The Application Of Objective Constructed Clinical Examination In The Assessment Of Internal Medical Nursing Teaching

Objective To demonstrate how to design and implement a suitable objective structured clinical examination (OSCE) mode in the assessment of medical nursing teaching. To probe into the feasibility and effects of applying OSCE in the assessment of internal medical nursing teaching. To offer clues to the innovation of the assessment and methods of nursing teaching.Methods The OSCE examination stations are set by the discussion of five professional nursing teachers. A class composed of 28 4-year undergraduate nursing students which enrolled to a Medical College in 2007 is selected by random to carry out the OSCE examination. SPSS 13.0 statistical analyses software packages are used to analyze the data collected from the examination. The details of the analysis include statistical description of the students'scores, item difficulty degree and item discrimination degree analysis, OSCE's reliability and validity analysis via computations of Cronbach's a coefficient, content validity and criterion-related validity coefficient. Probe into the feasibility of OSCE according to the analysis of time, staff, expenditure and place for the test. Questionnaires about the attitude to the OSCE examination have been delivered and completed among the nursing students and SPs to collect valuable suggestions on the design, organization, quality a, effectiveness of the OSCE and the training of SPs.Results 10 examination stations are designed,7 of which are SP stations, and the others are non-SP stations. The marking criterion is set in details. The total cost of the OSCE examination is RMB 1,900. An average time of 12.3±0.6 hours for SPs to spend to be trained qualified in acting as patients and markers. An average time of 6.3±0.4 for teachers to spend to train those SPs. It takes 7 hours for all students to finish the whole OSCE examination. The average total scores of OSCE are 67.82±7.25, following the standard normal distribution approximately. Examinees get comparatively higher scores in test content of knowledge and understanding, lower scores in test content of synthesis and evaluation. The overall difficulty coefficient is 0.68. Item difficulty degree is 0.41-0.87, item discrimination degree is between 0.17-0.76, reliability analysis of Cronbach coefficient a is 0.752, criterion-related validity coefficient is 0.70(P<0.01), scorer reliability is 0.81-0.96(P<0.01). So the examination results are true and credible. The results of questionnaires show that most examinees and SPs think OSCE is better than traditional examination and can be an effective tool to assess comprehensive quality of nursing skills.Conclusions The analysis results of the scores, quality, expenditures of examination show that the OSCE has appropriate distinction, good reliability and validity, the results are true and credible to evaluate the real composite performance of the nursing undergraduate students in studying of medical nursing. OSCE is feasible to be used as a formative assessment in medical nursing and the summaries of the OSCE results provide some suggestions for the innovation of teaching methods. OSCE can be applied in more fields of clinical nursing courses.