1. 2) Criteria for Successful Completion
Session Disclosure
1) Approval Statement
This continuing education activity was approved by the Western Multi-State Division, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
Arizona, Colorado, Idaho, and Utah Nurses Associations are members of the Western Multi-State Division. Approval # 72-17
2) Criteria for Successful Completion
To receive contact hours, participants must check-in to the session using the barcode scanner, attend the entire session and then complete both the session evaluation and full conference evaluation by July 31, 2017.
3) Conflicts of Interest
This educational activity does not include any content that relates to the products and/or services of a commercial interest that would create a conflict of interest.
4) Commercial Support
There is no commercial support being received for this session.

2. Diane Marcyjanik, PhD, RN
Objective Structured Clinical Examination (OSCE), Lasater, and Clinical Self-competence
Diane Marcyjanik, PhD, RN

3. Presentation Objectives
Describe the use of OSCE in an undergraduate curriculum.
Identify potential use of OSCE for end of program outcome assessment of clinical competence.
Explain use of OSCE as a holistic summative assessment strategy.

4. Activity What is Objective Structured Clinical Examination (OSCE)?
30 seconds to write down
Introduce yourself and share with neighbor
Image:

5. Definition of OSCE
An observed examination of clinical skills in a controlled simulated environment, with the utilization of structured checklists, simulators, and standardized patients.
(Jones, Pegram & Fordham, 2010; Meechan, Jones, & Valler, 2011; Paul, 2010)

6. Basic Principles Objective structured assessment of clinical skills
A series of stations
Predefined competency
Use of simulators or standardized patients
Students move between stations at timed intervals

7. OSCE examiner (faculty) is an observer.
Examiner does not ask questions
Only observe performance and mark the standardized scoring sheet accordingly
Some stations may require students to answer written questions without observer present
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8. Why OSCE?
Industry acknowledged students not ready for clinical practice (Kardong-Edgren, 2013)
Highly adaptable to a variety of competencies (McWilliam & Botwinski, 2012)
Needed a way to objectively assess clinical skills prior to graduation
Last time clinical skills objectively assessed- First semester junior
Gap in literature

9. Statement of the Problem
Nursing Students
Clinical Self-competence
Lasater Clinical Judgement Rubric
OSCE

10. Research Question
Is there a significant difference in clinical self-competence scores as measured by Laster Clinical Judgement Rubric (LCJR) between second semester senior baccalaureate nursing students who participate in OSCE and similar students who did not participate in OSCE?

11. OSCE-Kolb-Lasater OSCE Kolb Lasater Holistic Summative Assessment
Knowledge, Skills, Attitude
Kolb
Interaction between content and experiences
Reflection
Lasater
Clinical Self-competence
Self Reflection

12. The OSCE Orientation Cognitive (Knowledge): Ten point quiz
wound healing
Psychomotor (Skill): Dressing change
Wet to dry dressing change (mannequin- with voice over- standard set of responses)
Affective (Attitude): Patient Teaching
Homecare instructions for dressing change (standardized patient)
Debriefing

13. Criteria For Passing OSCE
STATION 1 = 10% of Total Score
STATION 2 = 70% of Total Score
STATION 3 = 20% of Total Score  
No missed Critical Behaviors and >85% of total points

14. Kolb (1984) Experiential Learning Theory
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15. Lasater (2007) Common Language Single Composite Score (Range 11- 44)
Four Dimensions Score
Noticing, Interpreting, Responding, Reflecting
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16. Study Purpose: Evaluate the effectiveness of OSCE Methodology:
Quasi-experimental (Pre-test/post-test)
OSCE Scenario:
Holistic and cultural diversity
Instrument:
Lasater Clinical Judgement Rubric
IRB:
Approval obtained
Data Analysis:
SPSS version 20.0

