The usefulness and acceptance of the OSCE in nursing schools

This qualitative study explores the usefulness and acceptance attributed by students and faculty members to an Objective Structured Clinical Evaluation (OSCE) administered to nursing undergraduates in Catalonia (Spain) for 10 years. Seventy undergraduate nursing students and twelve faculty members participated in the study. The data collection techniques included an open-ended questionnaire, a student focus group, and individualized faculty interviews. The students experienced the OSCE positively as a learning event that offered an opportunity for feedback that could help them master the required competencies. The OSCE increased students' responsibility by presenting them with a set of challenges that they had to tackle individually. Moreover, it reaffirmed their confidence in situations that closely resembled professional practice. Faculty members valued the ability of the OSCE to integrate and assess competencies, its objectivity, and the indirect information it provided on the effectiveness of the curriculum. The educational impact attributed to the OSCE and its acceptance among faculty and students suggest that it would be useful to re-implement it in the Bachelor's of Nursing in Catalan universities. Our findings may be of use to other nursing programs considering how to assess competency-based education, especially in the context of the European Higher Education Area.     

The Ottawa model for nursing curriculum renewal: An integrative review

BackgroundHigh-quality and relevant nursing education is needed to ensure graduates meet entry to practice competencies. Despite the important role of curricula in the development of nurses and the nursing profession, there does not appear to be a consistent or widely accepted approach to nursing curriculum renewal.ObjectiveTo identify and synthesize existing curriculum renewal/redesign practices, create an aggregated logic model depicting an evidence-informed process for nursing curriculum renewal, and stimulate dialogue about how to keep nursing curricula relevant in an ever-changing healthcare context.DesignAn integrative review, modeled on the Joanna Briggs Methodology of Systematic Reviews, of the available published articles, including empirical research and discussion articles.Data sourcesWe searched for quantitative, qualitative, and non-research literature (English and French) on full nursing programs or curriculum revisions for pre-licensure nursing students enrolled in an undergraduate or associate degree program. Databases included CINAHL, Nursing and Allied Health, and Medline from January 2010 to January 2017. We then did a hand search for articles from January 2017 to April 2019.SynthesisExtracted data were synthesized into an aggregated logic model based on Yin's method of cross-case analysis. Data included information about the internal context, the external context, drivers, the preparatory phase, the active phase, outcomes, and evaluation methods of the described curriculum renewal process.ResultsTwenty articles were included, which were published between 2010 and 2018. The resulting logic model, The Ottawa Model for Nursing Curriculum Renewal, includes information on the context, process and outcomes of the renewal process, and how and when to evaluate curricula.ConclusionThis synthesis aids in defining the process of curriculum renewal for undergraduate nursing education. It stimulates systems level thinking and reveals gaps, such as the need for further research into curriculum evaluation. The Ottawa Model for Nursing Curriculum Renewal is a usable template to aid educators undertaking their own process of curriculum renewal.     

Survey of Australian Schools of Nursing Use of Human Patient (Mannequin) Simulation

Rapid adoption of high-fidelity human patient (mannequin) simulation has occurred in Australian Schools of Nursing in recent years, as it has internationally. This paper reports findings from a 2012 online survey of Australian Schools of Nursing and builds on findings of earlier studies. The survey design allowed direct comparison with a previous study from the USA but limited its scope to the pre-registration (pre-service Bachelor of Nursing) curriculum. It also included extra mental health specific questions. Australian patterns of adoption and application of high-fidelity human patient (mannequin) simulation in the pre-registration nursing curriculum share features with experiences reported in previous US and Australian surveys. A finding of interest in this survey was a small number of Schools of Nursing that reported no current use of high-fidelity human patient (mannequin) simulation and no plans to adopt it, in spite of a governmental capital funding support programme. In-line with prior surveys, mental health applications were meagre. There is an absence of clearly articulated learning theory underpinnings in the use of high-fidelity human patient (mannequin) simulation generally. It appears the first stage of implementation of high-fidelity human patient (mannequin) simulation into the pre-registration nursing curriculum has occurred and the adoption of this pedagogy is entering a new phase.     

