Implementation of a Formative Objective Structured Clinical Exam to assess self evaluation in a rural BSN-DNP program

Abstract

Background and objective: The role of self-assessment in competency-based education has been controversial. The Objective Structured Clinical Exam (OSCE) has been used to assess competencies across the health professions. However, exploring the role of the OSCE as a method of self-assessment for nursing students has been limited. Objective: Implementation of a low cost pilot OSCE in a rural BSN-DNP program to explore graduate nursing students perceived self-evaluation of competencies to their actual OSCE performance.

Methods: Eight students enrolled in a small, rural Bachelor of Science and Nursing to Doctorate of Nursing Practice (BSN-DNP) program in the Family Nurse Practitioner (FNP) specialty track were required to complete an OSCE. Graduate students participating in the OSCE completed a Self-Assessment of Competency questionnaire prior to performing the OSCE and the results were compared to their actual performance on the OSCE. Using available resources, undergraduate students in the BSN program at the institution were utilized as standardized patients.

Results: Students perceived self-assessment of competence rated higher than their actual performance in subjective and objective data collection and implementation of a plan. Students’ actual performance was superior to their perceived self-assessment regarding communication with the patient.

Conclusions: Without competency-based self-assessments, students can be unaware of their strengths and weaknesses. The OSCE is an instrument that provides faculty and students with objective measures of self-evaluation and should be considered as a component of competency-based education in rural nursing institutions.