Application of the Objective Structure Clinical Evaluation in Evaluating Clinical Competence for a BSN Program

Jun-Yu Fan, Li-Fen Chao, Sui-Whi Jane^*

Department of Nursing & Graduate Institute of Nursing, Chang Gung University of Science and Technology, Kweishan, Taoyuan.

DOI: 10.4236/ojn.2014.412092                

Abstract

Given the complex clinical situations and the dynamic nature of nursing, the greatest challenge for nursing educators is performing objective evaluation of students’ clinical competence. The Objective Structured Clinical Evaluation (OSCE) is designed to address this challenge and it has been widely used in nursing education. However, its implementation in nursing education in Taiwan has been limited. Accordingly, a quasi-experimental design was utilized to examine students’ clinical performance and stress levels using a 12-station OSCE assessment. Further, we investigated the inter-rater reliability and internal consistency of the OSCE. After controlling for scores of clinical performance, overall differences in pre- and post-practicum stress in the OSCE group were significantly higher than in the control group (F (1, 89) = 4.89, p = 0.03). There was no group effect on practicum performance after controlling for grade point average (F (1, 89) = 2.69, p = 0.14). Cronbach’s alpha for 12 OSCE stations ranged from 0.22 to 0.80 and inter-rater reliability for all 12 stations showed Pearson’s r ranging between 0.76 and 1.00. Cohen’s kappa ranged from 0.70 to 1.00 (p < 0.001). Future studies should explore how OSCE can be best and most cost-effectively incorporated into the BSN curriculum.

Keywords

Clinical Competence, Objective Structured Clinical Evaluation (OSCE), Bachelor of Science in Nursing (BSN), Clinical Practicum, Last-Mile Practicum

