (10.3±3.4), (6.2±1.5) vs. (5.5±1.6), and (15.5±3.4) vs. (15.1±3.1), respectively, and the differences were all statistically significant ( P<0.05). The score of the self-efficacy dimension in the actual learning environment (10.9±2.5) was lower than that in the simulated learning environment (11.4±2.6), and the difference was statistically significant ( Z=-2.64, P=0.008). Conclusions:It is recommended that nursing faculty establish clinical teaching guidelines that combine actual clinical practice with simulated clinical practice to achieve optimal results.