PRIMER CASO

47 International Journal of Psychiatric Nursing. July-December 2015. Vol.1, No. 2

Objective Structured Practical Examination as a Tool for

49 International Journal of Psychiatric Nursing. July-December 2015. Vol.1, No. 2 International Journal of Psychiatric Nursing. July-December 2015. Vol.1, No. 2 50

INTRODUCTION

The teaching and learning of medical students has always been a complicated process, At times even the best of teachers may struggle in communicating knowledge and assessing its uptake. Assessment of gained knowledge is probably more diffi cult than delivering it. Assessment of clinical skills is far more important and complex as it directly link with patients care. The aim of this paper is to review the impact of OSPE on students learning i.e. OSPE as a learning tool.¹

OSPE replaced the table viva in the oral and clinical examinations. OSPE, as an assessment tool is not implemented in all institutions in India.

Following the introduction of OSPE it has become the major part of the practical examinations in each class, from fi rst year to fi nal year undergraduate and post graduate. The aim of OSPE is to make practical examinations fair, objective and standardized in line with Best Evidence Medical Education (BEME) and the local needs. Objectives of OSPE: 1.To test factual knowledge.2.To assess the clinical competence.3.To demonstrate common sense.4. To asses analytical thinking and communication.²

OSPE comprises of numerous short duration stations where the students are tested for various clinical skills, knowledge and a� itude in an objective fashion. In this way almost all areas of the syllabus are covered. This format of assessment leads to the organized and structured experience of the students to a wide range of diff erent clinical skills in a relatively shorter time period. It is designed to expose the candidates to a greater number of examiners and topics and also to reduce the eff ect that any one examiner has on the candidate’s score, thus making the system more structured and organized. It gives them a clear idea of their strengths and weaknesses in various aspects of the subject.³

Problem statement

“A study to assess the Objective structured practical examination as a tool for the formative assessment of practical skill: Nursing students Perception in a selected institute, Sirohi, Rajasthan”

OBJECTIVES

1. To determine the nursing students perception

of OSPE

Review of literature

A study was conducted on Objective structured practical examination as a tool for the formative assessment of practical skills of undergraduate students in pharmacology. This study a� empt to evaluate the feasibility of using OSPE as a tool for the formative assessment of undergraduate medical education in pharmacology. Students of second year MBBS, at the end of the fi rst term, were assessed by both the conventional practical examination and the Objective Structured Practical Examination (OSPE). A fi ve-station OSPE was conducted one week after the conventional examination. Perceptions of students regarding the new method were obtained using a questionnaire. The study result shows that There was no signifi cant diff erence in the mean scores between the two methods (P = 0.44) using the unpaired t test. The Bland Altman plot comparing the CPE (conventional practical examination) with the OSPE showed that 96% of the diff erences in the scores between OSPE and CPE were within the acceptable limit of 1.96 SD. Regarding the students’ perceptions of OSPE compared to CPE, 73% responded that OSPE could partially or completely replace CPE. OSPE was judged as an objective and unbiased test as compared to CPE, by 66.4% of the students.Finally study concluded that use of OSPE is feasible for formative assessment in the undergraduate pharmacology curriculum.³

A study was conducted on Objective structured practical examination in biochemistry: An experience in Medical College, Kolkata.the objectives of the study were to introduce OSPE as a method of assessment of practical skills and learning and to determine student satisfaction regarding the OSPE. Furthermore, to explore the faculty perception of OSPE as a learning and assessment tool. The fi rst M.B.B.S students of 2011- 12 batch of Medical College, Kolkata, were the subjects for the study. OSPE was organized and conducted on “Identifi cation of Unknown Abnormal Constituents in Urine.” Coeffi cient of reliability of questions administered was done by calculating Cronbach’s alpha. A questionnaire on various components of the OSPE was administered to get the feedback.result shows that 16 students failed to achieve an average of 50% or above in the assessment.

49 International Journal of Psychiatric Nursing. July-December 2015. Vol.1, No. 2 International Journal of Psychiatric Nursing. July-December 2015. Vol.1, No. 2 50

However, 49 students on an average achieved >75%, 52 students achieved between 65% and 75%, and 29 students scored between 50% and 65%. Cronbach’s alpha of the questions administered showed to be having high internal consistency with a score of 0.80.

Ninety nine percent of students believed that OSPE helps them to improve and 81% felt that this type of assessment fi ts in as both learning and evaluation tools. Faculty feedback refl ected that such assessment tested objectivity, measured practical skills be� er, and eliminated examiner bias to a greater extent. Finally study concludes that OSPE tests diff erent desired components of competence be� er and eliminated examiner bias. Student feedback refl ects that such assessment helps them to improve as it is eff ective both as teaching and evaluation tools.⁴

MATERIAL & METHODS

A descriptive survey approach was adopted to determine the nursing students perception of OSPE a sample of 60 1^st and 2^nd year B.Sc nursing students of Shri U S B college of nursing were selected by using non probability purposive sampling technique. The data collection was done after the approval from the institutional ethical commi� ee and the wri� en informed consent from the participants. The data was collected in two phases.

In phase 1: The students participating in the study were introduced to OSPE system by a short lecture and orientation programme was organized for faculty members participating in the study as observes. A total of 60 students were divided in to 6 groups of 10 in each, examined by 4 examiners for 2 consecutive practical days. structured checklist (answer key) for observed and unobserved was prepared along with examiners and students. And students instruction manual all validated by senior faculty members.

For the OSPE students were oriented by OSPE map and a wri� en instruction list before the start of the examination.

After the initial orientation students were exposed to the OSPE stations consisting of 5 stations on intravenous cannulation, two observed staions 2 unobserved station and one rest station of 3 to 6 minutes each arranged in the medical surgical laboratory in a clockwise manner he station were as follows. Station 1: (unobserved) sites of

intravenous cannulation (3 min), station 2: (observed) identifi cation of the sites of the cannula (3 min).

station 3: (unobserved) complication of intravenous cannulation (3 min)station 4 : (Rest station) station 5 : (observed) intravenous procedure demonstration (6 min).Marks were allo� ed for each station except for rest station.

In phase II: At the end of OSPE session data on students perception on OSPE were collected by using self administered structured checklist consisting of 5 broad based themes as

(1) Information received on OSPE (2) Atmosphere of OSPE (3) Arrangement of Stations of OSPE (4) Conduction of examination (5) Over all view on OSPE with 27 items.

At the end of the questionnaire, an open ended question was asked to elicit their opinions regarding this assessment method. The tool was validated by 3 experts in the fi eld of nursing education. In the check list, the students were instructured to tick mark the best response o the 27 statements either agree or disagree. Each agree carried a score 1 (one) and each disagree carried a score 0 (zero).the participation was voluntary and anonymous. The students were assumed that no action will be taken against them if they wish not to answer to the questionaire.The students were instructured to reply to their own answer sheet without any discussion with the peers.

Frequencies and percentages were used to analyze and interpret the data.

FINDINGS

All the 60 students (100%) participated in the study

Section1: students over all perception on OSPE in 5 broad areas N=60

Figure :1 depicts that majority of the students (90%) agreed on the overall arrangement of stations of OSPE.89% of the students agreed on overall conduction of examination and 89% also showed

51 International Journal of Psychiatric Nursing. July-December 2015. Vol.1, No. 2 International Journal of Psychiatric Nursing. July-December 2015. Vol.1, No. 2 52

positive response on overall view on OSPE. Majority of the students (87%) showed positive responses on overall view on OSPE. 79% of the students had positive responses on overall atmosphere of OSPE.

Section II : students perception on OSPE on