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A Comparative Study to assess the Opinion and Level of Satisfaction of the

Student Nurses regarding Objective Structured Clinical Examination (OSCE)
and Traditional Method of Clini...

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Research Article
A Comparative Study to assess the Opinion and
Level of Satisfaction of the Student Nurses regarding
Objective Structured Clinical Examination (OSCE)
and Traditional Method of Clinical Skills Assessment
related to Antenatal Examination
Ritu Soni1, Seema Rani2, Somibala Thokchom3, Shilpi Sarkar4
Abstract
Objective: The objective of the study was to assess and compare the opinion and level of satisfaction
of student nurses regarding objective structured clinical examination (OSCE) and traditional method of
clinical skills assessment.

Methodology: By using a comparative descriptive design, the study was conducted in the Rufaida College
of Nursing and National Skills Training Centre-DAKSH, Delhi. A total of 68 student nurses were selected
using purposive sampling technique and were randomly divided into OSCE group (n1=34) and traditional
group (n2=34). Self-structured observation checklist and evaluation proforma were used to obtain the
skills score of OSCE and traditional method respectively. Opinionnaire and satisfaction scale were used
to assess the opinion and satisfaction of the subjects regarding OSCE and traditional method of clinical
skills assessment.

Result: Findings revealed that the mean skills scores of OSCE group (56.67) were higher than the traditional
group (35.40) with (z=39.09, p<0.05). Other findings showed that both the groups were having positive
opinion 33 (97%), 31 (91%) and highest level of satisfaction 33 (97%), 32 (94%) regarding OSCE and
traditional method respectively.

Conclusion: There was no significant difference in the opinion and satisfaction scores among the students
related to OSCE and traditional method of clinical skills, although students scored higher when evaluated
by OSCE than traditional method.

Keywords: Clinical skills, OSCE method, Traditional method, Antenatal examination, Student nurses
Introduction
Evaluating students’ clinical performance is one of the most challenging responsibilities of a nursing instructor. However,
the realization that students gain various incomparable experiences clinically present a dilemma in measuring both
individual and program outcomes. It is therefore evident that a wide range of evaluative methods are necessary to assess
1
MSc. Nursing Student, 2 Assistant Professor, 3,4Tutor, Rufaida College of Nursing, Jamia Hamdard.

Correspondence: Ms. Ritu Soni, Rufaida College of Nursing, Jamia Hamdard.

E-mail Id: [email protected]

Orcid Id: http://orcid.org/0000-0002-7699-9311

How to cite this article: Soni R, Rani S, Thokchom S el al. A Comparative Study to assess the Opinion and Level of Satisfaction of
the Student Nurses regarding Objective Structured Clinical Examination (OSCE) and Traditional Method of Clinical Skills Assessment
related to Antenatal Examination. Int J Nurs Midwif Res 2017; 4(2): 9-12.

Digital Object Identifier (DOI): 10.24321/2455.9318.201711

ISSN: 2455-9318

© ADR Journals 2017. All Rights Reserved.

Soni R et al. Int. J. Nurs. Midwif. Res. 2017; 4(2)

student nurse’s clinical competence and greater emphasis Objectives of the Study
should be placed on those methods which encourage
the learning of clinical skills and concurrently provide an The objectives of the study were:
appropriate mechanism for assessing them.1
• To assess the clinical skills scores of student nurses by
Proper selection of a method of assessment can improve OSCE and traditional method of assessment related
student’s performance. Faulty methods of assessment to antenatal examination
can lead to wrong decisions that might be deleterious • To assess and compare the student nurses’ opinion
to the future activities of the students. Thus assessment about assessment by OSCE and traditional method
techniques appear to have an impact on study strategies and related to antenatal examination
to influence the performance of students. Nursing student’s • To assess and compare the student nurses’ level
perception of clinical competencies can be measured using of satisfaction regarding assessment by OSCE and
a variety of methods like written case studies, record of traditional method related to antenatal examination
performance, different types of simulations, essays, and
objective structured clinical examination.2 Methods and Material

