INTRODUCTION
Testing, measurement, and evaluation play an important
role in all educational institutions, including nursing educational
institutions. Evaluation tool have far reaching consequences for students in
their success or failure, consequently educators have the responsibility for
development of testing devices or procedures that fairly evaluates student’s
achievements and yields accurate results. The traditional system of practical
examination in nursing education consists of either assigning a procedure to a
student or patient for identifying the needs on a priority basis for giving
care. This depends upon student’s ability and availability of the patient for a
particular procedure. In spite of the innovations in the mode of evaluation of
student’s performance, the importance of conventional system of practical
examination can not be denied.
DEFINITION
Objective Structured
Practical Examination (OSPE) is a new pattern of practical examination. In OSPE
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. Nursing Path
Through OSPE one gets a
reasonable idea of the extent of achievement of each student in every practical
skill related to a particular discipline. It can be used for formative and
summative evaluation.
CHARACTERISTICS
- Objective: Because examiners use a checklist for evaluating the trainees.
- Structured: Because every trainee sees the same problem and performs the same tasks in the same time frame. Nursing Path
- Clinical: Because the tasks are representative of those found in real clinical situations.
- An examination.
PURPOSE
- Provide feedback on performance.
- Evaluate on the basis of clinical skills.
- Measures minimal competencies.
STEPS TO ORGANIZE AN OSPE
In order to organize an
OSPE one has to set objectives of practical experiences in a given discipline
related to a particular subject such as practical examination in medical
surgical nursing each student is supported to,
1. Demonstrate
practical skills: this may be done by assisting a student to,
a. Monitor
and record oral temperature.
b. Convert
39 degree to F.
c. Attach
a heart monitor to a patient. Nursing
Path
d. Test
urine for sugar.
e. Start
an IV drip on a patient.
2. Make correct and accurate observations:
this may be done by assigning a student to,
a. Interpret
type of fever from the given graph.
b. Identify
the type of arrhythmia from the ECG graph provided.
c. Differentiate
between normal and abnormal ECG.
These questions may not
require the examiners to observe the student in action. These questions can be
answered on a paper which can be collected later for evaluation.
3. Analysis and interpret data: this is one
of the important skill components to be judged for the continuity of patient
care. The nurse has to perform this task where she may come across normal and
abnormal data in relation to patient’s investigation reports. The student asked
to interpret,
a. Hamogram:
normal or abnormal.
b. Liver
function test reports. Nursing
Path
c. Renal
function test reports.
d. Laboratory
reports.
1. Identify patients problems: in order to
organize her work the nurse has to identify the patient’s problems and set
priority so as to clear to the immediate needs of the patient, such as to
identify,
a. Dyspnoea
on the basis of her observations.
b. Rigor
following blood transfusion.
c. Coning
following lumbar puncture. Nursing
Path
d. CSF
Rhinorrhea following head injury.
2. Plan of alternative nursing
interventions in a given situation: in order to provide need based care the
nurse plan’s alternative nursing interventions, as in case of air way
obstruction the student nurse is expected to,
a. Keep
the patient in side lying position.
b. Do
oropharyngeal suction.
c. Check
and record vital signs.
d. Start
oxygen inhalation if required. Nursing
Path
e. Keep
the things ready for endotracheal intubation.
f. Assist
the doctor in intubating the patient.
In order to assess certain
practical skills, the OSPE is organized in the form of several stations through
which the candidate rotate to complete one full round.
TYPES OF STATIONS
Sl No.
|
Stations
|
Question
|
Method of
scoring
|
1
|
Procedure
station
|
Check
and record BP
|
Observed
and scored by the examiner A using checklist
|
2
|
Question
station
|
List
5 factors which help in maintaining BP
|
Answer
on a sheet provided
|
3
|
Procedure
station
|
Take
oral temperature and record it
|
Observed
and scored by the examiner B
|
4
|
Question
station
|
Convert
39 degree C to F by using formula
|
Answer
on a sheet provided
|
5
|
Procedure
station
|
Test
the urine albumin and record it
|
Observed
and scored by the examiner C
|
6
|
Question
station
|
List
5 causes of albuminuria Nursing Path
|
Answer
on a sheet provided
|
HOW TO SCORE STUDENTS IN OSPE?
- For each specific skill, a checklist is prepared by breaking the skill being tested into essential steps and scores is assigned to each step which is proportional to the importance of the steps related to a particular procedure.
- The objectivity in assessment is achieved by getting each component tested at one particular station by the same examiner and have the students rotate through all the students.
- The time allowed is same for all the stations 3-5 minutes is the length of time allocated to each station.
ADVANTAGES
- Helps us to observe and assess student for different professional and clinical skills.
- Enables us to have an overall view of the student’s performance.
- Simulations of real life situations.
- Controlled and safe. Nursing Path
- Feedback from actors (simulators).
- Ready availability when required.
- Stations can be tailored to level of skill to be assessed.
- Scenarios that are distressing to real patients can be simulated.
DISADVANTAGES
- It is subjective as the student’s score depends on the whims, fancies and moods of the examiner.
- It is time consuming and there is a lack of standardized conditions in bedside which affects student’s score.
- The idealized ‘textbook’ scenarios may not mimic real life situation.
- May not allow assessment of complex skills.
- Cost.
- Training issues in setting up the stations.
STUDENT'S INSTRUCTION REGARDING OSPE
- Write your roll no. in bold figures and display it on your white coat so that the examiner can identify the candidate.
- Student’s are asked to report at a particular time, all of them are collected in a room or hall and explained the procedure of examination. Nursing Path
- Student’s may be given instructions that they will rotate around station (numbered 1 – 6) spending 3 minutes at each station.
CONCLUSION
Because OSCE have been
shown to be feasible and have good reliability and validity, their use has
become widespread as the standard for performance based assessment,
particularly an undergraduate examinations.
REFERENCE
- CB Gupta, PRINCIPLES AND PRACTICE OF MANAGEMENT 4th Edition, National Publishing House, New Delhi, PP 313 – 330
- Aggarwal JC, EDUCATION VOCATIONAL GUIDANCE AND COUNSELING, 8th Edition, Doaba House, New Delhi, 1998, Chapter – 23 PP 257 – 277
- Best W John and Khan V James, RESEARCH IN EDUCATION, 7th Edition, Ashok Ghosh, Printers in all of India Pvt. Ltd., New Delhi, 2002, PP 25 – 26, 106 – 107
- George K Aleyamma, PRINCIPLES OF CURICULUM DEVELOPMENT AND EVALUATION, Vivekananda Press, Nammakkal District, Tamil Nadu, 2002, Chapter – 5, Evaluation, PP 120 – 190
- Heidgerhen H Loietta, Teaching and Learning in School of Nursing, PRINCIPLES AND METHOD, 3rd Edition, Konark Publish Pvt. Ltd., New Delhi, 1994, PP 629 – 668
- Lancastie Jeanetle, NURSING ISSUES AND MANAGING CHANGE, Sally, Schrefer, Mosby Publications, 1999, Evaluation Program, PP 496 – 502
- Coon L Nancy, WISE MODEL LEADING AND MANAGING IN NURSING, Mosby Publication, Missouri, 1995, PP 200 – 201
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