Impact of ELNEC-undergraduate curriculum on associate degree nursing student primary palliative care knowledge

BackgroundPrimary palliative care (PPC) education is deficient in nursing curricula. The Endof-Life Nursing Education Consortium (ELNEC) curricula are frequently utilized PPC educational interventions; however, there is limited evidence exploring the impact of the new undergraduate curriculum on student knowledge.PurposeThe purpose of the study was to determine the impact of ELNEC-Undergraduate curriculum on associate degree nursing students’ knowledge of PPC.MethodsThe quasi-experimental study implemented a pretest/posttest design with a single cohort of associate degree nursing students enrolled in their final semester. Knowledge was assessed using the Undergraduate Nursing Palliative Care Knowledge Survey. Paired sample ttests analyzed change in knowledge. Hierarchical linear regressions analyzed the effect of student demographics on knowledge.ResultsKnowledge significantly increased after the implementation of the ELNECUndergraduate curriculum. No significant effects of demographic variables were identified.ConclusionThe ELNEC-Undergraduate curriculum is effective in improving associate degree nursing students’ knowledge of PPC.     

The Views of Heads of Schools of Nursing about Mental Health Nursing Content in Undergraduate Programs

Criticisms about the mental health nursing content of Bachelor of Nursing programs have been common since the introduction of comprehensive nursing education in Australia. Most criticism has come from the mental health nursing sector and the views of key stakeholders have not been systematically reported. Heads of Schools of Nursing have considerable influence over the content of nursing programs, and their perspectives must be part of ongoing discussions about the educational preparation of nurses. This article reports the findings of a qualitative exploratory study, involving in-depth interviews with Heads of Schools of Nursing from Queensland, Australia. Thematic data analysis revealed two main themes: Realising the Goal? and Influencing Factors. Overall, participants did not believe current programs were preparing graduates for beginning level practice in mental health settings. In particular, participants believed that the quality of mental health content was influenced by the overcrowded curriculum, the availability of quality clinical placements, the strength of the mental health team, and the degree of consumer focus. The findings suggest the current model of nursing education in Australia does not provide an adequate foundation for mental health nursing practice and alternative approaches should be pursued as a matter of urgency.     

The development of a six-station OSCE for evaluating the clinical competency of the student nurses before graduation: A validity and reliability analysis

BackgroundAssessing clinical competency in undergraduate nursing students is essential before they enter clinical practice. The objective structured clinical examination (OSCE) is widely used and is part of clinical competency assessment.AimThe aim of this study was to develop and validate a six-station OSCE for evaluating the clinical competency of the student nurses before graduation.MethodsOne-group longitudinal observational study. An OSCE of 6 stations of 10 min each was adopted. Blueprint setting, checklist development, and standard patient and examiner training were conducted. The mean, standard deviation, item scale (item-total correlation) and comparisons of extreme groups for item analysis. The inter-coder of examiners and inter-case of students were used to test reliability. Content Validity and concurrent validity were used to evaluate validity of OSCE.ResultsOne hundred nursing students participated in this study. The mean OSCE score of students who passed the registered nurses' examination was significantly higher than that of students who failed. Significant differences in OSCE score between students who remain versus left clinical job were observed at 3, 6 and 9 months after graduation.ConclusionThe OSCE is predictable method for assessing undergraduate students' first year clinical retention.     

Evaluation of an undergraduate nursing entrustable professional activities framework: An exploratory qualitative research

BackgroundEntrustable professional activities (EPA) are mainly used in graduate medical education and professional development and have not been widely implemented in nursing undergraduate settings. Nursing EPAs were therefore developed by the Alice Lee Centre of Nursing to translate theoretical nursing competencies into clinical practice and as forms of standardized clinical assessment tools. Feedback from various stakeholders is required to further refine the framework.ObjectivesTo explore the perceptions and experiences of using the new EPA framework in nursing students and hospital and university clinical instructors.DesignAn exploratory qualitative study using focus group interviews.ParticipantsSeven year-one nursing undergraduates, 12 year-two undergraduates, seven university clinical instructors, and 18 hospital clinical instructors participated in this study.MethodsThe students formed five groups, while the clinical instructors formed seven groups, each consisting of three to four participants. Semi-structured interviews were conducted to explore stakeholders' experiences and perceptions of the EPA assessment framework. Thematic analysis was used to analyze the data.ResultsDespite initial mixed reactions of confusion and relief, many students and clinical instructors commended the comprehensive and structured EPA framework and its emphasis on holistic patient-centered care. EPAs also allow flexible assessment methods, encourage critical thinking among students, and promote team-based care and peer teaching. However, the assessment using a two-dimensional matrix with multiple competencies for the EPAs, subjective assessment criteria, the lack of standardization using checklists, subjective assessment criteria, and the lack of, manpower, and time may potentially affect the accuracy of the clinical assessments. The effectiveness of the EPA framework was also dependent on the quality of feedback, students' intrinsic motivations, and learning environments. The refinement of EPAs and entrustment levels, a physical checklist, and an incorporation of EPAs into school curricula were recommended to improve practitioners' learning experiences.ConclusionsThe use of EPAs in nursing education continues to be a novel and evolving process. There remains a need for a further refinement of the EPA framework to tailor to instructors' expectations and students' capabilities.     

