Presented by Dr. Vivek Indramohan Faculty of Health / CHSCR BCU Evaluating student experiences when undertaking an objective structured clinical examination (OSCE) within the Faculty of Health

1.What is an OSCE? Why and where is it used? 2.So what is the problem? 3.Deciding the solution or the right pathway ! 4.Outcomes / Impact 5.Moving ahead in the right direction – The AAP ! 6.Summary Presentation

Objective Structured Clinical Examination (Skills and Physiology) Birmingham City University Faculty of Health Allied Health Professionals Nursing

Cognitive and behavioural performance of 1 st year level 4 nursing students in their assessments, etc. Various anecdotal evidences from students as in terms of students reporting problem (s) at their end. Their general outlook following the recent assessment and Other discussions initiated by students during the lectures, etc. What is the problem??? Both from an assessor and tutor point of view

Following a discussion with my students, the evidences were unidirectional and leading to: Nervousness and extreme panic conditions leading to - 1.Difficulty in accomplishing certain skills – Manual Blood Pressure measurement. 2.Problem with oral examination. 3.Memory issues with traditional students.

Way to approach the problem identified !!! What does literature say regarding this? Discussion with peers, line manager, other senior members of staff and Associate Dean so as to know what exists and doesn’t exists within the faculty. Similar issues seem to have been identified with respect to NSS previously as well !!!

What next? Today’s topic for presentation It’s a 2 phase pathway evaluating student experiences at different stages. First stage – A focus group based one. Second stage – A questionnaire based one. The first phase feeds into the second.

Why was the pathway designed in this way? Primary reason – To make the entire problem look a bit more formal among students. Cohort size (circa 460) of the first year students. To involve students for students – ‘SAP’ This will enhance the development of the questionnaire to be used in the second phase and Finally …

1.Stage 1 – Identify potential / suitable collaboration. 2.Stage 2 – Apply for funding. 3.Stage 3 – Apply for Faculty of Health Ethical approval and Indemnity. 4.Stage 3.1 – Obtain ‘Ethical approval and Indemnity’. 5.Stage 4 – Recruitment : Recruit phase 1 student volunteers Making it happen !!! Should I have to jump the hoop ? Well, You have no choice !!! Why ? Due to the cross-school nature of the problem. Why? Because you need to pay for student’s time ! Why ? Because the study involves students, emotions and may be sensitive issues. Any other alternatives ???

Cont.…. 6.Stage 5 – Conduct the study 7.Stage 6 – Analyse the results 8.Stage 7 – Disseminate the findings 9.Stage 8 – Submit an interim report to the faculty. 10.Stage 9 – Design the questionnaire for Phase 2 11.Stage 10 – Make sure its all ethical again. 12.Stage 11 – Conduct the phase 2 on obtaining the approval 13.Stage 12 – Analyse the results 14.Stage 13 – Disseminate the results 15.Stage 14 – Submit the project completion report to the faculty. 16.Stage 15 – Evaluate the impact.

Stages 1 to 3.1 – 1. Project team – Developed 2. Funding – Secured £ Ethical Approval and Indemnity – Obtained Currently in stages 4 to 7 – Proposed methodology is to undertake 4 focus groups (23 students) covering the four nursing fields – Mental Health, Adult, Child and Learning disability. 1.Recruited 4 Mental Health students via invitation and participant information sheet and pre-piloted the first focus group discussion (in May’13) covering 10 questions on the student experiences prior to, during and following a recent OSCE (Feb’13) that they had undertaken. 2.Positive feedback obtained from students following the pre-pilot discussion. 3.3 more focus groups to be conducted in Oct’13 – As soon as students are back from their placements. Which stage am I at ? Stages 8 to 15 – To be undertaken as part of phase 2 following Phase 1

Outcomes of the pre-pilot discussion… Following the pre-pilot discussion with ‘Mental-Health’ nursing students, important issues leading to increased stress and anxiety among students were identified… 1.Insufficient skills practicing sessions – ‘Vital source of nervousness’. 2.Need for additional interactive learning resources for physiology 3.Issues around OSCE Management and 4.Educational background of students. However the validity of these will depend on the outcomes of the remaining focus groups yet to be conducted.

Early to comment on this. Two possible outcomes – All the students will either have similar issues or they will not have any such issues. However, if there are issues around the areas mentioned above then appropriate R&D will be initiated with necessary approval and regulations in place. This in turn will improve the student satisfaction and the overall NSS outcome and Might even eventually allow me to attract external funding / grants. Impact of this study …

The time when this pathway was to be decided and to be initiated fitted well with the commencement of AAP programme. The periodic ALS meetings were indeed complimenting each and every stage of my chosen pathway and the peer feedback allowed me to decide if I was on the right track or not. The AAP programme was indeed a motivating factor for me to keep driving the idea generated and lead to the destination using the chosen pathway. This in turn has provided me an opportunity to further develop my professional practice, share my experience and disseminate a part of my findings amongst all of you today… How does this matter to AAP programme and today’s presentation ???

In summary… I identified a problem at the students end and decided into dwell deeper into it using this loop. Despite knowing the hoops that I had to jump, I used the same as an opportunity for my professional development and I used AAP as a binding and motivating factor to accomplish my objectives and reach the final goal.