Using Objective Structured Clinical Examination (OSCE) as Education in Advanced Practice Registered Nursing Education

Clinical supervision experience of nurses in or transitioning to advanced practice: A systematic review

AIMS

To systematically explore the clinical supervision (CS) experience for nurses transitioning to advanced practice.

DESIGN

A qualitative systematic review using Joanna Briggs Institute meta-aggregation following an a priori protocol published on PROSPERO (CRD42023426658).

DATA SOURCES

Qualitative studies obtained from Medline, CINAHL, PsycINFO, Scopus, Emcare and ERIC databases and ProQuest dissertations and theses for peer-reviewed, published and unpublished studies from inception to July 2023.

REVIEW METHODS

Two authors conducted data screening and abstraction. Quality was appraised using the Critical Appraisal Skills Programme tool and reporting followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist for systematic reviews.

RESULTS

Sixteen studies contributed to five synthesized findings: CS that is beneficial requires structure and commitment, trusting relationships are foundational for learning, lifting burdens and preventing burnout, learning through reflection, critical thinking and feedback and barriers to CS.

CONCLUSIONS

This review provides a meaningful exploration of CS to support nurses transitioning to advanced practice. Well-structured supervision offers a safe space to share work-related concerns and develop an advanced practitioner identity. Sharing experiences helps alleviate work-related burdens and reduce professional isolation and burnout.

IMPLICATIONS FOR THE PROFESSION

Peer-support networks are vital for successful transition to advanced practice.

IMPACT

This review highlighted the impact of effective supervisory relationships in forming professional identity and possible links with nursing retention.

PUBLIC CONTRIBUTION

No direct patient contributions are included as it forms part of a research degree.

Effectiveness of Objective Structured Clinical Examinations and Standardized Patient Simulations for Increasing Learner Knowledge in Family Nurse Practitioner Education: A Systematic Review of the Literature

AIM

The aim of this systematic review was to evaluate the effectiveness of using objective structured clinical examinations (OSCEs) and standardized patient (SP) simulations in family nurse practitioner (FNP) education to increase students' knowledge and skill competency.

BACKGROUND

Many programs use OSCE and SP simulation, but there is limited empirical data demonstrating their effectiveness for Kirkpatrick's level of learning.

METHOD

A systematic search of published and unpublished literature was conducted in seven databases/registries in February 2023. Quantitative, experimental studies and quasi-experimental studies with comparison and explicit FNP learner population were included.

RESULTS

Of 4,442 records, zero studies met the inclusion criteria. Some studies with eligible designs investigated different populations (e.g., acute care nurse practitioner, prelicensure students).

CONCLUSION

The absence of included studies in this systematic review upholds the established need for continued investigation and can be used to support funding opportunities addressing this critical gap in nursing education science.

Development of an Interactive 3D Visualization Tutorial for Pathophysiology in Graduate Nursing Education

BACKGROUND

A recent revision to the Nurse Practitioner Role Core Competencies will lead to robust changes in graduate education. Incorporating innovative technology into the core courses of advanced practice nursing will prepare practice-ready providers with a high level of competence leading to successful health outcomes, improved patient satisfaction, and decreased health care costs.

PROBLEM

Graduate education lacks effective, innovative, and interactive visualization tools to study pathophysiology. There is a lack of evidence for the use of 3-dimensional (3D) augmented reality (AR) and virtual reality in advanced practice core courses.

APPROACH

A collaborative iterative approach was used to design, develop, analyze, update, and reiterate a 3D AR tutorial for advanced pathophysiology.

OUTCOMES

Students had a positive experience and perceive 3D AR as a learning tool that can increase examination scores. The visualization connected the pathophysiologic process of a disease to the pathogenesis, clinical manifestations, and associated treatments.

CONCLUSIONS

3D AR tutorials are an effective solution to facilitate learning difficult concepts in pathophysiology by incorporating following multiple learning techniques: visual, aural, verbal, kinesthetic, and logical.

Training perinatal nurses in palliative communication by using scenario-based simulation: A quasi-experimental study

AIM

This study aimed to assess the impact of two educational modules on enhancing the communication confidence, competence and performance of perinatal nurses in the context of palliative care.

