客观结构化临床考试在护理本科生毕业考核中的应用

目的 分析客观结构化临床考试（OSCE）在护理本科生毕业考核中的应用情况,以促进考试改革.方法 以我院2006级110名护理本科生为研究对象,于毕业实习结束后开展OSCE多站式考试,对学生考试成绩进行统计.结果 本次OSCE考试信效度较好,成绩能反映学生的真实水平.结论 应用OSCE进行护理本科生考核是科学有效的临床护理能力评价方法.     

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。     

客观结构化临床考试在护生毕业实习出科考试中的应用

目的 总结OSCE模式的原则和框架应用于护理本科生毕业实习出科考试中的实践经验.方法 参考经典OSCE模式,设计出以一个病例贯穿始终的新型OSCE模式,并应用于2004级护生进行毕业实习的出科考试中.采用自行设计的问卷调查护生对该模式的态度.结果 75.0%的学生认为考试站点设置合理;78.1%的学生适应这种考试形式;100.0%的学生认为该考核模式可客观评价临床综合能力,同时认为通过该考核明确了下阶段的实习目的.结论 该OSCE模式客观评价学生的临床综合能力,真实地反映临床带教中的现存问题,为下一阶段的实习带教提供有益的参考.     

Application of nursing core competency standard education in the training of nursing undergraduates

PurposeTo evaluate the effectiveness of nursing core competency standard education in undergraduate nursing training.MethodsForty-two nursing undergraduates from the class of 2007 were recruited as the control group receiving conventional teaching methods, while 31 students from the class of 2008 were recruited as the experimental group receiving nursing core competency standard education. Teaching outcomes were evaluated using comprehensive theoretical knowledge examination and objective structured clinical examination.ResultsThe performance in the health information collection, physical assessment, scenario simulation and communication in the experimental group were significantly higher than those of the control group (p < 0.05).ConclusionsNursing core competency standard education is helpful for the training of nursing students' core competencies.     

应用客观结构化临床考试评价护理本科毕业生的临床能力

目的 采用客观结构化临床考试(objective structured clinical examination,OSCE)评价护理本科毕业生的临床能力.方法 设置OSCE考站,对2010届护理本科145名毕业生进行考核和成绩分析.结果 在本次考试中毕业生成绩分布均匀,分数在合理范围内,考试的信度及效度较好.结论 OSCE能够客观地反映毕业生的临床能力,但其考站的设置有待于进一步完善.     

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.     

Using standardized patients in enhancing undergraduate students' learning experience in mental health nursing

BackgroundConducting mental status examination and suicide risk assessment is an important skill required of nurses when they are in the clinical setting. With nursing students often expressing the anxiety and lack of confidence in doing so, the use of standardized patients provide an excellent opportunity to practice and become proficient with this skill in a simulated environment.ObjectivesTo explore the learning experience of undergraduate nursing students using standardized patients while practising their mental status examination and suicide risk assessment skills in mental health nursing module.DesignA pre- and post-test, single group quasi experimental design was used in this study. A standard didactic tutorial session and a standardized patient session was conducted to evaluate the learning experience of undergraduate nursing students learning mental status examination and suicide risk assessment. Outcome measures for this study include Student Satisfaction and Self-Confidence in learning scale.Qualitative comments in the form of open-ended questions were also collected in this study.SettingsA University offering nursing program from undergraduate to postgraduate level.ParticipantsA convenience sample of Year 2 undergraduate nursing students undertaking the mental health nursing module was included in this study.ResultsThe use of standardized patient session had significantly increased students' satisfaction and confidence level before they are posted to a mental health setting for their clinical attachment. There was a significant difference on students' self-confidence level for those who have taken care of a patient with mental illness after adjusting for pre-test on score in learning. Qualitative feedback obtained from students showed a positive outlook towards the use of standardized patient as an effective tool in augmenting didactic learning into practical skills.ConclusionsUsing standardized patient in mental health nursing education enhanced the integration of didactic content into clinical setting allowing students to practice their assessment skills learned in classroom and transfer it to the clinical area. The benefits of using standardized patient include allowing students to practice their communication skills and improving their confidence level in conducting mental status examination and suicide risk assessment by reducing anxiety as compared with traditional classroom and textbook-based pedagogy.     

Mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination to assess their competence in medicine administration

The aim of this study was to evaluate mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination (OSCE) in assessing their administration of medicine competence. Learning disability (n = 24) and mental health (n = 46) students from a single cohort were invited to evaluate their experience of the OSCE. A 10‐item survey questionnaire was used, comprising open‐ and closed‐response questions. Twelve (50%) learning disability and 32 (69.6%) mental health nursing students participated. The OSCE was rated highly compared to other theoretical assessments; it was also reported as clinically real and as a motivational learning strategy. However, it did not rate as well as clinical practice. Content analysis of written responses identified four themes: (i) benefits of the OSCE; (ii) suggestions to improve the OSCE; (iii) concern about the lack of clinical reality of the OSCE; and (iv) OSCE‐induced stress. The themes, although repeating some of the positive statistical findings, showed that participants were critical of the university setting as a place to conduct clinical assessment, highlighted OSCE‐related stress, and questioned the validity of the OSCE as a real‐world assessment. The OSCE has an important role in the development of student nurses' administration of medicine skills. However, it might hinder their performance as a result of the stress of being assessed in a simulated environment.     

