Data collection
The Objective Structured Clinical Examination was originally developed in the
University of Dundee in 1975 to assess the clinical competence of trainee
doctors (Harden & Gleeson 1979). Since then, the use of OSCEs has been
increasingly recognised as an effective evaluation tool for assessing the
practical skills of other healthcare students. In most allied health professions it
is recognised as a valid, reliable and practical assessment method (Harden &
Gleeson 1979, Sloan et al. 1995). This type of assessment is composed of
several short exercises, or stations, through which students rotate individually
for a given time. An OSCE is usually composed of 15 to 20 stations that last
between 3 and 10 minutes. Each station focuses on a particular clinical
aspect, either in a practical way and invigilated by an examiner, or in a
theoretical way, in the form of a pen and paper exercise. Students are given a
limited time at each station and have to wait for a signal before rotating to the
next one (Harden 1990). By the end of the OSCE, all students have passed
through all the stations and been marked according to a precise set of criteria.
Well-designed marking sheets and appropriate briefing and preparation of
examiners ensure that the overall examination is based on objective
judgements.
9
Designing effective OSCE stations is not easy. This type of examination is
time-consuming, resource intensive, and requires careful organisation and
planning to be successful (Harden 1990). However, this assessment method
can be flexible and tailored to the organisers’ needs (Alinier 2003). It is also
particularly useful for enabling students to evaluate themselves and determine
their own weaknesses (Bramble 1994, Sloan et al. 1995).
For the purposes of this study, a 15-station OSCE was developed. This meant
that only 15 students could be examined in each session. Students had five
minutes per station, with a one-minute gap to rotate to the next one, which
made the total examination last 90 minutes. Each OSCE session ran over two
hours as students needed to sign in, be given an anonymity number, and be
reminded about the organisation of the OSCE. The OSCE included four
theoretical stations with questions on safety and nursing practice (Alinier et al.
2004). Each of the other 11 stations was supervised by an examiner and
required students to use their clinical knowledge, technical ability, and
communication skills. Those stations were marked at the time of the
examination, whereas the theoretical stations were marked later. A concise
set of instructions and marking scales was prepared for the 15 stations in
order to make the marking as objective as possible. All OSCE examiners
were trained by the principal investigator to ensure consistency in the
marking.