OBJECTIVE STRUCTURED PRACTICAL EXAMINATION (OSPE)


 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?
  1. 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.
  2. 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.
  3. The time allowed is same for all the stations 3-5 minutes is the length of time allocated to each station.

ADVANTAGES
  1. Helps us to observe and assess student for different professional and clinical skills.
  2. Enables us to have an overall view of the student’s performance.
  3. Simulations of real life situations.
  4.  Controlled and safe.   Nursing Path
  5. Feedback from actors (simulators).
  6. Ready availability when required.
  7. Stations can be tailored to level of skill to be assessed.
  8. Scenarios that are distressing to real patients can be simulated.

DISADVANTAGES
  1. It is subjective as the student’s score depends on the whims, fancies and moods of the examiner.
  2. It is time consuming and there is a lack of standardized conditions in bedside which affects student’s score.
  3. The idealized ‘textbook’ scenarios may not mimic real life situation.
  4. May not allow assessment of complex skills.
  5. Cost.
  6. Training issues in setting up the stations.

STUDENT'S INSTRUCTION REGARDING OSPE
  1. Write your roll no. in bold figures and display it on your white coat so that the examiner can identify the candidate.
  2. 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
  3. 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
  1. CB Gupta, PRINCIPLES AND PRACTICE OF MANAGEMENT 4th Edition, National Publishing House, New Delhi, PP 313 – 330
  2. Aggarwal JC, EDUCATION VOCATIONAL GUIDANCE AND COUNSELING, 8th Edition, Doaba House, New Delhi, 1998, Chapter – 23  PP 257 – 277
  3. 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
  4. George K Aleyamma, PRINCIPLES OF CURICULUM DEVELOPMENT AND EVALUATION, Vivekananda Press, Nammakkal District, Tamil Nadu, 2002, Chapter – 5, Evaluation, PP 120 – 190
  5. 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
  6. Lancastie Jeanetle, NURSING ISSUES AND MANAGING CHANGE, Sally, Schrefer, Mosby Publications, 1999, Evaluation Program, PP 496 – 502
  7. Coon L Nancy, WISE MODEL LEADING AND MANAGING IN NURSING,  Mosby Publication, Missouri, 1995, PP 200 – 201


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