Australian Midwifery Standards Assessment Tool

Clinical Performance

The employment of clinical performance assessment is essential. It ought not to be dominated as its aids in the monitoring of students perspectives on their skills and abilities for the evaluation of academic wants and aid them to develop it professionally; also, being a core matter in the transition from college education (Robb and Dieter, 2002; Roud et al., 2005; Banaderakshah et al., 2005). After undertaking educational programs, most of the graduating nurses lack the skills to be incompetent in the outside market since most of their clinical performance skills are very poor and most of the time, they usually end up to start their duties as amateurs. This is because most of the nurses know theoretical pieces of literature which are hard to expatiate on it in several ways (Marshbun et al., 2009; Roud et al., 2005). Several scholars(Roud et al.,2005), when the students appreciate the essentials of services they get, they will continue more and more be responsible in every activity they undertake. Therefore, professionalism amongst the students is cultivated effectively. According to Arthur and Randle: "This viewpoint is consistent with the philosophy of the educational curriculum which aims to give students a chance to fulfil their potential. Professional self-concept has been a major concern over the past hundred years in various professional fields. In professions related to health care, the enhancement of professional self-concept is universally recognized as a major goal" (Corwin and Hengstberger-Sims, 2006, p.59-70).

According to Takase et al. (2002), the internal values constituted by nurses are the ones essential for making individual decisions which will in turn in a considerable manner affect the thoughts and conclusions they make. "Nursing professional self-concept consists of the information and beliefs that nurses have regarding their roles, values, and behaviour. Society's impression of nursing greatly influences nursing professional self-concept: nurses are worried about their image as nurses." (Harerian, 2009, p.1-8). Despite the advances in scientific research that have been made in the nursing profession and its efficacies in treatment as a lone area, most of the clinical skills are unknown to most individuals,

The OSCE Assessment Tool

According to Rose et al. (1988), Obstructive structured clinical examination (OSCE) has been recommended by different scholars and researchers as a useful tool in the evaluation of clinical performance among nursing students. This assessment tool was first acquainted by Harden, who was a medical lecturer at Scotland in the year 1975, as depicted by Harden et al. (1975). During OSCE, students illustrate their various skills of performance by doing practical in a circuit based on various stations as time goes through. When the predestined time reaches, a student enters the station and executes the predefined task within the time frame provided to the analysis of clinical skills.OSCE stations may either be non-interactive or interactive. The non-interactive OSCE demands written answers for a particular task or ordeals which do not require observation directly and are frequently assessed after the completion of exams (Austine et al., 2003).

On the other hand, interactive OSCE employs the 'standardized patient 'who often is an individual with training on the responsibilities of patients with particular ailments. The application of 'standardized patients 'often decreases stress among students who are afraid of evaluation and; it promotes a more prosperous surrounding to enable the student to learn and evaluate themselves. With the implication of a checklist, trained personnel's will be able to evaluate a student's clinical performance. Moreover, the total number of OSCE stations is usually between 15 to 20 individuals who are ascertained by the absolute number of stations present. If the OSCE number is heightened, the probability of reliability assessment increases at a high range (Harden, 1990). As the OSCE ends, all of the students ought to have undergone every station and received effective marking following the marking schemes.

Furthermore, OSCE has several advantages when compared with traditional practical examination while doing evaluation among student's communication and interpersonal skills, teaching and assessment skills, problem-solving skills and ethical and professional skills (Sloan et al., 1996). Secondly, with the employment of OSCE, the individual's flexibility components of a particular station reoccur in different tiny scenarios, case studies, short theoretical questions, simulations and eventually they aid students relaxation from time to time as elaborated by Alinier (2003). also, OSCE allows an innovative experience in learning for students as this offers a productive way of assessing clinical performance among students in a holistic way. According to Harden et al. (1988), he emphasizes that the actual ability of OSCE relies upon its power to evaluate a broad range of knowledge that amends the examination reliability. Inside OSCE, liableness is grounded upon the intercede among students assessing crew and the students who are being examined; These pros frequently provide a smooth application of OSCE in lots of nursing practices(Ross et al.,1988; Ahmad, Ahmad and Baker,2009; Rentschler et al.,2007; Sloan et al.,1996; Harden,1988).

Implementation and Evaluation Process of OSCE

Preparation of OSCE for First Aid Course Students

An OSCE undertook at one of the schools in Australia. It is essential for finding an ample space during the execution of the OSCE assessment since this will allow a massive space for students to walk freely in their stations, thus preventing confluence of students from different situations. Furthermore, before the execution of the assessment, it was vital to be aware of the efficacies of utilizing a standard operation for all students. Thus with all these considerations, we were able to develop three OSCE to depict the clinical performance skills:

The OSCE developed were to address similar objectives and marks were to be distributed equally among the common questions in the three OSCEs.
Every OSCE include ten stations that involved burn, bandage, airway technique, appropriate position, bleeding, splint, cardiopulmonary resuscitation and three various scenes which demanded the students to illustrate their clinical skills by executing first aid skills of a particular emergency condition.
The students had to be partitioned into three groups for ease assortment for every examination on a different day.
However, due to the confining figures of skills in the laboratories, standardized patients were employed during the OSCE. Five secretaries and five critical care nursing faculty staff(CCNFS) were given some training to allow them to execute roles for particular clinical emergencies such as choking, fractures and nose bleeding.
A five-minute duration was provided for rest in two stations during the ten station circuit of the OSCE schedule.