BACKGROUND

Concerns have arisen regarding the preparedness of perinatal nurses in delivering palliative care, especially in terms of deficiencies in communication skills and negative attitudes toward making life-support decisions for parents facing neonates with terminal conditions. Bridging this gap necessitates improved perinatal palliative care education for healthcare providers. Research has shown that simulation-based teaching effectively enhances procedural competence, communication skills and confidence among healthcare professionals. However, comprehensive curricula focusing on perinatal palliative communication remain limited.

DESIGN

This study used a quasi-experimental design employing a two-group repeated measure approach. It involved a purposive sample of 79 perinatal nurses from a hospital in northern Taiwan.

METHODS

A palliative communication course specifically designed for registered nurses in perinatal units was developed. Participants were allocated to either the experimental group (Scenario-Based Simulation, SBS) or the control group (traditional didactic lecture). Communication confidence and competence were assessed before and immediately after the course through structured questionnaires. Learning satisfaction was collected post-intervention and participants underwent performance evaluation by standardized parents one week later.

RESULTS

A significant training gap in palliative care exists among nurses in OB/GYN wards, delivery rooms and neonatal critical care units, highlighting the need for continuing education. All 79 participants completed the training course. Following the intervention, nurses in the SBS group (n=39) exhibited significant improvements in self-reported confidence (p <0.05), competence (p <0.01) and performance (p <0.001) in neonatal palliative communication compared with the traditional didactic lecture group (n=40). The SBS group also received higher satisfaction ratings from nurse learners (p <0.001).

CONCLUSIONS

The research findings support scenario-based simulation as a more effective educational approach compared with traditional didactic lectures for enhancing communication confidence and competence. These results were further reinforced by evaluation from standardized patients, highlighting the value of direct feedback in enhancing nurses' performance. Tailoring SBS designs to diverse nursing contexts and incorporating a flipped approach can further enrich the overall learning experience. Given its high effectiveness and positive reception, we recommend integrating this educational module into palliative care training programs for perinatal nurses.

Adolescent Simulation in a Health Assessment Course for Advanced Practice Nursing Students

ABSTRACT

Advanced practice registered nurse (APRN) students face challenges transitioning to practice. They benefit greatly from simulated learning experiences that build confidence and increase competence in the skills needed to perform in an APRN role. The purpose of this quality improvement project was to evaluate the effectiveness of a simulated adolescent well visit in an advanced health assessment course. Using a pretest/posttest design, qualitative and quantitative data were collected from participants. Results included high learner satisfaction, an increase in both self-reported competence and confidence, and an appreciation for the "safe space" of learning.

An analysis of the effectiveness of reflective learning through watching videos recorded with smart glasses-With multiple views (student, patient, and overall) in radiography education

The Objective Structured Clinical Examination (OSCE) is designed to assess medical students' skills and attitude competencies before clinical practice. However, no method of reflective learning using video-based content has been used in OSCE education. This study aimed to confirm whether using smart glasses-based educational content is effective for OSCE reflective learning using multiple views (patient, student, and overall). This educational intervention study included a control group exposed to the traditional learning method and an intervention group exposed to a learning method incorporating smart glasses. Participants were 117 (72 in the control group and 45 in the intervention group) third-year radiological technology students scheduled to take the OSCE and 70 (37 in the control group and 33 in the intervention group) who met the eligibility criteria. Mock OSCEs were administered before and after the educational intervention (traditional and smart glasses-based education) to investigate changes in scores. After the educational intervention, a self-reported comprehension survey and a questionnaire were administered on the effectiveness of the video-based content from different views for student reflective learning. Unexpectedly, the OSCE evaluation score after the preliminary investigation significantly increased for the smart glasses control group (0.36±0.1) compared to the intervention group (0.06±0.1) setting up the radiographic conditions (x-ray center and detector center; p = 0.042). The intervention group's lower score in the mock OSCEs may have been due to the discomfort of wearing the smart glasses to perform the radiography procedure and their unfamiliarity with the smart glasses, which may have affected their concentration. The findings suggest that smart glasses-based education for OSCEs can be improved (e.g., being easy to handle and use and trouble-free).

Dental hygiene educators' knowledge and implementation of objective structured clinical examination in United States dental hygiene programs

PURPOSE

In 2021, the American Dental Association (ADA) announced the intention to develop a standardized dental hygiene licensure objective structured clinical examination (DHLOSCE). The purpose of this study was to measure the United States (US) dental hygiene (DH) educators' foundational knowledge of OSCE development and delivery in light of the impending development of the DHLOSCE by the ADA's Testing Services.