Investigation of the teaching cognition and capabilities of clinical advisers for masters degree level nursing specialty graduate students

PurposeTo assess the culturing cognition and teaching of core capabilities of clinical advisers for masters degree level nursing graduate students in order to provide criteria for selecting and training clinical advisers, and to monitor clinical teaching quality.MethodsA questionnaire was completed by 66 nursing specialty clinical advisers. The questionnaire was divided into three sections: basic condition, culturing cognition of the nursing specialty graduate students, and self-evaluation of teaching core capabilities as measured by the Clinical Nursing Teachers Core Capabilities Graphic Rating Scale.ResultsForty-five of the surveyed advisers served undergraduate level students (68.18%), and seven of them (10.61%) had experience advising graduate nursing students. The advisers, in general, had limited knowledge regarding guidance for nursing specialty graduate students. The self evaluation total score for core capabilities teaching was (120.55 ± 7.37), containing professional capability (4.47 ± 0.34), leadership capability (4.01 ± 0.22), problem solving capability (3.89 ± 0.30), and education teaching capability (3.65 ± 0.23). The highest scored item was the capability to assess and handle a patients' condition (4.44 ± 0.56), while the lowest scored item was the capability to do scientific research (3.29 ± 0.89).ConclusionClinical advisers for nursing specialty graduate students in our survey were generally inexperienced with regarding to training and culturing nursing graduate students. These advisers were prepared for core teaching competency, but were not qualified to conduct scientific research. Based on these results, it would be beneficial to provide the clinical advisers more training on teaching cognition for graduate students and improve their competency to perform scientific research.     

在真实临床情境中护理本科生综合临床技能的评价

目的：介绍在真实临床情境中护理本科生综合临床技能的评价。方法：本研究通过在真实临床情境中客观结构化临床考试,采用《综合临床护理技能评核表》直接观察、评价180名护理本科四年级学生的综合临床技能。结果：绝大部分学生能完成护理评估、病例分析、给予护理干预并进行健康教育。但存在护理评估不全面、不深入,健康教育内容不完整、不恰当,操作步骤紊乱等现象。教师及学生对OSCE评价较好。结论：在真实临床情境中的OSCE,增强了情境的逼真度,可以客观地测试学生的综合临床技能。     

Improving the content and face validity of OSCE assessment marking criteria on an undergraduate midwifery programme: A quality initiative

Objective Structured Clinical Examinations (OSCE's) have been adopted as a means of assessing midwifery students' clinical skills. The purpose of the OSCE is to provide a standardised method for the evaluation of clinical skill performance in a simulated environment. This paper describes how a quality improvement initiative using both internal and external expert review was utilised to improve OSCE assessment marking criteria. The purpose of the quality initiative was to review the content and face validity of the marking criteria for assessing performance. The design and choice of tools used to score students' performance is central to reliability and validity. 20 videos of students from year one of a midwifery preregistration programme undertaking an OSCE assessment on abdominal examination and 18 videos of students response to obstetric emergencies e.g. PPH, and shoulder dystocia were available for review. The quality initiative aimed to strengthen the reliability and validity of the OSCE in assessing student performance. Conclusion: the use of global rating scales allows for the capturing of elements of professional competency that do not appear on specific criteria for skills performance checklists.     

Towards the implementation of OSCE in undergraduate nursing curriculum: A qualitative study

BackgroundDespite the fact that Objective Structured Clinical Examination is considered to be an efficient assessment method, their implementation in the undergraduate nursing curriculum encounters difficulties. However, the initiative of the European Higher Education Area to promote competency-based assessment may represent an opportunity to introduce this instrument in undergraduate nursing curriculum.ObjectiveTo explore the perception of nursing faculty members regarding the implementation of the OSCE as an assessment tool in Catalan Nursing Schools.Design/Participants/SettingIn this qualitative study, fifteen teachers participated in semi-structured interviews in eight Catalan Nursing Schools.MethodsSemi-structured interviews were conducted. A thematic content analysis was used to identify major themes in the interview data and collaborative analysis was undertaken to ensure rigorous results.ResultsThe relevant aspects that are emphasized by teachers included the consideration of the dual purpose of the OSCE via its formative and evaluative facets by enhancing the feedback received by students about their performance on the OSCE. The OSCE should be administered towards the end of the degree program and should complement other methods of assessment. Despite its high cost, the OSCE was deemed to be efficient as it enables student competencies to be assessed with objective criteria, which is a difficult task with other instruments. OSCE implementation is feasible with the institutional support of and collaborative work between schools.ConclusionsThe implementation of the OSCE in the Catalan undergraduate nursing degree programs is feasible if the project receives the support of all involved parties and if creative strategies are determined to reduce economic costs and optimize resources. With adequate feedback, the OSCE is an assessment tool that can provide high-impact training to students.     

