Assessing student midwives’ clinical skills using OSCEs in an academic setting

Recent changes to midwifery education in Ireland have included the establishment of a four year BSc Midwifery (BScM) programme in September 2006 and a shortened 18 month post registration Higher Diploma in Midwifery (HDM) programme in September 2007. The primary purpose of transfer of undergraduate midwifery education into the third level setting is to impact positively on the quality of maternity care given to mothers, babies and their families. While the change to third level education is very welcome every effort must be made to ensure that strategies which support the practice based nature of midwifery are reflected throughout the curriculum; Clinical midwifery staff and midwifery lecturers aim to develop students to their full potential so that at point of registration the student meets An Bord Altranais’s (2005) Requirements and Standards for Midwife Registration. The development of fundamental clinical skills is an important component in preparing students to meet the responsibilities of a midwife. However, the design of the curriculum has meant that students spend less time in the clinical practice environment with less time to gain competence in performing clinical skills. In addition, staff in clinical areas are carrying increasingly high workloads which has necessitated new approaches to the teaching, learning and assessment of clinical skills (Nicol and Freeth, 1998). It is important that midwives are not identified as having sole responsibility for the development of student midwives’ clinical skills but that lecturers and students themselves play a vital role in ensuring students have attained an appropriate level of clinical competence.; The development of clinical skills laboratories ensure that students have what O’ Neill and McCall (1996, p125) refer to as ‘beginning clinical competence before they are exposed to the ‘real world and real patients’’. O’ Neill and McCall (1996) also suggest that Objective Structured Clinical Examinations (OSCEs) have the potential to promote integration and consolidation of skills prior to clinical placement. OSCEs form part of the assessment strategy of the undergraduate midwifery programmes underpinned by the concept of women centered care in the University of Limerick. This paper evaluates the experiences of students and lecturers in the first stage of rolling out this strategy. Reference will be made to the preparation, process, and implementation of OSCEs. The benefits and limitations of this form of assessment in relation to this experience are considered and compared with the literature.