METHODS

The study was determined to be exempt from Institutional Review Board oversight. A 21-question survey was developed, pilot tested, and electronically disseminated through Qualtrics. The survey recruitment was emailed to the directors of all entry-level DH education programs in the US (n = 328), asking them to participate in the survey and to forward it to the clinical faculty in their institutions. Descriptive and inferential statistics were utilized to analyze the data.

RESULTS

There were 143 study participants, for a completion rate of 45%. Over two-thirds of respondents (64%) were unaware of the plans to develop the DHLOSCE, while 13% reported utilizing OSCEs to meet accreditation standards. Only 3% reported receiving a formal education in OSCE development compared to 29% who learned through a colleague or peer. Nearly half reported a lack of faculty experience as a barrier to OSCE implementation. Over three-quarters, 76% reported a lack of OCSE development committees within their program and only 14% had experience developing an OSCE station.

CONCLUSION

The study results suggest an urgent need for the development of OSCE training resources specific to DH education, as programs across the US prepare for the impending DHLOSCE.

The Episodic Tool: An innovative approach to teach clinical decision making in advanced health assessment

Advanced health assessment (AHA) serves as the foundational course in advanced practice nurse education in which students apply clinical decision-making skills to gather appropriate subjective and objective data and to begin to formulate diagnostic hypotheses. Summative objective structured clinical exams (OSCEs) have been used in AHA courses to evaluate students' clinical competence. After implementing summative OSCEs in AHA, we found that students struggled with evaluations requiring critical thinking skills and subsequently designed a teaching tool to address this gap. An Episodic Tool was created for the six main body systems with a chief complaint and three age and gender combinations. In small groups, students used the tool to identify pertinent history and physical exam components for a specific age and gender. A faculty-facilitated group discussion followed. A pre/post design was used in this quality improvement project to compare OSCE and oral clinical exam (OCE) scores. OCEs were used in 2020 due to COVID-19 limitations. There was a statistically significant increase of 7 % in the mean OCE/OSCE scores after implementation of the tool (p < .001). Qualitative feedback from students and faculty suggested the tool effectively enhanced students' critical thinking and clinical decision-making skills and promoted consistency across course sections.

Reported outcomes and characteristics of objective structured clinical examinations in advanced practice nursing education: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to identify the outcomes reported from objective structured clinical examinations in advanced practice registered nurse education and to describe their characteristics.

INTRODUCTION

Graduate medical education has used objective structured clinical examinations to assess student health professionals since 1975. Nursing programs have adopted objective structured clinical examinations to assess evidence-based practice and clinical competency of advance practice nursing students, but little is known about the outcomes that are being reported.

INCLUSION CRITERIA

This review will consider evidence on the outcomes and other characteristics of objective structured clinical examinations for students enrolled in graduate-level advanced practice nurse education programs (ie, nurse practitioners, clinical nurse specialists, nurse midwives, and nurse anesthetists). All types of evidence will be considered, including quantitative and qualitative studies, systematic reviews, as well as text and opinion papers.

METHODS

This review will be conducted in accordance with the JBI methodology for scoping reviews. A literature search will be conducted in PubMed, CINAHL, MEDLINE, Nursing and Allied Health, Scopus, and Google Scholar. Sources that are published in English or that could be translated into English will be considered for inclusion. No date limit will be applied. Study selection and data extraction will be conducted by three independent reviewers. Any disagreements will be resolved through discussion. The scoping review findings will be presented in a narrative style and reported using diagrams and extraction tables.

Overcoming COVID-19 Challenges: Using Remote and Hybrid Simulation Designs in DNP Programs

Simulation is a critical component of nursing and medical education used to teach skills and assess student performance. In March 2020, faculty members-including the authors-at the Grace Center for Innovation in Nursing Education at the Edson College of Nursing and Health Innovation (Edson College) simulation programs at Arizona State University quickly responded to the crisis presented by COVID-19. Within a few days, all nursing simulations were transitioned from a predominately in-person design to fully online. Maintaining simulation activities throughout the first several months of the pandemic allowed students at Edson College to meet clinical assessment objectives. This transition, implemented in 2 phases, included a detailed plan of action for all Doctor of Nursing Practice (DNP) nurse practitioner objective structured clinical exams (OSCEs). The challenges required innovative planning and flexibility while maintaining the integrity of the OSCE and simulation experience. The methods implemented out of necessity are now an important part of the authors' curricular toolbox, providing options for continued and future educational practice. This paper details the simulations designed and implemented in 2 DNP programs: the family nurse practitioner and acute care pediatric nurse practitioner programs.