Enhancing OSCE preparedness with video exemplars in undergraduate nursing students. A mixed method study

BackgroundObjective structured clinical examinations (OSCEs) are designed to assess clinical skill performance and competency of students in preparation for ‘real world’ clinical responsibilities. OSCEs are commonly used in health professional education and are typically associated with high levels of student anxiety, which may present a significant barrier to performance. Students, including nursing students, have identified that flexible access to exemplar OSCEs might reduce their anxiety and enable them to better prepare for such examinations.AimTo implement and evaluate an innovative approach to preparing students for OSCEs in an undergraduate (registration) acute care nursing course.MethodA set of digitized OSCE exemplars were prepared and embedded in the University-based course website as part of usual course learning activities. Use of the exemplars was monitored, pre and post OSCE surveys were conducted, and qualitative data were collected to evaluate the approach. OSCE grades were also examined.FindingsThe online OSCE exemplars increased self-rated student confidence, knowledge, and capacity to prepare and provided clarity around assessment expectations. OSCE exemplars were accessed frequently and positively received; but did not impact on performance.ConclusionVideo exemplars aid student preparation for OSCEs, providing a flexible, innovative and clear example of the assessment process. Video exemplars improved self-rated student confidence and understanding of performance expectations, leading to increased engagement and reduced anxiety when preparing for the OSCE, but not overall OSCE performance. Such OSCE exemplars could be used to increase staff capacity and improve the quality of the student learning experience.     

Nursing students' misunderstandings when learning about stroke care: A phenomenographic study

BackgroundConsidering the prevalence and complexity of a stroke, it is necessary to think about how undergraduate nursing students are developing knowledge for stroke care.AimTo obtain a vision of nursing students' learning, exploring difficulties concerning understanding stroke care delivery.DesignA phenomenographic research approach.Locations and ParticipantsThis research is based on written exam papers (n = 126) from third-year nursing students enrolled in the 2015–16 academic year in two Nursing Schools in Spain.ResultsThe analysis revealed four conceptions in which students demonstrated difficulties understanding stroke care delivery: 1) limitation of the neurological assessment to the level of consciousness and use of the Glasgow Coma Scale; 2) association of haemorrhagic stroke with hypovolaemia; 3) justification of the need for appropriate patient positioning and postural changes based solely on preventing pressure ulcers; and 4) assertion that strength exercises help improve spasticity.ConclusionsEmpirical identification of these conceptions among undergraduate nursing students, together with agreed definitions of learning outcomes, in the subject of stroke care delivery will allow educators to design evidence-based teaching-learning strategies.     

Nursing informatics and undergraduate nursing curricula: A scoping review protocol

AimThis scoping review aims to review contemporary published literature on Nursing Informatics education in undergraduate nursing education.IntroductionNursing is the largest workforce in health care and nurses are increasingly required to work with digital information systems. The need for nurses to understand and embrace information technology is closely linked with the ability to function in the contemporary healthcare workplace. However, despite the early adoption of Nursing Informatics in Australia in the 1980 s, there remain barriers to Nursing Informatics engagement and proficiency, including poor computer literacy, limited professional development and a lack of undergraduate informatics education.DesignThis scoping review will be developed in adherence with the JBI Manual for Evidence Synthesis: Scoping Reviews and the PRISMA-ScR Checklist.MethodsTo be included in this scoping review, papers need to include Nursing Informatics education for undergraduate nursing students in a Bachelor of Nursing program. Undergraduate nursing students are defined as individuals enrolled in a recognised nursing program leading to registration as a Nurse. To meet the requirements for registration as a Registered Nurse, in Australia, individuals are required to complete a Bachelor of Nursing program at a university (Australian Qualifications Framework Level 7) For the purpose of this scoping review, undergraduate nursing students are defined as those individuals undertaking a three year Bachelor of Nursing program at a university. Equivalent international definitions will be also used in the scoping review procedure. Sources of information will be included if they were published between 2015 and 2022 and describe curriculum recommendations (including barriers to implementing Nursing Informatics education). The purpose of the identified timespan is to reflect the rapidly evolving nature of health informatics and digital technologies. The requirement for curriculum recommendations is to reflect the purpose of the scoping review as the basis for a Delphi study, where Nursing Informatics and its integration into Bachelor of Nursing curricula will be explored and described in collaboration with domain experts.Ethics and disseminationEthics approval has been obtained for this scoping review (Project ID: 2156) from the Flinders University’s Human Research Ethics Committee and has been determined to be low risk.     

