1.

Introduction

The OSCE is defined as “an approach to the assessment of clinical competence in which the
components of competence are assessed in a well planned or structured way with attention being
paid to objectivity” (Harden 1988, p. 19). Objective structured clinical examination (OSCE) was
first introduced in medical education by Harden in Scotland in 1975 It is now emerged in other
disciplines including nursing, pharmacy, and dentistry to test clinical skill performance. OSCEs
are now used Within schools of Nursing and Midwifery as they can potentially assess both the
theoretical and practical aspects of student‟s. The OSCE as an assessment method, which was
mainly performancebased, had numerous advantages and had proven a useful complement to the
traditional paper-based or computerbased assessment methods. Very importantly, the method not
only assessed knowledge but also skills which were demonstrated by doing. 'OSCE demonstrate
particular advantages over traditional forms of testing such as multiple choice tests, in assessing
communication and interpersonal skills, professional judgment and moral/ethical reasoning.

The OSCE examination tests a wide range of skills thus greatly reducing the sampling error. This
very significantly improves the reliability of the examination” Harden, 1988.Assessment of
clinical skills has a central role in medical education and the selection of suitable methods has
been a matter of permanent concern for clinical teachers, course directors and medical educators.
The objective structured clinical examination is now established as one of the most valid, reliable
and effective tests for the assessment of clinical skills. In a typical OSCE, examiners rotate
through a number of stations staffed by either real or standardized patients, where they are
required to perform different clinical tasks. The examiners are observed and their performance is
assessed using structured checklists.

Background of the Study

The Objective Structured Clinical Examination (OSCE) is a form of assessment in, which the
student demonstrates clinical skills, and underpinning knowledge, usually in simulated
conditions (Fidment, 2012). The OSCE is becoming more prevalent within healthcare education
programmes, because it is regarded as a useful method for assessing, skills, and underpinning
knowledge required for practice (Merriman and Westcott, 2010). Using the OSCE, as assessment
tool for student nurses‟ clinical competence has been an integral part of the overall assessment
strategy since formal nursing assessment began. The objective structured clinical examination
(OSCE) has been in use in the assessment of medical students for over 20years. In the last 10
years, there has been increasing interest in this form of assessment in other health professional
disciplines, such as nursing and physiotherapy (Walters and Adams, 2002). Moreover, the
important of feedback from nursing students and faculty has been useful in effecting
improvements to the process and greater emphasis has been placed on the teaching and
evaluation of history taking, communication, and technical competencies.
During the OSCE examination, students rotate around a circuit of stations on a timed basis. At
the ring of a bell, each student enters the station and performs the predefined timed task. Each
station assesses a different clinical competency such as history taking, interpretation of clinical
data, performing one or more clinical tasks, or solving a problem (Ahmad et al., 2009). The
number of OSCE stations is normally from 15 to 20, and the number of students in each OSCE
session is determined by the number of stations. Increased number of the stations enhances the
reliability of the assessment (Harden, 1990). By the end of the OSCE stations, all the students
will have gone through each station and been marked according to a standardized marking
system (El-Nemer and Kandeel, 2009). Learning in the clinical environment provides the real
world context for nursing students to develop the knowledge, skills, attitudes, and values of a
registered nurse (LevettJones et al., 2007).

Need of the Study

The traditional format of examination that included long and short cases with oral examinations
was preserved until recent changes. In response to recommendations to improve the validity and
fairness of the examination through adoption of proven reliable methods and approaches in
assessment and evaluation in nursing education

OSCE is designed to overcome deficiencies in conventional clinical examination OSCE ensures

evaluation of predetermined clinical competencies. In OSCE method of assessment is more
objective as small components like history, general and systemic exam vital singed etc are
assessed Marks allotted according to predetermined list.

The need of this study was to assess undergraduate nursing students‟ perceptions and level of
satisfaction of OSCE as a new method of clinical competency assessment in undergraduate
nursing curriculum and to determine student acceptability of the process and provide feedback to
enhance further development of the assessment.

Many general practitioners are very much aware of the need of a more realistic method of
assessing the skills and abilities of students. General practitioner recognizes this need and is
currently investigating the feasibility, reliability and validity of introducing such an alternative as
an integral part of the examination.