Observed structured clinical examination as a means of assessing clinical skills competencies of ANPs

Observed structured clinical examinations (OSCEs) are a common method of assessment within higher education to prepare for the advanced nurse practitioner (ANP) role. This article reviews a wide range of literature relating to OSCE assessment in the healthcare arena, from an ANP, interprofessional and advanced clinical practice perspective. Theories underpinning OSCE and advanced nursing roles are explored, with relevant supporting literature indicating how established OSCEs can become integrated with other methods to improve outcomes for this level of practice. Alternative assessments are explored with specific reference to the context of the education delivered, and the suitability for higher education today.

Quality management of objective structured clinical examinations: An integrative literature review

BACKGROUND

Objective Structured Clinical Examinations are widely adopted as a clinical assessment method in nurse education. Quality is an integral aspect of the design and implementation of OSCEs, facilitating their credibility and rigour. However, there is a dearth of literature regarding the management of the quality of Objective Structured Clinical Examinations.

OBJECTIVE

To summarise existing literature regarding best practices on the management of the quality of Objective Structured Clinical Examinations in health science education.

DESIGN

An integrative literature review.

DATA SOURCES

EBSCOhost, including CINAHL, eBook Collection, E-journals, ERIC, Health Source-Consumer Edition, Health Source-Nursing/Academic Edition, Humanities International Complete and MEDLINE, together with Cochrane Online, PubMed, Taylor & Francis Online and ScienceDirect, were searched, followed by hand searching of references as well as a manual search for grey literature, using Google.

REVIEW METHODS

Using predetermined inclusion and exclusion criteria, research documents (experimental, non-experimental, descriptive and qualitative studies), non-research documents (editorials, opinion letters), including grey literature, published between January 2010 and March 2021.

RESULTS

A total of thirteen (n = 13) studies were included in the review. A total of 22 quality measures were identified, which should be applied in the preparation and planning, implementation and evaluation phases of Objective Structured Clinical Examinations. The preparation and planning phase is crucial for the quality of Objective Structured Clinical Examinations, as more than half (n = 12) of the 22 quality measures were identified in this phase.

CONCLUSIONS

There is limited available recorded evidence that defines and describes the management of the quality of Objective Structured Clinical Examinations. Future research should focus on the context-specific use of psychometric analysis to ensure generation of valid, objective and consistent assessment during Objective Structured Clinical Examinations. More rigorous large-scale studies (such as quantitative or randomised controlled trials) regarding management of variances amongst examiner scores, impact of moderation on Objective Structured Clinical Examinations, and virtual Objective Structured Clinical Examinations should be conducted.

Sexual Assault Forensic Examiner Recruitment and Retention: Using Simulation to Teach a Trauma-Informed Interview

Traditionally, sexual assault nurse examiner training focuses on examination skills and evidence collection. Gathering history and supporting the patient in a trauma-informed approach are equally important components of postassault care. Simulation is an established tool in healthcare education; however, there is limited research on applying simulation to the training of sexual assault nurse examiners. The Sexual Assault Forensic Examiner Recruitment and Retention program developed and delivered standardized patient-simulated scenarios to teach elements of trauma-informed sexual assault interviews. Simulation allowed trainees the opportunity to practice interviews and receive direct feedback from the standardized patient actor and experienced examiners. Evaluation results showed that learners valued this opportunity, endorsing that it improved their ability to conduct a forensic interview. This innovative program introduced a framework for training new examiners on trauma-informed interview techniques, using standardized patients.

The predictors of nursing students' clinical competency in pre-internship objective structured clinical examination: The roles of exam anxiety and academic success

BACKGROUND

Identifying the predictors of nursing students' clinical competency in objective structured clinical examination (OSCE) is of utmost importance. Therefore, the present study was to investigate the predictive roles of exam anxiety and academic success in nursing students' clinical competency in the pre-internship OSCE.

