Osce and ospe

whole content of OSCE and OSPE

1. J.G COLLEGE OF NURSING, AHMEDABAD. SUB : Nursing Education TOPIC : OPSE/OSCE SUBMITTED TO, SUBMITTED BY, Mr. P Yonatan, Ms.Sonal Patel, Asst. Professor, F.Y.M.Sc(N ), J.G College of Nursing, J.G College of Nsg, Ahmedabad. Ahmedabad .

2. objective structured PRACTICAL examination ( OSPE )

3. Introduction The term OSPE is derived from OSCE in 1975 which was later extended to practical examination and modified by Harden and Gleeson. Practical examination has several problems especially in terms of its outcome Out of the various method adopted the OSPE was largely tested on the basis on success of OSCE.

4. Definition Objective structured practical examination (OSPE) is a new pattern of practical examination, in which each component of clinical competence is tested uniformly and objectively for all the students who are taking up a practical examination at a given place.

5. Features of OSPE The main features of OSPE is that the process and the product are tested giving importance to individual competencies. The examination covers a broad range of clinical skills and content much wider than a conventional examination. The scoring is objective, since standards of competence are present and agreed check lists are used for scoring.

6. Where questions are asked in response stations, these are always objective. Simulations can be used for acute cases and there is scope for immediate feedback. Patient variability and examiner variability are eliminated thus increasing the validity of the examination. An analytical approach to the assessment. Feedback to teacher and student.

7. Stations A “station” is the site at which the student is assessed on particular ability. The total number of station will vary based the number of skills, behaviors and attitudinal items to be tested For most clerkships or courses, the total will vary from 10-25 (usually 20)

8. During this exam student pass through a number of station OSPE exam ideally consist of 15 – 20 stations for exam of a particular course. The time for each stations should not be less than four minutes Students are rotated through all the station and move to the next station at the ring of the bell.

9. Each station is design to test experimental competences At some stations called procedures station students are given task to perform on subjects At all station there are observer with agreed checklist to mark the student performance. At other station called response station student write answer of objective type question or record their findings of the pervious procedure station

10. Set up “Stations” Stations are of different types History Taking stations: e.g. “This patient complains of abdominal pain. Take a history pertaining to abdominal pain.” Examination stations: Student’s ability to perform a clinical examination is assessed, e.g. “Record ankle jerk response.” Skill stations: Student’s are tested on their ability to perform a skill. E.g. Provide CPR, start IV line.

11. Set up “Stations”...... Communication station : Communication ability of a student is assessed. E.g. “Advise the mother of a three year old child with diarrhea regarding use of ORT for her child.” Response stations: Interpretative ability of a student is assessed. E.g. “interpret this Chest X ray of a 40 year old patient with acute dyspnea and state 3 reasons for your answer” Rest stations: To give students a chance to organize their thoughts.

12. Duration of station Duration of station has been fixed. Make sure that the task expected of the student can be accomplished within the time. Time ranging 4 to 15 minutes. 5 minutes station probably most frequently chosen. The time depends on the competencies to be assessed in the examination.

13. Movement in the Stations

14. Explanation of procedure and response station by example.

15. Check List 1.Explain to subject what he is going to do. 2.Applies the pressure cuff correctly. 3.Ask the subject to sit comfortably. 4.Keep the bell of stethoscope correctly on capital fosse. 5.Deflates the pressure from the cuff properly. 6.Take care to repute to the procedure to insure correct reading of systolic and diastolic pressure. 7.Thanks subject at the end of recording. 8.Reset the instrument and closes it down properly.

16. Advantages of OSPE 1. It is useful for any subject. 2. It can also examine both the clinical and Experimental skills. 3. Checklists are used for marking and evaluation. 4. Student take more interest due to verity and keep themselves alert during the whole process. 5. Exam is modified easily as per institutional circumstances. 6. Large no of students can be tested with in the short time.

17. Disadvantages of OSPE 1. If proper planning, briefing to the student, preparation of procedure of response stations are not done properly then the whole process of OSPE may become failed. 2. Separate observer for each station is required. 3. Costly method.

18. OBJECTIVE STRUCTURE CLINICAL EXAMINATION (OSCE)

19. INTRODUCTION: An OSCE is a modern type of examination often used in Health sciences (like Medicine, chiropractic, physical therapy, Radiography, Nursing, Pharmacy and Dentistry) to test clinical skill performance and competence in skills such as communication, clinical examination, medical procedures/prescription, exercise prescription, etc.