4. Review of Literature

Review of literature related to Perception of OSCE:

1) In Feb 2015 Medical & Dental College (Bahria University Islamabad) was conducted the
study on Students‟ Perception Regarding Objective Structured Clinical Examination (OSCE) this
prospective cross sectional study was conducted on final year MBBS at Islamabad Medical and
Dental College. Results: Among 100 participants, 80(80%) considered OSCE as fair mode of
examination, 85(85%) said it covered a wide range of skills, clinical and theoretical knowledge.
Regarding the advantages of OSCE, 78 (78%) said it is a type of examination that is easy to pass
as compared to viva exam as multiple tasks give more chance to pass, 82(82%) consider OSCE a
better than simple viva examination as in OSCE they appear in both static and interactive
stations while in viva their verbal skills count in passing the examination. However 69% found
OSCE exhausting and lengthy and 88(88%) found it to be more stressful.

2) In 2013 A descriptive exploratory research was conducted in an institute of Nursing in Riyadh

city, Saudi Arabia non probability convenience sample of 80 nursing students who completed
their community health nursing as well as maternity nursing OSCE examination were recruited
for the study, Results of the study revealed that the majority of the students in both courses
provided positive feedback about the OSCE attributes as (95%) agreed that the OSCE was a
realistic assessment for the course. In regards to the quality of OSCE performance, the majority
of the students agreed that OSCE exam was fair (95%), covered a wide range of knowledge
(90%) ,it was well administrated (96.3%) .

3) In October 2015 Dr. Wajed Hatamleh1, Dr. Zeinab Abu Sabeeb2 “Nursing Students
Perceptions of an Objectives Structured Clinical Examination” The results revealed that the
majority of the students (67.3%) reported that they prefer OSCE over the traditional evaluation
methods. Furthermore, 43.6% of the students considered OSCE fairer and 50.9% students
believed that OSCE is the easiest method of assessment as compared to the other formats

4) The study was qualitative, which adopted hermeneutic phenomenology for interpreting
student lived experiences of the OSCE process Byrne and Smyth (2008) concluded that students
already exposed to an OSCE described feeling less anxious and better prepared for their
subsequent clinical placements. Data was collected through semi-structured interviews with
students. Analysis revealed three main themes: (1) anxiety about the OSCE, (2) preparation was
a seen as a coping strategy and (3) simulation was a further cause of anxiety. This study found
similar experiences among the students interviewed. The OSCE had caused feelings of anxiety,
yet students felt that the assessment was ultimately beneficial to them.

5) A review of the nursing literature was conducted through an initial search of the
computerized databases of CINAHL, Pub Med, Google Scholar and Medline with full text. The
initial search identified 351 papers. The selected search criteria included English language
articles written between 2005 and 2013. Sixteen studies (13 quantitative and 3 qualitative) were
included for the review. The major findings reveal that OSCE is an effective tool for evaluation
from faculty and student perspectives in all the studies. The key issues recognized include the
complexity of the exam, time consumption, accelerated stress perception of the students and high
cost in the conduction of the exam.

6) This was a one-step single-group descriptive study which was conducted through a researcher-
made questionnaire for Reviewing the nursing students‟ views toward OSCE test The sample
size included 50 freshman nursing students The study environment was the Clinical Skills
Laboratory of School of Nursing and Midwifery in Isfahan University of Medical Sciences
Results indicated that the view of most of the students in OSCE test has been good in terms of
equipment and facilities with relative frequency of 59.2 percent, conditions of holding the
examination with relative frequency of 50.9% and total test with relative frequency of 55.1%; in
terms of physical environment, students‟ view was moderate with relative frequency of 469%.

Problem statement

A study to assess the effectiveness of OSCE in terms of Knowledge and practice among b.sc
nursing 3rd year students of TMCON, Moradabad.

Purpose

This study was to investigate the student‟s perception of The OSCE as part of an evaluation of
clinical skills.

Objectives

 To assess the Pre-test knowledge of b.sc 3rd year students regarding OSCE process on
among adolescent.
 To assess the Post-test knowledge and practice regarding myopia and its prevention
among adolescent children.
 To evaluate the effectiveness of structured teaching program on myopia and its
prevention.
 To determine the association between post-test knowledge score with their selected
demographic variables.

Research Approach: A descriptive study design was uses to fit nature of the study

Research design: Survey method used for this study.

Setting of study: TMCON , Moradabad.

Population: Undergraduates Nursing Students

Sample: B.Sc. 3rd year nursing students

Sample size:

Sampling technique: Purposive Sampling technique

Inclusion Criteria

• Only Basic B.Sc. 3rd year Nursing Students

• Present and available at the time of study.

• Students physically healthy

Exclusion Criteria

Repeater students.

Students who are absent