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

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.

Psychometric testing and cost of a five-station OSCE for newly graduated nurses

BACKGROUND

The Objective Structured Clinical Examination (OSCE) is widely used in nursing education, but its implementation is costly and resource intensive, potentially limiting its feasibility. A five-station OSCE was designed to replace a previously validated 12-station OSCE but was not evaluated for its psychometric properties.

PURPOSE

This study aimed to evaluate the validity, reliability, acceptability, educational impact, and cost of a five-station OSCE using Van der Vleuten's utility formula.

METHODS

This study was based on a cross-sectional, nonexperimental design involving psychometric testing, a survey, and a cost analysis.

RESULTS

The five-station OSCE showed high content and predictive validity and inter-rater reliability among examiners. The OSCE format was well accepted by participants and achieved a cost saving of 45.2% compared with the 12-station format.

CONCLUSIONS

The five-station OSCE provides an authentic and objective assessment of competence among newly graduated nurses.