17. Sample Sampling Design: Non-Probability Sampling Method:
Non-Randomized
Sample Size:
Intervention - 28
Control - 7

18. Demographics Sample Size Age: Mean age: 22.5 years
Intervention: n = 28 ( 76 %)
Control: n = 7 ( 54 %)
Age: Mean age: 22.5 years
Ethnicity: 97 % Caucasian and 3 % Asian
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19. Results: Total Scores Paired Samples Test Mean (SD) t P
Mean (SD) t P
Intervention n = 28
Total pre-score
Total postscore
33.0 (2.7)
34.4 (2.4)
-3.840
< .05
Control
n = 7
33.7 (1.1)
34.9 (2.7)
-1.922 NS

20. Four Phases: ANOVA Phases Group Pretest Mean (SD) Posttest Noticing
Noticing
Intervention *
Control
2.9 (2.0)
3.0 (.13)
3.1 (.17)
3.1 (.38)
Interpreting
Intervention
2.9 (.37)
3.0 (.00)
3.0 (.19)
2.9 (.19)
Responding
2.9 (.36)
3.0 (.14)
3.1 (.35)
3.2 (.22)
Reflecting
3.3 (.39)
3.3 (.46)
3.3 (.48)

21. Recommendations Expand to a larger population Longitudinal study
True control group
Identify other tools to evaluate clinical self-competence
Compare clinical self-competence score and OSCE score

22. Creating an OSCE

23. Brainstorming: Dressing Change OSCE Scenario
Psychomotor OSCE Station:
Scenario:
Josefina Vicaro is a 47-year-old woman who was admitted to the hospital with an open wound on her left leg. The patient is in bed with a dressing in place. The Doctor has ordered a wound culture and dressing change schedule.

24. Dressing
OSCE
Rubric Development
Faculty Orientation
Responses
Patient
Student Preparation

25. Implementation of OSCE
Rubric development
Faculty orientation
Standardized patient orientation
Student preparation

26. Dressing Change Rubric

27. Dressing Change Rubric

28. Summary OSCE start small (one station at a time) Faculty orientation
Debriefing
Standardized patient orientation
Student preparation
Student orientation to include use of mannequins and/or live standardized patients.

30. References
Adamson, K. A., & Kardong-Edgren, S. (2012). A method and resources for assessing the reliability of simulation evaluation instruments. Nursing Education Perspectives, 33(5),
Bensfield, L. A.,Olech, M. J., & Horsley, T. L. (2012). Simulation for high-stakes evaluation in nursing. Nurse Educator, 37(2), doi: /NNE.0b013e b8c
Bultas, M. W., Hassler, M., Ercole, P. M., & Rea, G. (2014). Effectiveness of high-fidelity simulation for pediatric staff nurse education. Pediatric Nursing, 40(1),
Jones, A., Pegram, A., & Fordham-Clark, C. (2010). Developing and examining and objective structured clinical examination. Nurse Education Today, 30, doi: /j.nedt
Kardong-Edgren, S. (2013). A wake up call…with an objective structured clinical examination. Clinical Simulation in Nursing, 9 (1), e3-e4. Retrieved from (12)
Kirkman, T. R. (2013). High fidelity simulation effectiveness in nursing students' transfer of learning. International Journal of Nursing Education Scholarship, 10(1), 1-6. doi: /ijnes
Kirton, S., & Kravitz, L. (2011). Objective structured clinical examinations (OSCEs) compared with traditional assessment methods. American Journal of Pharmaceutical Education, 75(6), 1-7.
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs, NJ: Prentice-Hall.
Lasater, K. (2007). Clinical judgment develo9ment: Using simulation to create an assessment rubric. Journal of Nursing Education, 46(11),
McWilliam, P. L., & Botwinski, C. A. (2012). Identifying strengths and weaknesses in the utilization of objective structured clinical examination (OSCE) in a nursing program. Nursing Education Perspectives, 33(1), doi: /
Meechan, R., Jones, H., & Valler-Jones, T. (2011). Students' perspectives on their skills acquisition and confidence. British Journal of Nursing, 20(7),
Paul, F. (2010). An exploration of student nurses’ thoughts and experiences of using a video-recording to assess their performance of cardiopulmonary resuscitation (CPR) during a mock objective structured clinical examination (OSCE). Nurse Education in Practice, 10, doi: /j.nepr

31. Thank You! Diane Marcyjanik, PhD, RN Assistant Professor

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