基于标准化患者的客观结构化临床考试在护理本科毕业生临床技能考评中的应用

目的探讨标准化患者（standardized patient,SP）和客观结构化临床考试（objective structured clinical examination,OSCE）在护理本科生临床技能毕业考评中的应用。方法通过撰写SP病例、建立SP考评标准、选拔和培训SP,设置了基于SP的OSCE,对35名护理本科毕业生进行临床技能的考评。结果多站式考核总分为30分,考生总成绩在21.4～27.之间,平均为（24.86±1.37）分。45.7%的考生对SP的人文关怀不够,应对能力欠佳。结论基于SP的OSCE能较全面地考核护理本科毕业生的临床技能,考评发现部分考生临床技能掌握有不足之处,建议在专业课程教学和临床实习中引入基于SP的OSCE。     

护理本科生在客观结构化临床考试中出现的问题与原因分析

目的 通过总结客观结构化临床考试(OSCE)中学生出现的问题,分析其产生的原因,寻找解决问题的方法与途径.方法 应用OSCE出科考试观察和评价学生的综合表现.结果 学生OSCE出科考试总体水平不高.主要问题表现为规范性较差、临床思维尚未形成、人文关怀能力不强.结论 加强学生临床思维能力、临床实践能力和人文精神培养,必须着力做好医院护理临床带教教师的培训,改进带教方法,提高课堂教学质量,为培养学生的综合能力提供有利条件和环境.     

Evaluating the cutoff score of the advanced practice nurse certification examination in Korea

AimThis study aimed to evaluate the cutoff score of the Advanced Practice Nurse (APN) certification examination determined using two standard-setting methods and to compare it with the current score.BackgroundThe APN qualification is established by passing a certification examination. However, the method of determining the passing criterion is different among countries. In Korea, the passing criterion has been predetermined as 60% of the total score or above without any theoretical or empirical basis.DesignIn this study, two typical and popular standard-setting methods, the modified Angoff and Bookmark methods, were used to determine the passing criterion of the APN certification examination.MethodsThe performance data of a gerontological APN certification examination were used to conduct standard setting with both the modified Angoff and Bookmark methods. The total number of examinees in the dataset was 121. Item analysis with a 2-parameter logistic model was performed based on the item response theory using the Bilog-MG3.0 program. A total of 5 raters in APN education and clinical nursing practice were selected.ResultsThe modified Angoff and Bookmark methods gave cutoff scores of 113 and 110.5 with passing ratios of 52.9% and 57.0%, respectively. These results were different from the conventional cutoff score of 90 with a passing ratio of 93.4%.ConclusionThe present arbitrary fixed cutoff score should be reconsidered to improve the robustness of the APN qualification and standard-setting methods should be employed to determine an adequate cutoff score for the APN certification examination to ensure the competency of APNs in providing advanced care.     

Enhancing cultural competency and empathy toward foreign patients for Korean nursing students through a simulation: A quasi-experimental study

AimThis study aimed to develop a transcultural nursing simulation-based learning program with patients from the United Arab Emirates and evaluate its effects on cultural competence and empathy among undergraduate nursing students in South Korea.BackgroundThe importance of cultural competency and empathy has increased with the increased number of foreign patients in Korea. The United Arab Emirates (UAE) is one of the top Middle Eastern countries from which patients visit Korea for medical services. Because South Korea is a largely homogenous country, foreign patients often experience difficulties in their hospitalizations when Korean nurses lack cultural competency in caring for them. To improve cultural competency, a practical form of education, such as a simulation, is necessary. In addition, the simulation module based on cultural competency model allowing nursing students to provide effective and culturally responsive services to ethnically diverse patients.DesignThis quasi-experimental study used a non-randomized control group design with a convenience sample.MethodsThe program was administered to 53 Korean undergraduate nursing students (26 control and 27 experimental). Fourteen teams of two students practiced infection prevention training with the mother of a 7-year-old child with immunodeficiency. Participants’ cultural competency and empathy were assessed before and after the TN-SBL using an online survey. The effects of cultural competency and empathy were analyzed using a generalized estimation equation.ResultsNursing students in the TN-SBL group showed more positive improvement in cultural competence and had increased cognitive empathy levels than students in the control group.ConclusionThe simulation module developed in this study improved students’ cultural competency and empathy levels. It is valuable because the scenario was developed based actual clinical cases of Emirati patients and their families. The simulation module was designed based on the cultural competency model to raise awareness of cultural diversity and allow students to directly practice culturally competent care. It can be used to educate Korean nurses and improve the quality of care provided to Arabic-speaking Muslim patients.