The Objective Structured Clinical Examination (OSCE) as a strategy for assessing clinical competence in midwifery education in Ireland: A critical review

Smith, V. and Muldoon, K. and Biesty, L. (2012) The Objective Structured Clinical Examination (OSCE) as a strategy for assessing clinical competence in midwifery education in Ireland: A critical review. Nurse Education in Practice, 12 (5). pp. 242-247. ISSN 14715953 (ISSN)

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In Ireland, to register as a midwife, all student midwives must be deemed competent to practice with the assessment of competence an essential component of midwifery education. A variety of assessment strategies, including observed practice, clinical interviews, portfolios of reflection, the Objective Structured Clinical Examination (OSCE) and written examination papers, are utilised to assess midwifery students' clinical competence. In this paper, a critical review of the OSCE as a strategy for assessing clinical competence in one third level institution in Ireland is offered. Although utilised for assessing competence across a range of areas (e.g. obstetric emergencies and pharmacology/drug administration), the use of the OSCE for assessing midwifery students' competence in lactation and infant feeding practices, as an example for this paper, is described. The advantages, disadvantages, validity and reliability of the OSCE, as an assessment strategy, are critically explored. Recognising that no single assessment strategy can provide all the information required to assess something as complex as clinical performance, the OSCE, when viewed alongside other forms of assessment, and with relevance to the topic under examination, may be considered a valuable strategy for enhancing the assessment of students' clinical competence, and for embracing diversity within midwifery education and training. © 2012 Elsevier Ltd.