20. OSCE DESIGN: O bjective – all candidates are presented with the same stimuli

21. What is an OSCE? O bjective S tructured – Specific foundational and functional competencies are tested at each station and the marking sachem for each station is structured

22. What is an OSCE? O bjective S tructured C linical E xamination – Test of performance of clinical competencies, with an emphasis on skills and attitudes

23. Definition An Objective Structured Clinical Examination (OSCE) is a modern type of examination often used in health sciences (e.g. medicine, , physical therapy, radiography, nursing, pharmacy, ) to test clinical skill performance, and competence in skills such as communication, clinical examination, medical procedures / prescription, exercise prescription, and interpretation of results.

24. Objective All candidates are assessed using exactly the same stations (although if real patients are used their signs may vary slightly) with the same marking scheme. In an OSCE candidates get marks for each step on the mark scheme that they perform correctly which therefore makes the assessment of clinical skills more objective rather than subjective, where one or two examiners decide whether or not the candidate fails based on their subjective assessment of their skills.

25. e.g. A simple model of the skin can be used to enable the student to demonstrate how to give an I/M injection. To set the scene at the beginning of each station, the student will be given a short scenario to read. This will provide the information necessary to establish the context in which the specific set of skills in to be performed and will identify the skills being examined. NEED OF OSCE:

26. METHOD & STATION : TWO TYPES PROCEDURE STATION e.g. Taking history of a patient Examine this patient’s pulse EXAMINER OBSERVES QUESTION STATION MCQs related to finding Interpretation of temperature chart STUDENT ANSWERS ON THE ANSWER SHEET

27. Characteristics of OSCE:

28. 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 competence are preset and agreed check lists are used for scoring. Where questions are asked in response stations, these are always objective. Simulations can be used for acute cases and there is scope for immediate feedback. Patient variability and examiner variability are eliminated thus increasing the validity of the examination . Features of OSCE  

29. In an OSCE, clinical skills are tested rather than pure theoretical knowledge. It is essential to learn correct clinical methods and then practice repeatedly until one perfects the methods . Marks are awarded for each step in the method; hence, it is essential to dissect the method into its individual steps, learn the steps, and then learn to perform the steps in a sequence. Preparation

30. Most universities have clinical skills labs where students have the opportunity to practice clinical skills. It is often very helpful to practice in small groups with colleagues, setting a typical OSCE scenario and timing it with one person role playing a patient, one person doing the task and (if possible) one person either observing and commenting on technique or even role plating the examiner using a sample mark sheet. In doing this, the candidate is able to get a feel of running to time and working under pressure.

31. Miller (1990) recommends that, in order to demonstrate competency, ‘knows’, ‘knows how’, ‘shows how’ and ‘does’ are necessary. This means that, in terms of demonstrating clinical competency, knowledge (knows), competence (knows how), demonstration (shows how) and clinical performance (does) are all important. Knowing, Showing, Doing, e.g. Pain Assessment

32. ORGANISATION OF OSCE ADVANCE PLANNING ORGANISATION THE DAY BEFORE EXAMINATION THE DAY OF EXAMINATION AFTER THE EXAMINATION A. Advance Planning : Time ideally 6 months for major examination 8 weeks for formative.

33. B) The Day Before The Examination Final check for preparations & arrangement in ward Final documentation to be given to each examiner C) The Day Of Examination Coordinator -1 hour prior Final check for arrangement Staff member brief the student All examiners have arrived and are at their correct station D) After The Examination 1) Give feedback to students by showing checklists & questions scored by examiners.

34. Advantages of OSCE Students were appraised about their performance. It also highlighted the need for clinical supervision. The students were evaluated on objectives in clinical competence based on set criteria. It gave the faculty the opportunity to differentiate the high with the low performance objectively. Skills in applying principles were assessed and students also learnt at the same time.

35. All students could be assessed within 90 minutes, which was less than the time taken for traditional practical examination (3 hrs ). Students were provided opportunity to apply principles, interpret data and effective time management was provided, several skills were assessed at the same time. It was student-centered approach.

36. DISADVANTAGES Knowledge and skills tested in COMPARTMENTS , not for ability to look at the patient as a whole. Can combine with traditional type ‘Long Case’ to overcome. DEMANDING for examiners and patients – use more patients/ simulated patient. TIME taken for planning in advance greater than traditional examination. More effort and time are required before examination. Can reduce with a ) Experience and b) Bank of objective test items & checklist .

37. BIBLIOGRAPHY Elakkuvana Bhaskara Raj.D , “Text Book of Nursing Education ” EMMESS Medical Publishers , Second Edition,2015, Page No: 266 to 269 2. R Sudha , “Principles and Concepts of Nursing Education ” Jaypee Brothers Medical Publishers(p)LTD, First Edition,2013, Page No:181 to 188 3. www.slideshare.com