BASICS OF OSCE & OSPE

By:- Firoz QureshiDept. Psychiatric Nursing

Presentation Points ……• Nursing Process• Teaching-learning objectives• Clinical Nursing Practice• Clinical & practical• Nursing care skill evaluation• History of OSCE• Principles of OSCE/OSPE• OSCE/OSPE: What, Why, When, Where, How• OSCE/OSPE: Advantages & Disadvantages

Nursing: An Independent Practice

• A ‘Problem-solving’ approach, known as ‘Nursing Process’ : Major Parts are –

1. Identifying person’s Health Needs (Nursing Diagnoses)

2. Setting Nursing Care Goals (Objectives)3. Providing Nursing Care (Nursing Interventions) 4. Examining the outcome of nursing care

(Evaluation)

Nursing Education: Teaching-Learning Objectives

Designed on three domains (areas) – (Bloom’s Taxonomy, 1964)

Taxonomy means Classification1. Cognitive (Intellectual Skills): Knowledge,

understanding, application, analysis, synthesis & evaluation

2. Affective: Feelings, attitude, communication 3. Psychomotor: Working skills

Educational Objectives

Nursing Process

Clinical Nursing Practice

• Clinical competency is demonstrated

when a task of nursing care is performed

using all these three domains

What is ‘CLINICAL’ ?From Dictionaries & Thesaurus:• At the bed-side• Based on direct observation of a living patient in

actual situation, analysis of the observation results, making diagnosis of the problem and deciding treatment

• Applying objective or standardized methods of observation

• A Hands-on experience of students

What is ‘PRACTICAL’ ?

• To practice skills of all three domains• In a laboratory • In a simulated (duplicate) situation• Learning by doing • Drill method of learning • Steps of habit formation – - Imitation - Internalization - Automatism

Nursing Care Skill Evaluation

We, Human Beings are made up of body, mind or emotions and we all belong to our own family & society.

And all these are bound together – interrelated

& inter-dependant.

• Hence, illness affects not only our body, but also

our mind, our family life & surroundings

• Health Care (Nursing care) should include all

these parts of Individual Human Being

Therefore, ideally- Examination of Nursing Care Skills should

include evaluation of all the three domains of Teaching-Learning Objectives

Examination is Students’ PERFORMANCE EVALUTION - Not Personal Evaluation

Ideal Nursing Care Skill needs –Expert Coordination of ~

• Heart (Feelings for people’s health care needs, empathy)

• Head (Clinical Decision –making skill, needs accurate & adequate knowledge)

• Hands (Perfection & Quickness of doing work – Nursing Procedures)

History of OSCE

OSCE was developed in Dundee, Scotland in the early 1970’s by Dr. Harden and colleagues -– The OSCE is now used in over 50 countries

world-wide.– There is a national OSCE in Canada adopted

by all medical school.– According to INC, ANM practical exams

should be conducted by OSCE.

Principles of OSCE/OSPE

What is a Principle?

Statement of a fact scientifically proved and which guides our every action E.g., Physical exertion increases pulse rate

- Can be measured accurately E.g., Appropriate communication helps to prevent spread of diseases- Can not be measured very accurately, as there are many factors in spreading a disease

Principles of OSCE/OSPE

• A structured evaluation process organized step by step in logical sequence ensures examination of all skills related to a specific activity.

• Skills to be tested are assigned in form of specific questions.

Principles of OSCE/OSPE

• Organization of questions as ‘simple to complex’ and ‘known to unknown’ is less threatening to UG students.

• Evaluation by a standard CHECKLIST makes it impartial.

• Check list is prepared by breaking the skill to be tested into its very important components.

OSCE & OSPE

Let us understand ~

What? Why? When? Where? How?

OSCE

Objective : examiners use a checklist for evaluating the trainees

Structured: trainee sees the same problem and performs the same tasks in the same time frame

Clinical: the tasks are representative of those faced in real clinical situations

What………….? (Meaning of OSCE)

Objective Structured Clinical Evaluation - OSCE - is a process where selected specific skills of students, which they have learnt in their course of study, are systematically tested or evaluated.

As students perform skills in actual situation, the evaluation is done using structured checklists.

e.g., Physical Health Assessment Skill

What………….?(Meaning of OSPE)Objective Structured Practical Evaluation - OSPE - is a process where selected specific skills of students, which they have learnt in their course of study, are tested or evaluated. As students perform skills in labs, the evaluation is done using structured checklists.

e.g., Measuring Hb by Hemoglobinometer, Urine testing for sugar

Purpose Of OSCE & OSPE

To Eliminate the Following:

• Variability• Defects in competencies examined• Difficulties in conducting Exams

Boursicot, Ware and Hazllet (2011),

Why?Need for OSCE & OSPE

To replace the usual method of evaluation of students’ clinical competency, as it has many drawbacks –

• 15-20 students are examined at a time, can’t observe individual performance

• All domains of learning objectives can’t be evaluated in such short time

• Subjectivity in evaluation

When?OSCE & OSPE

• Can be conducted as a Formative Evaluation, in parts throughout the year

(Periodic Sessional Examinations)• Also it can be carried out at the end of academic

year, as a Summative Evaluation• Before scheduling OSCE/OSPE, it must be

ensured that students have attained all domains of learning objectives, whether it is in parts or whole

Where?OSCE & OSPE

• OSCE is conducted in actual situations, where living human beings need competent health care, in hospital or community

• OSPE is conducted typically in labs, where learning activities are related to health care, either diagnostic (Urine testing) or supportive (Therapeutic diet planning)

• OSCE & OSPE are usually combined, as holistic health care involves all aspects of human health

In Summary

• The main features of OSCE/OSPE is that both the process and the product are tested giving importance to individual competencies.

• The examination covers a broad range of clinical skills much wider than a conventional examination.

• The scoring is objective, since standards of competency are preset and agreed check lists are used for scoring. Where questions are asked in response stations, these are always objective.

Advantages of the OSCE/OSPE

• All components of clinical Exams are assessed• Objective examination • Experienced examiners can control the

complexities of the examination• Can be used with larger number of students• Reproducible• End of examination FEED BACK to students

encourages students’ self-evaluation and self-learning

Advantages (cont)• Components of clinical skills& standards of

competencies are pre-planned, so Objectivity & Reliability is higher

• The variable of the examiner and the patient are to a large extent removed

• Fun activity within the department or college, which promotes team work

• Students’ full involvement inspires learning

Disadvantages of OSCE/OSPE• Knowledge and skills are tested in

compartments. But inter-related compartments sequentially organized, following Nursing Process can solve this problem

• The OSCE may be difficult for both examiners and patients

• More time in setting it up• Special Training needed for teachers• Shortage of experienced examiners

THE KEY TO A SUCCESSFUL

OSCE/OSPE IS

CAREFUL PLANNING

Tell me & I forget Show me & I may remember Involve me & I will understand, Soaking up my senses with Infinite knowledge.

Any new effort is challenging. But if we all put together our mind, intellect and

courage – we can bring changes in our existing system of Students’ Performance Evaluation.

Thank You & Best Wishes