Item Type: Article
Additional Information: Cited By :6; Export Date: 23 February 2015; Correspondence Address: Smith, V.; School of Nursing and Midwifery, University of Dublin, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland; email:; References: (2000) The Code of Professional Conduct for Each Nurse and Midwife, , An Bord Altranais, An Bord Altranais, Dublin; (2005) Requirements and Standards for the Midwife Registration Education Programme, , An Bord Altranais, An Bord Altranais, Dublin; Barman, A., Critiques on the objective structured clinical exam (2005) Annals Academy of Medicine, 34 (8), pp. 478-482; Bartfay, W.J., Rombough, R., Howse, E., LeBlanc, R., The OSCE approach in nursing education: objective structured clinical examinations can be effective vehicles for nursing education and practice by promoting the mastery of clinical skills and decision-making in controlled and safe learning environments (2004) The Canadian Nurse, 100 (3), pp. 18-25; Benner, P., From novice to expert (1982) American Journal of Nursing, 82 (3), pp. 402-407; Benner, P., (1984) From Novice to Expert: Excellence and Power in Nursing Practice, , Addison-Wesley, Menlo Park, USA; Bujack, L., McMillan, M., Dwyer, J., Hazelton, M., Assessing comprehensive nursing performance: the Objective Structural Clinical Assessment (OSCA). Part 1 - development of the assessment strategy (1991) Nurse Education Today, 11, pp. 179-184; Brookes, D., Objective structured clinical examination assessments (2007) Nursing Times, 103 (43), pp. 30-31; Butler, M., Fraser, D., Murphy, R., What are the essential competencies required of a midwife at the point of registration? (2008) Midwifery, 24 (3), pp. 260-269; Chesser, A., Laing, M.R., Miedzybrodzka, Z.H., Brittenden, J., Heys, S.D., Factor analysis can be a useful standard setting tool in a high stakes OSCE assessment (2004) Medical Education, 38, pp. 825-831; Cowan, D., Norman, I., Coopamah, V.P., Competence in nursing practice: a controversial concept - a focused review of the literature (2005) Nurse Education Today, 25, pp. 355-363; Cullen, L., Fraser, D., Symonds, I., Strategies for interprofessional education, the interprofessional team Objective Structured Clinical Examination for midwifery and medical students (2003) Nurse Education Today, 23, pp. 427-433; Dupras, D.M., Li, T.C., Use of the objective structured clinical examination to determine clinical competence (1995) Academic Medicine, 70 (11), pp. 1029-1034; Govaerts, M.J., van der Vleuten, C.P., Schuwirth, L.W., Optimising the reproducibility of a performance-based assessment test in midwifery education (2002) Advanced Health Science Education Theory and Practice, 7 (2), pp. 133-145; Harden, R., Assessment of clinical competence using the objective structured examination (1975) British Medical Journal, 1, pp. 447-451; Harden, R., What is an OSCE? (1988) Medical Teacher, 10 (1), pp. 9-22; Harden, R., Gleeson, F.A., Assessment of clinical competence using an objective structured clinical examination (OSCE) (1979) Medical Education, 13, pp. 41-54; Hodges, B., OSCE! Variations on a theme by Harden (2003) Medical Education, 37, pp. 1134-1140; International Confederation of Midwives (2010) Essential Competencies for Basic Midwifery Practice, ,; International Confederation of Midwives (2011) Global Standards for Midwifery Education, ,; Jones, A., Pengram, A., Fordham-Clarke, C., Developing and examining an objective structured clinical examination (2010) Nurse Education Today, 30, pp. 137-141; Khattab, A.D., Rawlings, B., Assessing nurse practitioner students using a modified objective structured clinical examination (OSCE) (2001) Nurse Education Today, 21, pp. 541-550; MacMullen, M., Endacott, R., Gray, M., Jasper, M., Carolyn, M.L., Scholes, J., Webb, C., Portfolios and assessment of competence; a review of the literature (2003) Journal of Advanced Nursing, 41 (3), pp. 283-294; Major, D.A., OSCEs - seven years on the bandwagon: the progress of an objective structured clinical evaluation programme (2005) Nurse Education Today, 25 (6), pp. 442-454; Miller, G.E., The assessment of clinical skills/competence/performance (1990) Academic Medicine, 65 (SUPPL.), pp. s63-s67; Mitchell, M.L., Henderson, A., Grove, S., Dalton, M., Nulty, D., The objective structured clinical examination (OSCE): optimising its value in the undergraduate nursing curriculum (2009) Nurse Education Today, 29, pp. 398-404; Newable, D., Swanson, D., Psychometric characteristics of the objective structured clinical examinations (1988) Medical Education, 22, pp. 325-334; Noonan, M., Barry, M., Bradshaw, C., Assessing student midwives' clinical skills: using OSCEs in an academic setting (2009) The Practising Midwife, 12 (5), pp. 55-57; Nulty, D.D., Mitchell, M.L., Jeffrey, C.A., Henderson, A., Groves, M., Best practice guidelines for use of the OSCEs: maximising value for student learning (2011) Nurse Education Today, 31, pp. 145-151; O'Connor, T., Fealy, G.M., Kelly, M., McGuinness, A.M., Timmins, F., An evaluation of a collaborative approach to the assessment of competence among nursing students of three universities in Ireland (2009) Nurse Education Today, 29, pp. 493-499; Roberts, C., Newable, D., Jolly, B., Hampton, K., Assuring the quality of high-stakes undergraduate assessments of clinical competence (2006) Medical Teacher, 28 (6), pp. 535-543; Roberts, J., Brown, B., Testing the OSCE: a reliable measurement of clinical nursing skills (1990) The Canadian Journal of Clinical Nursing Research, 22 (1), pp. 51-59; Rushforth, H.E., Objective structured clinical examination (OSCE): review of the literature and implications for nursing education (2007) Nurse Education Today, 27, pp. 481-490; Schuwirth, L., van der Vleuten, C., The use of clinical simulations in assessment (2003) Medical Education, 37 (SUPPL.), pp. s65-s71; Ward, H., Barratt, J., Assessment of nurse practitioner advanced clinical practice skills: using the objective structured clinical examination (OSCE) (2005) Primary Health Care, 16 (3), pp. 22-24; Ward, H., Willis, A., Assessing advanced clinical practice skills (2006) Primary Health Care, 16 (3), pp. 22-24; Wass, V., van der Vleuten, C., Shatzer, J., Jones, R., Assessment of clinical competence (2001) The Lancet, 357, pp. 945-949; Watson, R., Stimpson, A., Topping, A., Porock, D., Clinical competence assessment in nursing: a systematic review of the literature (2002) Journal of Advanced Nursing, 39 (5), pp. 421-431; Way, R., Assessing clinical competence (2002) Emergency Nurse, 9 (9), pp. 30-34; Wessel, J., Williams, R., Finch, E., Gemus, M., Reliability and validity of an objective structured clinical examination for physical therapy students (2003) Journal of Allied Health, 32 (4), p. 266; Worth-Butler, M., Fraser, D., Murphy, R., Eliciting the views of experienced midwives about the assessment of competence in midwifery (1996) Midwifery, 12 (4), pp. 182-190
Uncontrolled Keywords: Clinical competence; Midwifery education; Objective Structured Clinical Examination, OSCE; Student midwives; article; education; female; human; Ireland; methodology; midwife; nursing education; nursing evaluation research; pregnancy; standard; Educational Measurement; Humans; Midwifery; Nursing Education Research
Depositing User: National Forum
Date Deposited: 06 Dec 2015 18:51
Last Modified: 12 Dec 2015 15:10

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