Factors contributing to undergraduate nursing students' satisfaction with a video assessment of clinical skills

BackgroundClinical skill assessment via Objective Structured Clinical Assessment (OSCA) has many challenges for undergraduate nursing students. These include high levels of anxiety that can compromise performance during the assessment, inconsistency with assessor reliability and is inconsistent with clinical skills performance in the real world. The implementation of a Video Assessment of Clinical Skills (VACS) that integrates formative feedback may be a way to address the challenges posed by OSCA assessment.ObjectivesThe aim of this study was to examine the acceptability, utility, and nursing student satisfaction with a formative feedback strategy – the Video Assessment of a Clinical Skill (VACS).DesignA cross sectional survey.SettingsUndergraduate Bachelor of Nursing degree students from a large Australian University.ParticipantsThird year undergraduate nursing students (final year) enrolled in a Bachelor of Nursing Program.MethodsParticipants were recruited via purposive sampling. A pre-survey (prior to VACs assessment) and post-survey (after VACS assessment) were completed. This paper reports on the open-ended responses in the post-survey that explored students' insights and perceptions into formative feedback and its impact on their learning for the VACS assessment.ResultsA total of 731 open-ended responses were analysed with findings being organised into 3 major themes; (i) Flexibility and reflexivity, (ii) Editing and repeated attempts, and (iii) Working together.ConclusionsVideo Assessment of a Clinical Skill has demonstrated good utility, acceptability, and satisfaction among undergraduate nursing students.     

Scholarship revisited: a Collaborative Nursing Education Program's journey

The Collaborative Nursing Program in British Columbia is a nursing education program composed of 10 partners, including five community colleges, four university colleges, and one university. The Board of Accreditation of the Canadian Association of University Schools of Nursing granted a 7-year accreditation to the Collaborative Nursing Program partners in November 2000. During the past several years, the partners have begun to view their collaborative curriculum development, implementation, and evaluation through the lens of scholarship. Using Boyer's model of scholarship, they have begun to evaluate their work of discovery, integration, application, and teaching against criteria in Scholarship Assessed: Evaluation of the Professorate. This article describes the journey the collaborative partners undertook in exploring the meaning of scholarship across the partnership and within each nursing school.     

应用客观结构化临床考试评价中医护理本科生临床综合能力

目的探讨客观结构化临床考试(OSCE)在中医护理本科生临床综合能力评价中的应用方法和作用。方法选取2009～2010年在我院实习的61名护理本科毕业生,运用OSCE进行毕业考核。结果 OSCE平均成绩为(79.21±4.81)分,平均难度为0.79,平均区分度为0.54。88.5%的学生和87.5%的教师认为OSCE考试内容的设置合理,有助于掌握临床技能,并且对今后的工作有帮助。结论 OSCE是科学有效的临床护理技能评价方法,能真实反映学生的临床综合能力,促进护理教育改革,应当推广使用。     

The implementation of a nursing student clinical assessment tool onto an online platform: An evaluation by clinical facilitators and academic staff

BackgroundFormative and summative assessment plays an integral role in the learning process for undergraduate nursing students on clinical placement.AimEvaluate the integration and implementation of the Australian Nursing standards assessment tool to the online SONIA database.MethodsThe study was designed to evaluate the experiences of clinical facilitators and academic staff using the online platform, which included an online survey and focus group sessions.FindingsWhilst there are benefits gained from using the online system, results highlighted limitations in using technological devices on clinical placement and a lack of education in using the online platform.DiscussionImplementation of a student clinical assessment tool onto an online platform was introduced to counteract the inherent challenges of managing hard-copy assessment data and meet sustainable teaching practices. Participants noted an ease of accessibility to assessment, although issues identified were access to internet in healthcare organisations and lack of education prior to the implementation of the online tool would have supported their experience.ConclusionIntegration of the Australian Nursing Standards Assessment Tool (ANSAT) onto the planet software database brought significant improvements to the access and management of clinical placement assessment information.     