METHODS

In this descriptive-analytical study, a total number of 102 nursing students, meeting the inclusion criteria and enrolled in the sixth semester (third year) of the graduate nursing program in Iran, were firstly selected by the census method. The pre-internship OSCE was then implemented at eight stations based on a pre-designed schedule template. The required data were also collected through a demographic-academic characteristics questionnaire and the State-Trait Anxiety Inventory to determine the exam anxiety score, the nursing program grade point average (GPA) to reflect on the levels of academic success, and the OSCE score to control clinical competency. The data analysis was also performed at the significance level of 0.05.

RESULTS

The linear regression model, in which the exam anxiety, the nursing program GPA, and the demographic-academic characteristics variables had been imported, could explain 33.52% of the variance of the nursing students' clinical competency in the pre-internship OSCE (R² = 0.616). Of the variables concerned, only the nursing program GPA could be a significant predictor of the nursing students' clinical competency scores in the OSCE, so that 0.8 points were added to the clinical competency scores in the OSCE as the nursing program GPA increased by one unit (p = 0.000, β = 0.717), but no significant relationship was observed between exam anxiety and clinical competency in the pre-internship OSCE among the nursing students.

CONCLUSIONS

The results of this study endorsed the use of the OSCE in assessing the nursing students' clinical competency and implementing learning strategies to strengthen the levels of academic success in such individuals.

Using Objective Structured Clinical Examination as a Teaching Tool in a Hybrid Advanced Health Assessment Course

BACKGROUND

Advanced health assessment is a required course in advanced practice RN (APRN) education, essential to providing the foundation for differential diagnosis (DD) skills and the ability to formulate a plan of care.

PROBLEM

Feedback from clinical preceptors revealed that our doctor of nursing practice (DNP) students struggled to make a DD.

APPROACH

This educational quality improvement project collected data from 7 cohorts of DNP students in either the Family Nurse Practitioner or Adult Gerontology Nurse Practitioner program to evaluate their readiness for clinical practicums and to inform necessary curriculum revisions.

OUTCOMES

Data revealed that students' ability to identify 3 DDs correctly during the summative health assessment objective structured clinical examination was inconsistent. Qualitative data revealed students lacked understanding on how to use results from the physical assessment to formulate a DD.

CONCLUSION

The findings of this project corroborate those from the literature that suggest we should teach APRN students DD skills explicitly.

Effects of an Adaptive Education Program on the Learning, Mental Health and Work Intentions of New Graduate Nurses

Health care workers are at a higher risk of psychological distress than ordinary people. Stress affects physical and mental health, and can even produce an intention to leave. The current training for new graduate nurses (NGNs) during this transitional period mostly focuses on the cultivation of professional ability, with less attention to mental health or emotional feelings, and thus there are insufficient structured support strategies. As such, this study explores the effects of intervention through an appropriate education program on the learning, mental health and work intentions of new recruits during the transition period. A pre-test and post-test for a single group was designed for new nursing staff in a large teaching hospital in northern Taiwan. The test period was from May 2017 to December 2018, and a total of 293 cases were accepted. A three-month adaptive education program was provided and evaluated in terms of: care for learning, care for health, improving professional ability, and individualized guidance on satisfaction, mental health disturbance and work intention. The new graduate nurses who received gentle care and counseling showed a downward trend in their BSRS-5 scores and statistical differences over time (p < 0.001). The higher the BSRS-5 score, the easier it is for new graduate nurses in acute and intensive care units. There is a tendency for turnover leave (p = 0.03). After the intervention of the overall plan, the turnover rate of new graduate nurses within three months was 12.6%, and the one-year retention rate was 87.9%. The adaptive education program uses multiple support strategies to improve learning and professional abilities, to reduce psychological emotions, and thereby to increase retention. Today will face new medical challenges; the education programs will become more important across clinical care settings, and it will be important to rigorously validate their performance in helping NGNs.

Nursing students' perceptions on the use of clinical simulation in psychiatric and mental health nursing by means of objective structured clinical examination (OSCE)

BACKGROUND

In view of the rising incidence and prevalence of mental disorders, and the stigma often attached to persons with these pathologies, the question of specific, appropriate training for nursing students is one of great importance. Objective structured clinical examination (OSCE) and clinical simulation may provide a useful means of introducing the student to this environment.