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Garside, J.R. and Nhemachena, J.Z.Z. (2013) A Concept Analysis of Competence and Its Transition in Nursing. Nurse Education Today, 33, 541-545. http://dx.doi.org/10.1016/j.nedt.2011.12.007
[2]	Tilley, D.S. (2008) Competency in Nursing: A Concept Analysis. Journal of Continuing Education in Nursing, 39, 58-64. http://dx.doi.org/10.3928/00220124-20080201-12
[3]	Bourbonnais, F.F. and Kerr, E.J. (2007) Preceptoring a Student in the Final Clinical Placement: Reflections from Nurses in a Canadian Hospital. Journal of Clinical Nursing, 16, 1543-1549. http://dx.doi.org/10.1111/j.1365-2702.2006.01828.x
[4]	Anema, M. and McCoy, J. (2010) Competency-Based Nursing Education: Guide to Achieving Outstanding Learner Outcomes. Springer, New York.
[5]	Pijl-Zieber, E.M., Barton, S., Konkin, J. Awosoga, O. and Caineet, V. (2014) Competence and Competency-Based Nursing Education: Finding Our Way through the Issues. Nurse Education Today, 34, 676-678. http://dx.doi.org/10.1016/j.nedt.2013.09.007
[6]	Byrne, E. and Smyth, S. (2008) Lecturers’ Experiences and Perspectives of Using an Objective Structured Clinical Examination. Nurse Education Practice, 8, 283-289. http://dx.doi.org/10.1016/j.nepr.2007.10.001
[7]	Houghton, C.E., Casey, D., Shaw, D. and Murphy, K. (2012) Staff and Students’ Perceptions and Experiences of Teaching and Assessment in Clinical Skills Laboratories: Interview Findings from a Multiple Case Study. Nurse Education Today, 32, e29-e34. http://dx.doi.org/10.1016/j.nedt.2011.10.005
[8]	Walsh, M., Bailey, P.H. and Koren, I. (2009) Objective Structured Clinical Evaluation of Clinical Competence and Integrative Review. Journal of Advanced Nursing, 65, 1584-1595. http://dx.doi.org/10.1111/j.1365-2648.2009.05054.x
[9]	Beddoe, A.E. and Murphy, S.O. (2004) Does Mindfulness Decrease Stress and Foster Empathy among Nursing Students? Journal of Nursing Education, 43, 305-312.
[10]	Gibbons, C., Dempster, M. and Moutray, M. (2007) Stress and Eustress in Nursing Students. Journal of Advance Nursing, 61, 282-290. http://dx.doi.org/10.1111/j.1365-2648.2007.04497.x
[11]	Del Prato, D., Bankert, E., Grust, P. and Joseph, J. (2011) Transforming Nursing Education: A Review of Stressors and Strategies That Support Students’ Professional Socialization. Advances in Medical Education and Practice, 6, 109-116. http://dx.doi.org/10.2147/AMEP.S18359
[12]	Evans, W. and Kelly, B. (2004) Pre-Registration Diploma Student Nurse Stress and Coping Measures. Nurse Education Today, 24, 473-482. http://dx.doi.org/10.1016/j.nedt.2004.05.004
[13]	Chen, Y.-W. and Hung, C.-H. (2014) Predictors of Taiwanese Baccalaureate Nursing Students’ Physio-Psycho-Social Responses during Clinical Practicum. Nurse Education Today, 34, 73-77. http://dx.doi.org/10.1016/j.nedt.2013.02.021
[14]	Duchscher, J.E.B. (2009) Transition Shock: The Initial Stage of Role Adaptation for Newly Graduated Registered Nurses. Journal of Advance Nursing, 65, 1103-1113. http://dx.doi.org/10.1111/j.1365-2648.2008.04898.x
[15]	Yonge, O., Myrick, F. and Haase, M. (2002) Student Nurse Stress in the Preceptorship Experience. Nurse Educator, 27, 84-88. http://dx.doi.org/10.1097/00006223-200203000-00012
[16]	Sharif, F. and Masoumi, S. (2005) A Qualitative Study of Nursing Student Experiences of Clinical Practice. BMC Nursing, 9, 4-6.
[17]	Hopkins, T.H. (2008) Early Identification of At-Risk Nursing Students: A Student Support Model. Journal of Nursing Education, 47, 254-259. http://dx.doi.org/10.3928/01484834-20080601-05
[18]	Harden, T.K., Klein, R.L., Smith, R.R., Thureson-Klein, A.K. and Lowry, M.W. (1975) Serum Dopamine Beta-Hydroxylase Activity Following Subarachnoid Hemorrhage in Man. Medical Biology, 53, 100-106.
[19]	Alinier, G. (2003) Nursing Students’ and Lecturers’ Perspectives of Objective Structured Clinical Examination Incorporating Simulation. Nurse Education Today, 23, 419-426. http://dx.doi.org/10.1016/S0260-6917(03)00044-3
[20]	Schuwirth, L.W. and van der Vleuten, C.P. (2003) The Use of Clinical Simulations in Assessment. Medicine Education, 37, 65-71. http://dx.doi.org/10.1046/j.1365-2923.37.s1.8.x
[21]	Watson, R., Stimpson, A., Topping, A. and Porock, D. (2002) Clinical Competence Assessment in Nursing: A Systematic Review of the Literature. Journal of Advanced Nursing, 39, 421-431. http://dx.doi.org/10.1046/j.1365-2648.2002.02307.x
[22]	Bartfay, W.J., Rombough, R., Howse, E. and Leblanc, R. (2004) Evaluation: The OSCE Approach in Nursing Education. The Canadian Nurse, 100, 18-23.
[23]	Hale, L.S., Lewis, D.K., Eckert, R.M., Wilson, C.M. and Smith, B.S. (2006) Standardized Patients and Multidisciplinary Classroom Instruction for Physical Therapist Students to Improve Interviewing Skills and Attitudes about Diabetes. Journal of Physical Therapy Education, 20, 22-27.
[24]	Nestela, D., Kneeboneb, R., Nolanb, C., Akhtarc, K. and Darzib, A. (2011) Formative Assessment of Procedural Skills: Students’ Responses to the Objective Structured Clinical Examination and the Integrated Performance Procedural Instrument. Assessment & Evaluation in Higher Education, 36, 171-183. http://dx.doi.org/10.1080/02602930903221469
[25]	Sheu, S., Lin, H.S., Hwang, S.L., Yu, P.J., Hu, W.Y. and Lou, M.F. (1997) The Development and Testing of a Perceived Stress Scale for Nursing Students in Clinical Practice. The Journal of Nursing Research, 5, 341-352.
[26]	Sheu, S., Lin, H.S. and Hwang, S.L. (2002) Perceived Stress and Physio-Psycho-Social Status of Nursing Students during Their Initial Period of Clinical Practice: The Effect of Coping Behaviors. International Journal of Nursing Studies, 39, 165-175. http://dx.doi.org/10.1016/S0020-7489(01)00016-5
[27]	Al-Zayyat, A.S. and Al-Gamal, E. (2014) Perceived Stress and Coping Strategies among Jordanian Nursing Students during Clinical Practice in Psychiatric/Mental Health Courses. International Journal of Mental Health Nursing, 23, 326-335. http://dx.doi.org/10.1111/inm.12054
[28]	Brannick, M.T., Erol-Korkmaz, H.T. and Prewett, M. (2011) A Systematic Review of the Reliability of Objective Structured Clinical Examination Scores. Medical Education, 45, 1181-1189. http://dx.doi.org/10.1111/j.1365-2923.2011.04075.x
[29]	Kline, P. (2000) The Handbook of Psychological Testing. 2nd Edition, Routledge, London.
[30]	Chan, C.K., So, W.K. and Fong, D.Y. (2009) Hong Kong Baccalaureate Nursing Students’ Stress and Their Coping Strategies in Clinical Practice. Journal of Professional Nursing, 25, 307-313. http://dx.doi.org/10.1016/j.profnurs.2009.01.018
[31]	Jimenez, C., Navia-Osorio, P.M. and Diaz, C.V. (2010) Stress and Health in Novice and Experienced Nursing Students. Journal of Advance Nursing, 66, 442-455. http://dx.doi.org/10.1111/j.1365-2648.2009.05183.x
[32]	Gorostidi, X.Z., Egilegor, X.H., Erice, M.J.A., Iturriotz, M.J.U., Garate, I.E., Lasa, M.B. and Cascante, X.S. (2007) Stress Sources in Nursing Practice. Evolution during Nursing Training. Nurse Education Today, 27, 777-787. http://dx.doi.org/10.1016/j.nedt.2006.10.017
[33]	Jain, S.S., DeLisa, J.A., Eyles, M.Y., Nadler, S., Kirshblum, S. and Smith, A. (1998) Further Experience in Development of an Objective Structured Clinical Examination for Physical Medicine and Rehabilitation Residents. American Journal of Physical Medicine & Rehabilitation, 77, 306-310. http://dx.doi.org/10.1097/00002060-199807000-00009
[34]	Roberts, J. and Brown, B. (1990) Testing the OSCE: A Reliable Measurement of Clinical Nursing Skills. The Canadian Journal of Nursing Research, 22, 51-59.