Staff and Students Training Session

The examining team was composed of staffs from every department who had received significant training on OSCE prior to the literal exam.
The OSCE training package had to be developed to provide training to students as they were about to partake their OSCE at the final stage.
The group of students that were receiving training at the skill laboratories were to partake the final OSCE seven days earlier.
Before the commencement of training, the students incurred some orientation about the form of the OSCE and examination process employed.

Administration of the OSCE

An OSCE answer booklet with a cover, instruction and answer sheet was prepared for every station; then checklist for observation for the clinical procedure followed.
Furthermore, the rubric test was employed in marking of the entire OSCE booklet utilizing a standard marking system.
Prior to the commencement of the OSCE, examiners were to expatiate several guidelines to students.
Though the station was interactive and non-interactive, the students were urged to illustrate some clinical knowledge and psychomotor acquirements.
The three groups of students were to rotate around the station after hearing the bell sound after five minutes.
Right away after completion of the OSCE, the entire group of students was secerned about the purpose of the study and its essentiality; thus, they were asked to give their feedback about the novel assessment tool.
Ethical consideration was upheld since anonymity, confidentiality and voluntary engagement was emphasized to the students and their tutors before the commencement of the OSCE exercise.

The results of the OSCE assessment tool for clinical performance are available at the appendix.

Conclusion on Application of OSCE

Clinical performance is essential to the graduates from critical care nursing staff since the ability to uphold individual skills is vital for employment purposes. It is the responsibility of nursing students to attain maximum practical skills and theoretical works to ascertain various opportunities of work ahead—furthermore, the employment of OSCE as a technique for assessing nursing students performance in clinical activities. From the results ascertained from nursing school X in Australia, OSCE was conceived to be a wrathful and suitable assessment tool for promoting and enhancing clinical performance.

References for Application of OSCE

Alinier, G. (2003). Nursing students' and lecturers' perspectives of objective structured clinical examination incorporating simulation. Nurse education today, 23(6), 419-426.

Austin, Z., O'Byrne, C., Pugsley, J., & Munoz, L. Q. (2003). Development and validation processes for an objective structured clinical examination (OSCE) for entry-to-practice certification in pharmacy: the Canadian experience. American journal of pharmaceutical education, 67(1/4), 642.

Bakar, R. A., & Ahmad, N. (2009). Assessing nursing clinical skills performance using objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia.

Banaderakhshan, H., Mehrabi, Y., Yazdani, S., Mortazavi, F., Saedi, N., & Azizi, F. (2005). Comparison of knowledge attitude and professional performance between nurses and senior student's of medical science of shahid beheshti. Journal of Research in Medical, 29(1), 37-43.

Harden, R. M. (1990). Twelve tips for organizing an objective structured clinical examination (OSCE). Medical teacher, 12(3-4), 259-264.

Marshburn, D. M., Engelke, M. K., & Swanson, M. S. (2009). Relationships of new nurses' perceptions and measured performance-based clinical competence. The Journal of Continuing Education in Nursing, 40(9), 426-432.

Randle, J. and Arthur, D., 2007. The professional self concept of nurses: a review of the literature from 1992-2006. Australian Journal of Advanced Nursing, The, 24(3), p.60.

Rentschler, D. D., Eaton, J., Cappiello, J., McNally, S. F., & McWilliam, P. (2007). Evaluation of undergraduate students using objective structured clinical evaluation. Journal of Nursing Education, 46(3), 135-139.

Robb, Y., & Dietert, C. (2002). Measurement of clinical performance of nurses: a literature review. Nurse Education Today, 22(4), 293-300.

Ross, M., Carroll, G., Knight, J., Chamberlain, M., Fothergill‐Bourbonnais, F., & Linton, J. (1988). Using the OSCE to measure clinical skills performance in nursing. Journal of Advanced Nursing, 13(1), 45-56.

Roud, D., Giddings, L. S., & Koziol-McLain, J. (2005). A LONGITUDINAL SURVEY OF NURSES'SELF-REPORTED PERFORMANCE DURING AN ENTRY TO PRACTICE PROGRAMME. Nursing Praxis in New Zealand, 21(2).

Sloan, D. A., Donnelly, M. B., Schwartz, R. W., Felts, J. L., Blue, A. V., & Strodel, W. E. (1996). The use of the objective structured clinical examination (OSCE) for evaluation and instruction in graduate medical education. Journal of Surgical Research, 63(1), 225-230.

Takase, M., Kershaw, E., & Burt, L. (2002). Does public image of nurses matter?. Journal of professional Nursing, 18(4), 196-205.

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