Professional Documents
Culture Documents
e-ISSN: 23201959.p- ISSN: 23201940 Volume 4, Issue 6 Ver. IV (Nov. - Dec. 2015), PP 01-12
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Prof. of Community health nursing Department, Faculty of Nursing/ Menoufia University, Egypt
lecturer of Community health nursing Department, Faculty of Nursing/ Menoufia University, Egypt
Abstract
Background: Objective Structured Clinical Examination has gained acceptance as a benchmark for clinical
skills assessment. The aim of this study was to examine the efficacy of Objective Structured Clinical
Examination tool for improving B.Sc. nursing students' antenatal examination.
Methods: Subjects: All "70" B. Sc. nursing students in the fourth year, faculty of nursing Menoufia University,
Egypt was included in the sample. Instruments: It consisted of a structured interviewing questionnaire and
observational checklist, which consisted of 5 Objective Structured Clinical Examination stations including
antenatal history-taking, general examination, standardized blood pressure measurement technique skills,
standardized body weight measurement technique skills and antenatal advice skills. All tools were used for prepost intervention.
Results: The study showed that there was statistical significant improvement in final B. Sc. nursing students'
antenatal examination practices skills in posttest than pretest. Also, there was statistical significant improvement
in Objective Structured Clinical Examination station regarding vital signs after intervention.
Conclusion: implementation of Objective Structured Clinical Examination tool has succeeded in achieving
significant improvement in final B. Sc. nursing students' antenatal examination practices skills.
Recommendations: implementation of Objective Structured Clinical Examination tool through teachingassisted videos for all clinical skills.
Keywords: Antenatal examination, Nursing, Objective Structured Clinical Examination
I. Introduction
Objective Structured Clinical Examination (OSCE) was first introduced by Harden and Gleeson into
medical education in Scotland in 1975 [1]. Objective Structured Clinical Examination (OSCE) is a modern type
of evaluation and often used in medical sciences to measure clinical skills such as communication, clinical
examination, medical procedures / prescriptions / techniques, and interpretation of results [2]. The method that
has used in many psychiatric and other clinical centers worldwide [3-5] has shown a credible validity and
reliability [6].
OSCE normally consists of several short stations, in which each examinee is examined on a one-to-one
basis with one or several examiner(s) and either real or simulated patients, computer simulators [7], moulages
[8] or videos [9]. Students have a fear of being overwhelmed by a lack of experience. Their anxiety level
influences their decision-making, which is directly related to clinical judgment. High student anxiety can lead to
decreased student learning. In addition, when students lack confidence in their ability to complete a nursing
skill, they focus on their feelings of anxiety in not knowing what to do or their concern that they will make a
mistake. The fear of making mistakes is the highest anxiety-producing situation for both junior and senior-level
students [10].
OSCE clinical skills are tested and then practiced repeatedly until one perfects the skill. Candidates
rotate through stations, completing all stations in their circuit. It is considered an improvement over traditional
examination methods because the stations can be standardized, fairer peer comparison and complex procedures
can be assessed without endangering patients health [11]. Antenatal care (ANC) is recognized as a key maternal
service in improving a wide range of health outcomes for women and children. It provides an opportunity to
provide interventions for improving maternal nutrition, to encourage skilled attendance at birth and use of
facilities for emergency obstetric care [12&13].
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V. Methods
5.1. Research Design: Quasi-experimental design (one group pre test post test design) was used to achieve the
aim of the study.
5.2. Research Setting: The study was conducted at Community Health Nursing department, faculty of nursing,
Menoufia University, Egypt.
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VI. Results
Table (1): Antenatal History Taking OSCE Station Items Mean Total Score among studied students
before and after intervention
Antenatal History Taking OSCE Station Items Checklists
Getting ready
Setting the stage for the interview
Obtaining the agenda and chief concern
History Personal Information
Medical and Surgical History
Family History
Daily Habits and Life style (first visit)
Obstetric History
Menstrual and Contraceptive History (First Visit)
Present Pregnancy (First Visit)
Danger Signs and Recording
14.796
0.000
14.197
12.563
12.390
15.455
17.319
10.269
8.292
12.907
14.969
0.001
1.000*
0.001
0.001
0.001
0.001
0.001
0.001
0.001
0.001
0.001
*Not Significant
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0.965
6.730
17.208
8.235
9.752
12.553
11.722
0.338*
0.001
0.001
0.001
0.001
0.001
0.001
*Not Significant
Table (2) demonstrated OSCE station items related to general examination mean total score among studied
students before and after intervention. As noticed from the table, there was statistical significant improvement in
OSCE station regarding vital signs check respiration, assessment of general well-being, look for pallor, look for
signs of jaundice, head examination and neck examination and check for edema of the studied students after
intervention (9.46+1.58, 26.49+5.07, 13.80+2.42, 8.57+2.55, 22.51+3.87and 14.10+1.87 respectively) compared
with (6.60+3.15, 8.59+6.90, 8.69+4.25, 3.80+2.87, 11.70+6.72 and 7.34+4.61 respectively) before intervention.