Contextualising numeracy skill development and assessment in a first year undergraduate nursing subject: A mixed methods research study

BackgroundUndergraduate nursing students continue to perform poorly on clinically-related numeracy tasks, making errors that betray fundamental misconceptions about the underlying mathematics. Graduate nurses are also prone to error in this area but they have the benefit of performing their calculations in a real-world setting with the assistance of colleague nurses if required. These conditions are difficult to simulate in a classroom environment, but when effort is made in this direction the effects can be rewarding for students and educators.ObjectivesTo investigate the effect on undergraduate nursing students' learning experience and test performance of a practical, clinically contextualised numeracy workshop featuring individual and collaborative modes of assessment.DesignA mixed methods study using pre and post tests and a survey.SettingsClinical practice classrooms at an Australian university.ParticipantsFirst year undergraduate nursing students undertaking a subject whose curriculum features medication safety and clinically-related numeracy.MethodsAdministration of individual and collaborative short-answer pre and post tests, a survey, and facilitation of team-based, clinically-related numeracy activities over a 1.5 h workshop. All test marking, data collection and analysis were performed by the authors.ResultsPositive responses to survey questions probing students' judgement of the effect of contextualised learning on their confidence, engagement and proficiency in nursing numeracy, as well as the value of working in a clinical setting. Significant improvement in students' performance in pre/post tests.ConclusionsContextualised, practical and collaborative learning and assessment of nursing numeracy is valued by students and has a positive effect on their experience and performance in the content area.     

Disaster education for Australian nursing students: An integrative review of published literature to inform curricula

BackgroundGlobally, families and communities are impacted by disasters every day. Nurses are integral to assisting in disasters, in the support and enablement of individuals and communities. However, some studies indicate that nurses feel ill-equipped to assist, partially because disaster content is not thoroughly addressed in the undergraduate curriculum. Therefore, nursing schools need to equip undergraduate nursing students with the knowledge and preparation required to assist effectively during and/or following a disaster.AimTo explore priority disaster topic areas aimed at preparing Australian undergraduate nursing students to assist in caring for survivors in the aftermath of disasters.MethodThis study used an integrative review methodology. Various databases and platforms were searched for literature published between 2000 and 2018 using Medical Subject Heading terms and keywords relating to the undergraduate nursing curriculum. A thematic analysis of the included papers was conducted.ResultsA total of 10 articles were identified that meet the inclusion criteria. The reviewed studies highlighted that the areas of disaster knowledge, assessment and triage, critical thinking, teamwork, technical skills, mental wellbeing, legal and ethical consideration, and socio-cultural contexts, are relevant for the undergraduate curriculum.DiscussionThis review highlights disaster education and training topic areas that could be considered for inclusion in Australian undergraduate nursing curricula. The content relating to disaster assistance must be incorporated into nursing schools’ curriculum.ConclusionThe incorporation of disaster-related content in the undergraduate nursing curriculum may enhance the disaster preparedness of nursing students and the nursing workforce more broadly.     

Undergraduate nurse students' perspectives of spiritual care education in an Australian context

BackgroundThe Australian Nursing and Midwifery Accreditation Council competency standards highlight the need to provide holistic care that is inclusive of spiritual care. Literature shows that internationally many nurses feel unsure of how to provide spiritual care which has been attributed to a lack of spiritual care education during undergraduate nursing programs.AimThis study explores the impact of a spiritual care subject in an undergraduate nursing program in an Australian tertiary institution.MethodQualitative research design using in-depth semi-structured interviews.SettingA tertiary institution with a Christian orientation in Sydney, Australia.ParticipantsSix undergraduate nursing students who had completed the spiritual care subject.Data ResultsTwo themes emerged from the data: Seeing the person as a whole and Being with the person.ConclusionsThe spiritual care subject had a positive impact on the perceptions of undergraduate nursing students. In particular students perceived themselves more prepared to provide holistic care that was inclusive of spiritual care.     

The perceptions of undergraduate student nurses of high-fidelity simulation-based learning: a case report from the University of Tasmania

This paper reports a qualitatively informed curriculum research project in the three-year Bachelor of Nursing (BN) at the School of Nursing and Midwifery (SNM) at the University of Tasmania. The project investigated the perceptions of second year undergraduate nurses and their academic teachers of their experiences of high-fidelity simulation using the Laerdal Vital Sim Nursing Kelly and Nursing Anne technology(2) as part of their preparation for clinical practice. An associated curriculum benchmarking audit was also undertaken. A voluntary purposeful sample of students enrolled in a clinically-based practise unit(3) participated in the research, along with a small cohort of academic teachers. The results indicated that undergraduate nursing students value the opportunity to practice nursing activities in a safe environment prior to clinical placement. Students believed that simulation is an innovative strategy that promotes active learning and has great potential for developing clinical competence and increasing confidence prior to practise. The academic staff reported a similar belief about the potential of high-fidelity simulation in a case-based curriculum. The associated curriculum benchmarking audit provided evidence to support further integration of high-fidelity simulation in the undergraduate nursing program.