The Effects of Task Characteristics and Cognitive Loading on Clinical Examination Performance in Nursing Students

Friday, 28 July 2017

Hsiang-Chu Pai, PhD, RN
Department of Nursing, Chung-Shan Medical University; Chung-Shan Medical University Hospital, Taichung, Taiwan


The integration and education and practice has received wide attention in the nursing profession. In this regard, the objective structured clinical examination (OSCE) is being increasingly used with students in nursing programs in Taiwan before they enter clinical practice in hospitals. Most studies, however, examine OSCE’s advantage, while few focus on the impact of task characteristics and the relationship between task characteristics, task cognitive loading, and skill performance for the OSCE. The purpose of this study was to examine the task characteristics of and cognitive loading that occurs during OSCE administration among third-year nursing students who are seeking a baccalaureate in nursing and to explore the association between the task characteristics, cognitive loading, and clinical examination performance.


A correlation study design was employed. A total of 118 nursing students who sat for the clinical examination were recruited. The data were collected in January 2015. Students’ ages ranged from 21 to 31, and the mean age was 21.68 (SD =1.23). The majority of students were female (78.05 %).The measures included task characteristic, task cognitive loading, and skill performance scores. The structural equation modeling (SEM) approach with partial least squares (PLS) was used in the data analysis.


The results of this study indicated that students perceived the top dimensions of the task characteristics of the OSCE was “task significance”. Further, “task identity and feedback from job” and “task autonomy” had a significant negative effect on task cognitive loading (β = -0.14; β = ‑0.18, p < .05), respectively. In contrast, “task variety and significance” had a significant positive effect on cognitive loading (β = 0.20, p < .01), and cognitive loading had a significant negative effect on student’s OSCE performance score (β = -0.25, p < .001).


We found that increased task variety and significance and reduced task autonomy, task identity, and feedback during OSCE were associated with increased task cognitive load, which, in turn, reduces OSCE performance. This study demonstrated that task cognitive loading plays an important role between students’ perceived task characteristics and performance during the OSCE. We suggest that skill examination begin with the presentation of a simple strategy (low element interactivity) and gradually work up to more complex tasks