Educational significance and challenges of conducting the objective structured clinical examination twice for midwifery students before and after clinical training: A longitudinal single university study during 2014-2019 in Japan.

This study aimed to clarify the educational significance and issues associated with administering the objective structured clinical examination (OSCE) twice to midwifery students, i.e., before and after clinical training. In Sapporo City University in Japan, 37 assessment items of the OSCE were configured as "Overall," with 17 items as midwifery's normal delivery preparation (Part 1) and 20 items as midwifery's normal delivery assistance (Part 2). All students had attended lectures with textbooks. The first and second OSCEs were conducted before and after the clinical training, respectively. The scores of 54 students were retrospectively analyzed over 6 years (2014-2019). The results of the first and second OSCEs were compared. Statistical analysis was performed using Mann-Whitney U test, Wilcoxon signed rank-sum test, Fisher's exact test, and analysis of variance. The mean scores for "Overall" [0-37], "Part 1" [0-17], and "Part 2" [0-20] in the second OSCEs were significantly higher than those in the first OSCE (Overall: 22.7 vs 19.3, Part 1: 9.50 vs 7.71, Part 2: 13.2 vs 11.6, p<0.05, respectively). Regarding "Overall" and "Part 1," a positive correlation was observed between the first and second OSCEs, wherein the full scores of "Part 1," converted from 17 to 20 points to match the full scores of "Part 2," were significantly lower than those of Part 2 (p<0.05, respectively). There was a positive correlation between the scores of the first and second OSCEs in "Part 1" and "Part 2" (p<0.05). The scores increased between the two OSCEs, and participants could objectively grasp the knowledge and skills. The OSCEs conducted twice were useful in skilling-up the normal delivery preparation and assistance skills of midwifery students. However, developing an advanced educational method might be necessary for the midwifery students' preparation of normal delivery, because the scores in the OSCEs were lower.