OBJECTIVES

To examine the perceptions and satisfaction of nursing students after their participation in a targeted mental health course in which the main specialist skills were acquired via clinical simulation.

DESIGN

A quantitative, descriptive, transversal study was conducted, in which the participants in a mental health course completed a questionnaire on their satisfaction with the experience.

PARTICIPANTS

The study population consisted of 141 nursing students enrolled in a mental health course and currently in the third year of their Nursing Degree studies at the University of Málaga (Spain).

RESULTS

The overall satisfaction expressed was more than 8 out of 10 (mean score = 8.43, SD = 1.25) and the students' satisfaction with specific aspects of the procedure exceeded 4 out of 5. The study results show that these nursing students considered the methodology in question to be useful preparation for clinical practice (mean score = 4.78, SD = 0.45), that they appreciated the participation of an expert (mean score = 4.72, SD = 0.60) and that receiving the opinions of their peers about their performance was an enriching part of the experience (mean score = 4.54, SD = 0.64).

CONCLUSIONS

The participants reported a high degree of satisfaction with the OSCE procedure and observed that this method should be implemented more frequently. Debriefing is viewed as a vital contribution to the learning process and to the participants' satisfaction. However, further research is needed to study the impact of stress and anxiety on the acquisition of skills via OSCEs.

Objective Structured Clinical Examinations as a Method of Competency Evaluation in a Primary Care Nurse Practitioner Program

BACKGROUND

Objective structured clinical examinations (OSCEs) are an effective method of instruction and evaluation. Their use in nurse practitioner (NP) programs as a means of evaluation warrants further exploration.

PURPOSE

The purpose of this project was to test the applicability and feasibility of implementation of OSCEs as a means of formative evaluation in a primary care NP program and to determine student feedback about the experience.

METHODS

This project evaluated the implementation of an educational intervention using 2 previously developed and tested OSCE scenarios with standardized patients.

RESULTS

Mean scores were computed for the subcategories, as well as for global rating scores on the OSCE. Strong correlations were found across categories within the scenario; no correlations were found between scenarios. Moderate intraclass correlation coefficients were achieved. Student feedback about the experience, including perceived competence and confidence, was overwhelmingly positive.

CONCLUSIONS

This project demonstrates success of a pilot OSCE program.

The emerging literature for the triad of health informatics, healthcare quality and safety, and healthcare simulation

The areas of health informatics, healthcare quality and safety, and healthcare simulation are often thought of as separate domains. The purpose of this position paper is to report on the interdependence that is emerging as an important triad across the healthcare/health system continuum. A qualitative review of 24 studies suggests the interdependence of health informatics, healthcare quality and safety, and healthcare simulation reaches much broader than traditional utilisation of simulation. We suggest ways that organisations can take advantage of the interdependence of this triad across a broader variety of healthcare environments, including teamwork, communication, and complex system relationships. In conclusion, the reviewed 24 studies suggest that the research in the triad focuses on simulation education and computerised simulation, and when coupled with health informatics, bears greater strength on quality improvement or patient safety.

Realistic health care simulation scenario: what is relevant for its design?

We sought to describe the stages of scenario development with emphasis on the most relevant aspects according to the literature and guidelines of The International Nursing Association for Clinical Simulation and Learning and Best Evidence Medical Education, which are discussed and exemplified on the basis of our professional experience. The following stages were described and commented on for scenario design: planning, objectives, simulation structure and format, case description and perception of realism, pre-debriefing, debriefing, evaluation, materials and resources, and pilot test. A scenario design based on good practices involves important elements, and each stage is closely interrelated and interdependent in its creation process.

Experiences of using an OSCE protocol in clinical examinations of nursing students - A comparison of student and faculty assessments

Peer-assessment in nursing education using an OSCE protocol is an increasing educational activity that complements that of teachers. However, little is known about how students' and teachers' assessments correspond. The study aimed to compare OSCE assessments made by student examiners and faculty examiners during examinations of clinical skills in undergraduate nursing education. Four cohorts of third-year nursing students participated between 2014 and 2016. The students underwent a clinical examination of the management of central venous catheters and totally implantable venous access devices. Students who performed the examinations were observed both by a faculty examiner and student examiner. Both observers used the same OSCE protocol for the assessment but independently. The OSCE protocols from both faculty and student examiners were reviewed and compared. Total agreement between the student and faculty examiner was reached in 127 of 135 (94%) paired protocols. The level of agreement was substantial with a kappa value of 0.79 (95% CI 0.65-0.93). The conclusion was that the level of agreement between student and faculty examiners was high when using an OSCE protocol in clinical examinations of two different clinical skill tasks. The structured checklist (OSCE protocol) was easy to use for the student examiners despite the lack of experience or training in advance.

