Huang Hsiang-Ping, Chao Li-Fen, Wang Yu-Hsin, Liu Ying-Mei, Ni Lee-Fen, Jane Sui-Whi
PhD, RN, Assistant Professor, Department of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC.
PhD, RN, Associate Professor, Department of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC.
Hu Li Za Zhi. 2017 Dec;64(6):67-76. doi: 10.6224/JN.000084.
The objective structured clinical examination (OSCE) is one of the evaluation strategies used to examine the clinical competence of nursing students. More attention needs to be paid to establishing an examination that is based on the standardized protocol and on reliability and validity.
The aims of this study were to develop an OSCE that is based on a standardized protocol and to analyze the content validity and predictive validity, inter-rater consistency, internal consistency, item-to-total correlation, and the degree of discrimination and difficulty of this OSCE.
Based on the blueprint for OSCEs that use an 8-station format, this study used a descriptive, cross-sectional design and a sample population of 207 senior students who were preparing for their last-mile practicum at a nursing technology university in northern Taiwan. The study period lasted from September 2015 to October 2016. Furthermore, the validity, reliability, degree of discrimination, and difficulty of the OSCE were examined.
An OSCE with an eight-station format was developed. The content validity index (CVI) was .85-1.0, inter-rater reliability was .80-1.0, Cronbach' alpha internal consistency was .53-.82, and item-to-total correlation was .36-.63. In addition, the level of difficulty of the OSCE was easy to moderate and the discrimination of the OSCE ranged from fair to excellent. Meanwhile, the OSCE scores of the participants appeared to be a valid predictor of scores on the last mile practicum.
CONCLUSIONS / IMPLICATIONS FOR PRACTICE: According to the standardized protocol of OSCE development, an 8- station nursing OSCE format is reliable and valid, providing fair levels of difficulty and discrimination. The developed OSCE may be applied to evaluate the clinical competence of nursing students prior to beginning their last mile practicum. The results from the present study may provide a reference for nursing educators who are responsible for developing OSCE evaluation strategies.
客观结构化临床考试（OSCE）是用于评估护生临床能力的评估策略之一。需要更加关注建立基于标准化方案以及可靠性和有效性的考试。
本研究的目的是开发一种基于标准化方案的OSCE，并分析该OSCE的内容效度和预测效度、评分者间一致性、内部一致性、项目与总分相关性以及区分度和难度。
基于采用8站式格式的OSCE蓝图，本研究采用描述性横断面设计，样本为207名在台湾北部一所护理技术大学准备最后阶段实习的大四学生。研究期从2015年9月持续到2016年10月。此外，还对OSCE的效度、信度、区分度和难度进行了检验。
开发了一种8站式格式的OSCE。内容效度指数（CVI）为0.85 - 1.0，评分者间信度为0.80 - 1.0，Cronbach's alpha内部一致性为0.53 - 0.82，项目与总分相关性为0.36 - 0.63。此外，OSCE的难度水平为易到中等，区分度从一般到优秀。同时，参与者的OSCE分数似乎是最后阶段实习分数的有效预测指标。
结论/实践启示：根据OSCE开发的标准化方案，8站式护理OSCE格式可靠且有效，提供了合理的难度和区分度水平。所开发的OSCE可用于在护生开始最后阶段实习之前评估其临床能力。本研究结果可为负责制定OSCE评估策略的护理教育工作者提供参考。