OSCE is an acronym for Objective Structured Clinical The samples for the present study comprised of 68 B.Sc.
Examination. OSCE was developed in the University of (Hons) final year and P.B.B.Sc. final year student nurses
Dundee in the early 1970s and later introduced by Dr. of Rufaida College of Nursing, Jamia Hamdard, who have
Ronald Harden and his colleagues in 1975. After some undergone maternal and child healthcare skills training at
modification, it was described in detail in 1979.3 It is a National Skills Training Centre – “DAKSH”, Jamia Hamdard,
form of assessment in which the student demonstrates and had been taught antenatal examination. The subjects
clinical skills and underpinning knowledge, usually in were selected using total enumeration sampling technique
simulated condition, which includes several “stations” in and were randomly allocated into OSCE (34) and traditional
which examinees are expected to perform specific clinical group (34) using the lottery method. The tool was prepared
tasks within a specified time period (5–30 min).4 by reviewing various literatures. The tool comprised of
the following:
Within the traditional practical exams for evaluating
student’s clinical performance, a student is assigned to Part-I: Participant information sheet
an examiner who would observe her/his performance for
It consists of four items, i.e., age in years, gender, previous
the entire examination when providing nursing care to a
marks in years and course.
patient in the clinical area.5
Part-II: It consists of four tools.
Amiri and Nickbakht7 conducted a study on satisfaction of
students, faculty members and tutors in 2012. The purpose Tool-1: Observational checklist to assess clinical skills by
of the study was to investigate students’ and examiners’ OSCE method. It consists of 6 stations, hand washing, weight
opinions about the audiology exam in Iran on 52 people monitoring and recording, blood pressure monitoring, urine
including students and faculty members. The test was testing for albumin and sugar, hemoglobin estimation and
divided into 10 sections and data was collected through a abdominal palpation and auscultation respectively.
questionnaire after they participated in the test section.
The findings of the study revealed that the majority of the Tool-2: Evaluation proforma to assess clinical skills by
students and examiners preferred OSCE than conventional traditional method. It consists of 12 items.
method. Highest satisfaction in both the groups was related
to the equipment and the lowest satisfaction was related Tool-3: Structured opinionnaire to determine the opinion
to the time allotted to each test section. of the subjects regarding assessment of clinical skills by
OSCE and traditional method. It consists of 20 items, each
Written test assesses only student’s cognitive ability and with five alternative responses as strongly agree, agree,
cannot evaluate the student’s actual behavior in clinical neutral, disagree and strongly disagree.
setting. OSCE is one of the best methods for student
evaluation. It emphasizes on learning practical skills Tool-4: Satisfaction scale to determine the level of
rather than the acquisition from books and notes of large satisfaction of the subjects regarding assessment of clinical
volumes of factual information and as such provides a skills by OSCE and traditional method. It consists of 14 items
suitable tool for improvement of undergraduate education each with five alternative responses as highly satisfied,
in nursing. Therefore, there is an imperative need to adopt moderately satisfied, neutral, less satisfied and unsatisfied.
implementing it and taking into consideration studying The tool was found to be valid with few corrections,
students’ satisfaction with it in addition to assessing their which were duly incorporated and final draft of the tool
clinical performance.6 was prepared. After obtaining formal approval from the

ISSN: 2455-9318 10
Int. J. Nurs. Midwif. Res. 2017; 4(2) Soni R et al.