In addition, there was no statistical significant difference between total score of introduction and vital signs
check radial pulse before and after intervention where p= (0.338).
Table (3): OSCE Station Items Related to Standardized Blood Pressure Measurement Mean Total Score
among Studied Students before and After Intervention
Standardized Blood Pressure Measurement OSCE Station
Items Checklists
Prepared setting for measurement
Palpatory Method
Auscultatory Method
Documentation and Explain recommended follow up to
woman
18.548
8.194
11.303
0.001
0.001
0.001
3.91+3.72
10.917
0.001
9.51+1.32
Table (3) displayed OSCE station items related to standardized blood pressure measurement mean total score
among the studied students before and after intervention. As displayed, there was statistical significant
improvement in OSCE station regarding prepared setting for measurement that was quiet and free of
interruptions, palpatory method, auscultatory method and documentation and explain recommended follow up to
woman of the studied students after intervention (23.61+2.52, 27.73+3.33, 33.07+3.18 and 9.51+1.32
respectively) compared with (12.31+4.36, 19.44+7.58, 24.83+5.44 and 3.91+3.72 respectively) before
intervention
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Table (5): Pre and Post Intervention Results of Studied Students Regarding OSCE Station Items of Met
Antenatal Advice Skills
Antenatal advice skills OSCE Station Items Checklists
Select suitable setting for teaching.
Sit comfortably, avoid distracting movements, and look
directly to woman.
Greet the woman and her companion and offer the
woman a seat
Introduced your self by name
Identified your role
Asked for the woman's full name
Ensured woman readiness, comfort, and privacy
Explain the importance of the teaching's topic
Ask about woman's previous feedback related topic
Use clear language that the woman can easily understood
Avoid technical terms
Give correct and complete information.
Maintain eye contact
Put first things first
Use pictures or illustration
Explain pictures and point to them as you talk
Look mostly at the client and not at the flip chart or
poster
Repeat instructions
Be specific
Make links
Organize information, put things in categories
Check understanding
Correct any misinformation or misunderstanding the
woman may have
Summarize the teaching
Ask woman about present feedback related topic after
teaching
No.
52
Pre test
%
74.3
Post test
No.
%
65
92.9
2.711
0.007
60
85.7
66
94.3
1.732
0.083*
66
94.3
64
91.4
0.632
0.527*
63
41
41
42
47
27
61
50
49
65
41
31
23
90.0
58.6
58.6
60.0
67.1
38.6
87.1
71.4
70.0
92.9
58.6
44.3
32.9
66
64
62
60
67
67
59
62
56
61
50
68
68
94.3
91.4
88.6
85.7
95.7
95.7
84.3
88.6
80.0
87.1
71.4
97.1
97.1
0.905
4.004
3.550
3.286
4.082
6.172
0.500
2.353
1.347
1.155
1.521
5.925
6.564
0.366*
0.001
0.001
0.001
0.001
0.001
0.617*
0.019
0.178*
0.248*
0.128*
0.001
0.001
31
44.3
62
88.6
4.841
0.001
23
44
44
37
32
32.9
62.9
62.9
52.9
45.7
45
62
52
52
53
64.3
88.6
74.3
74.3
75.7
3.667
3.402
1.461
2.611
3.550
0.001
0.001
0.144*
0.009
0.001
27
38.6
60
85.7
5.154
0.001
18
25.7
55
78.6
5.516
0.001
27
38.6
63
90.0
5.555
0.001
*Not significant
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Mean+SD
Before
After intervention
intervention
26.01+9.67
55.56+8.66
58.50+19.77
113.74+14.54
19.877
19.915
0.001
0.001
63.67+15.18
98.90+7.26
17.260
0.001
41.96+15.23
75.64+8.12
15.207
0.001
14.89+3.46
21.56+3.62
11.016
0.001
Figure (1): Total Score of each OCSE Station before and after Intervention
Table (6) and Figure (1) illustrated total score of each OCSE station before and after intervention. As noticed
from the table and figure, there was statistical significant improvement in Antenatal history taking checklist
OSCE station one, Antenatal physical examination checklist OSCE station two, Standardized blood pressure
measurement technique skills checklist OSCE station three, Standardized body weight measurement technique
skills checklist OSCE station four and Antenatal advice skills checklist OSCE station five after intervention
(55.56+8.66, 113.74+14.54, 98.90+7.26, 75.64+8.12 and 21.56+3.62 respectively) compared with (26.01+9.67,
58.50+19.77, 63.67+15.18, 41.96+15.23 and 14.89+3.46) respectively before intervention.
VII.
Discussion
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VIII.
Conclusions
The implementation of OSCE tool has succeeded in achieving significant improvement in final B. Sc.
nursing students' antenatal examination practices skills. This improvement in final B. Sc. nursing students'
antenatal examination practices skills led to students gain more confidence when confronted by pregnant women
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IX. Recommendation
Implementation of OSCE through teaching-assisted videos for all clinical skills.
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