The Osce Applied Research, Evaluation Of Clinical Competence Of Undergraduate Nursing Students

ObjectiveObjective Structured Clinical Examination (OSCE) has been a novel examination mode to evaluate clinical competence in the medical education and qualification examination fields. Based on the successful experience in the medical education examination fields and combining with the characteristics of the nursing specialty, a detailed OSCE scheme suitable for the nursing undergraduates of different grades and categories will be presented in this paper. Under such a well-designed examination mode, the nursing undergraduates'knowledge, skills and professional attitudes will be evaluated through actual test. By qualitative and quantitative analysis of the examination scores, examination quality and examination effect, the advantages and viabilities of the OSCE will be verified and renovation suggestions about the nursing undergraduates'teaching reforms will be provided. The achievements of the statistic analyses and application practice will lay the theoretical basis; provide objective evidence and accumulate practical experience for the clinical competence evaluation of different kinds of nursing students.Methods1. Using Delphi methods, the nursing undergraduates'clinical competence OSCE examination stations with its'weighting and grading standard are set by widely collecting experts'suggestions.2. Through 13 OSCE examination stations subjected to 3 parts of testing contents (including nursing skill operation examination, SP-based nursing care case'histories examination and written examination of professional attitude and critical thinking), the clinical competence examination is actually carried out among 405 nursing undergraduate students with different grades under different educational systems and the clinical competence are comprehensively evaluated.3. SPSS 13.0 and LISREL8.0 statistical analyses software packages are used to complete the following tasks.(1) Statistical description of the students'scores.(2) Hotelling's T2 and LSD-t test of the differences of the students under different educational systems and grades.(3) Item difficulty degree and item discrimination degree analysis.(4) OSCE's reliability and validity analysis via computations of Cronbach'sαcoefficience, content validity, construct validity and criterion-related validity coefficience.4 Questionnaire and informal discussion participated by all the students and teachers related to the OSCE are hold to collect valuable suggestions on the design, organization, quality and effectiveness of the OSCE. The successful experiences are summarized and the renovation directions are highlighted.Results1. 13 OSCE examination stations with its'detailed testing contents and weightings and the grading standard of the nursing inquiry station being liable to cause subjective diversity have been set.2. Standardized Patients (SP) acted by the clinical nursing teachers have simulated patient's behaviors comparatively truly and evaluated the students'performance accurately.3. All the nursing skill operation examination related stations have comparatively higher scores. In adverse, all the nursing care case'histories examination and professional attitude and critical thinking examination related stations have comparatively lower scores. However, the OSCE scores are generally following the standard normal distribution approximately. The variance analysis results show that the scores'difference among students under different educational systems and grades has statistical significance.4. The related indexes of the OSCE examination are as follows: Item difficulty degree is 0.71~0.89, item discrimination degree is between 0.30 ~ 0.76, the reliability is 0.757, content validity is 0.92, and criterion-related validity coefficient is 0.69. So the examination results are true and credible.5. The results of questionnaires and informal discussion show that OSCE is consistently recognized by the teachers and students and the result of it can be used to assess clinical competence of nursing undergraduate students.ConclusionsNursing undergraduate clinical competence OSCE examination has been cosmically and earlier carried out in domestic nursing education field in this paper. With the uniform standard and means, the clinical competence of nursing undergraduate students under different educational systems and grades has been evaluated. The analysis results of the scores, quality, and effectiveness of examination show that the designed OSCE scheme has appropriate distinction, good reliability and validity. The examination results are true and credible to evaluate the real clinical competence of the nursing undergraduate students and so suitably as effective tools. The summaries of the OSCE results provide some suggestions to the nursing undergraduate teaching reform.