Experiences of nursing students and examiners with the Objective Structured Clinical Examination method in physical assessment education: A mixed methods study

This study explores the experiences of undergraduate nursing students and examiners with the Objective Structured Clinical Examination (OSCE) as an evaluation of physical assessment skills. A mixed methods approach captures participants' perceptions and experiences with the OSCE. The sample consisted of 55 students enrolled in the physical assessment course and eight external examiners. Data were collected using a standardized questionnaire and focus group interviews, using semi-structured questions, recorded and transcribed for thematic analysis. Quantitative data were analyzed using SPSS software. Results indicated that participants regarded the OSCE as a valuable assessment tool that enhances in-depth learning and preparation of students for clinical practice. Participants also perceived the exam to be a stressful experience, citing the need for more time on examination stations. Recommendations for improving the OSCE process included extending preparation prior to the exam, training of simulated patients, adopting a blended learning model, and upgrading the setting of the exam. This paper supports evidence of the value of the OSCE as an appraisal of physical assessment skills in undergraduate nursing education.

Simulação clínica e treinamento para as Práticas Avançadas de Enfermagem: revisão integrativa

Resumo Objetivo Analisar a contribuição do uso da simulação clínica como estratégia para o ensino e treinamento das práticas avançadas de enfermagem. Métodos Foi realizada uma Revisão Integrativa e feito as buscas nas bases de dados Embase, LILACS, PubMed, CINAHL e Scopus, com os descritores e palavras-chaves Advanced practice nursing AND simulation. Resultados Foram identificados 68 artigos; após serem excluídos os duplicados e os que não respondiam à questão norteadora, foram analisados 11 artigos. Os dados evidenciaram que a simulação permitiu um exame aprofundado para avaliar o desempenho dos alunos nas práticas avançadas em relação a abordagem do paciente e liderança; este método auxiliou o aluno a assumir responsabilidade nas tomadas de decisões, a conduzir os cuidados com o paciente, a direcionar a equipe, interagir com a família, além de demonstrar liderança, priorização, delegação, colaboração e profissionalismo. Conclusão Os trabalhos analisados evidenciaram que a simulação clínica contribuiu para o ensino das práticas avançadas de enfermagem aumentando a consciência clínica e o desenvolvimento de competências para manejo clínico avançado, habilidades de liderança e de trabalho em equipe; a maioria dos trabalhos foram realizados com pós-graduandos.

Mitigating the Challenges of Objective Structured Clinical Examination (OSCE) in Nursing Education: A Phenomenological Research Study

BACKGROUND

Objective evaluation of clinical competencies is a key component of undergraduate nursing education programs. Objective Structured Clinical Examination (OSCE), widely used in nursing education internationally has limited utilization in undergraduate nursing programs in the United States. The efficacy of OSCE as a valuable method of objective evaluation of students' clinical competencies is not so much the problem for the nursing faculty; overcoming the impediments of its implementation is a much greater challenge.

OBJECTIVE

To explore the strategies for mitigating the challenges of OSCE in baccalaureate nursing education program.

DESIGN/PARTICIPANTS/SETTING

In this descriptive phenomenological research study, 10 undergraduate nursing faculty participated in semi-structured interviews at a public university in the North-Eastern region of United States.

METHOD

Observations and semi-structured interviews were conducted. All interviews were recorded and transcribed. Colaizzi seven steps analysis framework was used to identify major themes in the collected data. The clear, detailed, and sequential procedural processes in both data collection and analysis ensured rigorous and trustworthy results.

RESULTS

Five mitigating OSCE strategies utilized by the faculty included: administrative and technical supports, use of clinical instructors during evaluation, faculty OSCE education, limitation of validation to the required skills essential for professional practice, and collaboration among all course faculty members.

CONCLUSION

Utilization of OSCE as an objective evaluation method is feasible in United States undergraduate nursing education programs if creative strategies are determined to mitigate its challenges.