Objective Structured Clinical Examinations (OSCEs) are widely used in Advanced Practice Registered Nursing Graduate Programs and are recognized as a reliable and valid method to assess clinical (Aronowitz, et al, 2017; Miller & Carr, 2016; Mitchell, et. al, 2015). While the OSCE has generally been accepted by faculty members as a performance-based assessment, it is often poorly accepted by students. Use of OSCE in undergraduate programs is well documented; its use in graduate programs is less documented. For graduate students the use of OSCEs involves patient scenarios which require complex clinical reasoning skills, advanced practice knowledge and skills, and interpersonal/communication skills. Successful completion requires proficiency in multiple areas, including the ability to complete a thorough health assessment, advanced physical assessment skills, advanced pharmacology knowledge, interpretation of diagnostic tests, diagnostic reasoning skills, establishment of an evidenced-based treatment plan, effective teaching, and the ability to document the assessment and plan. Despite its acceptance as a reliable and valid clinical evaluative method, the most frequently cited disadvantage of the OSCE is student anxiety and is known to produce higher levels of stress and anxiety among students when compared to more traditional forms of testing. The aim of this project was to examine the differences in student self-reported anxiety levels and clinical competencies for OSCE mastery as students progressed through the final three semesters in a family nurse practitioner program.
Methods:
The project examined three consecutive retrospective clinical reflection student assignments at 30 minutes prior, during, after, and following debriefing to determine students’ self-perceived anxiety levels. In addition students assessed their self-perceived clinical competency.
The descriptive study utilized a convenience sample of 72 subjects including both males and females. Data was analyzed using SPSS and the Friedman’s test that is a non-parametric test looping within groups to test differences in ranks of scores on 3+ related groups using nominal and ordinal data. Through utilization of Benner’s Novice to Expert Theory (1982), our hypothesis was that student OSCE anxiety would decrease and self-reported competency scores would increase each semester during their final year in a family nurse practitioner program.
Results:
Through utilization of Benner’s Novice to Expert Theory (1982), our hypothesis that student OSCE anxiety would decrease and self-reported competency scores would increase each semester during their final year in a family nurse practitioner program was on target.
Conclusion:
Results from this study add to the body of reported evidence on self-perceived student OSCE anxiety and clinical competency. Through dissemination of this project, faculty utilizing OSCEs as an evaluative process will have an understanding of student self-reported anxiety and clinical competency to provide optimal learning opportunities.