Kelly Michelle A, Mitchell Marion L, Henderson Amanda, Jeffrey Carol A, Groves Michele, Nulty Duncan D, Glover Pauline, Knight Sabina
1Curtin University, Kent Street Bentley, Perth, Western Australia 6102 Australia.
2Griffith University and Princess Alexandra Hospital, University Drive, Meadowbrook, Queensland 4122 Australia.
Adv Simul (Lond). 2016 Apr 2;1:10. doi: 10.1186/s41077-016-0014-1. eCollection 2016.
Objective structured clinical examinations (OSCEs) have been used for many years within healthcare programmes as a measure of students' and clinicians' clinical performance. OSCEs are a form of simulation and are often summative but may be formative. This educational approach requires robust design based on sound pedagogy to assure practice and assessment of holistic nursing care. As part of a project testing seven OSCE best practice guidelines (BPGs) across three sites, the BPGs were applied to an existing simulation activity. The aim of this study was to determine the applicability and value of the OSCE BPGs in an existing formative simulation.
A mixed methods approach was used to address the research question: in what ways do OSCE BPGs align with simulations. The BPGs were aligned and compared with all aspects of an existing simulation activity offered to first-year nursing students at a large city-based university, prior to their first clinical placement in an Australian healthcare setting. Survey questions, comprised of Likert scales and free-text responses, used at other sites were slightly modified for reference to simulation. Students' opinions about the refined simulation activity were collected via electronic survey immediately following the simulation and from focus groups. Template analysis, using the BPGs as existing or a priori thematic codes, enabled interpretation and illumination of the data from both sources.
Few changes were made to the existing simulation plan and format. Students' responses from surveys ( = 367) and four focus groups indicated that all seven BPGs were applicable for simulations in guiding their learning, particularly in the affective domain, and assisting their perceived needs in preparing for upcoming clinical practice.
Similarities were found in the intent of simulation and OSCEs informed by the BPGs to enable feedback to students about holistic practice across affective, cognitive and psychomotor domains. The similarities in this study are consistent with findings from exploring the applicability of the BPGs for OSCEs in other nursing education settings, contexts, universities and jurisdictions. The BPGs also aligned with other frameworks and standards often used to develop and deliver simulations.
Findings from this study provide further evidence of the applicability of the seven OSCE BPGs to inform the development and delivery of, in this context, simulation activities for nurses. The manner in which simulation is offered to large cohorts requires further consideration to meet students' needs in rehearsing the registered nurse role.
客观结构化临床考试（OSCE）在医疗保健项目中已使用多年，作为衡量学生和临床医生临床能力的一种方式。OSCE是一种模拟形式，通常具有总结性，但也可能具有形成性。这种教育方法需要基于合理教学法进行稳健设计，以确保整体护理实践和评估。作为一个在三个地点测试七个OSCE最佳实践指南（BPG）的项目的一部分，这些BPG被应用于一项现有的模拟活动。本研究的目的是确定OSCE BPG在现有的形成性模拟中的适用性和价值。
采用混合方法来解决研究问题：OSCE BPG在哪些方面与模拟相契合。在一所位于大城市的大学，将BPG与为一年级护理学生提供的现有模拟活动的各个方面进行比对和比较，这些学生即将在澳大利亚医疗环境中进行首次临床实习。对在其他地点使用的由李克特量表和自由文本回答组成的调查问卷进行了微调，以提及模拟。在模拟结束后，通过电子调查和焦点小组收集学生对改进后的模拟活动的意见。使用BPG作为现有或先验主题代码的模板分析，能够对来自这两个来源的数据进行解释和阐释。
对现有的模拟计划和形式几乎未做改动。来自367名学生的调查回复以及四个焦点小组表明，所有七个BPG都适用于模拟，以指导学生学习，特别是在情感领域，并满足他们在为即将到来的临床实践做准备时的感知需求。
发现模拟和由BPG指导的OSCE在意图上存在相似之处，能够就情感、认知和心理运动领域的整体实践向学生提供反馈。本研究中的相似之处与在其他护理教育环境、背景、大学和司法管辖区中探索BPG对OSCE的适用性的研究结果一致。BPG还与通常用于开发和实施模拟的其他框架和标准相一致。
本研究结果进一步证明了七个OSCE BPG在为护士模拟活动的开发和实施提供信息方面的适用性。向大批学生提供模拟的方式需要进一步考虑，以满足学生在演练注册护士角色方面的需求。