concerned authority, the pilot study was conducted in descriptive and inferential statistical methods. Descriptive
Rufaida College of Nursing, and National Skills Training statistics mean, percentage, frequency were used whereas
Centre – “DAKSH”, Jamia Hamdard, New Delhi, on eight inferential statistics Fisher exact test, Chi-square test and
DGNM interns. Clinical skills of the OSCE and traditional Z test were used. p value less than 0.05 was considered
group were assessed through observational checklist and as statistically significant.
evaluation proforma. Opinion and level of satisfaction
regarding the OSCE and traditional method of assessment Results
were assessed through the opinionnaire and satisfaction
Data presented in Tables 1, 2 and 3 shows that mean clinical
scale. The findings of the pilot study suggested that it was
skill score of study participants in OSCE (56.67) was higher
feasible to conduct the study. Thirty-four student nurses
than the traditional group (35.40). The calculated ‘Z’ value
were assigned to each group who had undergone skill
(39.09) was more than the table value of Z=1.96 at 0.05
lab training at National Skills Training Centre – DAKSH
level of significance, which indicated that there was a
and had been taught antenatal examination at Rufaida
significant difference between mean clinical skill scores of
College of Nursing, New Delhi, selected using purposive
OSCE and traditional group. In OSCE group 33 (97.1%) study
sampling technique. Informed consent was taken from the
participants had positive opinion and 1 (2.94%) was having
study participants for participation in the study. Each study
negative opinion whereas in traditional group, 31 (91.17%)
participant was given individual code number. Participant
had positive opinion and 3 (8.8%) were having negative
information sheet was filled by the study participants. In
opinion. There was no significant difference between the
the first two weeks, clinical skills of Group 1 were assessed
opinion score of the study participants. Regarding level of
by OSCE and Group 2 was assessed by the traditional
satisfaction in OSCE group, 33 (97.1%) study participants
method of assessment by using structured checklist and
were satisfied and 1 (2.94%) was unsatisfied whereas in
evaluation proforma, respectively. In the third week, study
traditional group 32 (94.11%) were satisfied and 2 (5.88%)
participants were asked to fill the structured opinionnaire
were unsatisfied. To compare the level of satisfaction,
and satisfaction scale to assess the opinion and level of
Fisher’s exact test was applied and p-value was calculated
satisfaction regarding OSCE and traditional method.
as 0.834, which is more than 0.05 level of significance. This
Comparison was done between both the groups’ opinion
shows that there was no significant difference between
and level of satisfaction regarding OSCE and traditional
the level of satisfaction of the study participants of both
method of assessment. The data was analyzed using
the groups.
Table 1.Mean, Standard Deviation, Mean Difference, and ‘Z’ Value of Clinical Skills Scores of Student
Nurses in OSCE and Traditional Group Related to Antenatal Examination
n1+n2=68
Group Possible Obtained Mean S.D. Mean ‘Z’ Test p-value
Range of Score Range of Scores Score Difference Value
OSCE group 0–60 50–60 56.67 2.28 21.27 39.09 0.0001*
Traditional group 0–60 30–40 35.40 2.22
Z(66)=1.96, *p<0.05, (Significant at 0.05 level of significance)

Table 2.Comparison of Frequency and Percentage of Student Nurses Related to

Opinion regarding OSCE and Traditional Method
n1+n2=68
Category Possible Range OSCE group Traditional Group Test Used p-value
of Score Frequency % Frequency %
Positive opinion 60–100 33 97.1 31 91.17 Fisher 0.834
Negative opinion 20–60 1 2.94 3 8.8 exact test Not significant
Table 3.Comparison of Frequency and Percentage Distribution of Student Nurses
related to Level of Satisfaction regarding OSCE and Traditional Method
n1+n2=68
Category Possible Range OSCE Group Traditional Group Test Used p-value
of Score Frequency % Frequency %
Satisfied 43–70 33 97.1 32 94.11 Fisher exact 0.3337 Not
Unsatisfied 14–42 1 2.94 2 5.88 test significant

Discussion significant difference between the mean clinical skills

scores (56.67) of OSCE group and (35.4) of traditional
In the present study, findings showed that there was a group, i.e., scores of the study participants of OSCE group

11 ISSN: 2455-9318
Soni R et al. Int. J. Nurs. Midwif. Res. 2017; 4(2)

were higher than the traditional group. Consistent to the Conflict of Interest: None
present study, Eldarir et al.3 found in their study that there
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Date of Submission: 2017-06-27
examination. Study participants’ opinion and satisfaction
scores might have been influenced by Hawthorne effect. Date of Acceptance: 2017-08-05

ISSN: 2455-9318 12

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