The use and effect of OSCES in post-registration nurses : an integrative review

Background: Objective structured clinical examinations (OSCEs) have been used in the undergraduate medical setting since the 1970s, however little is known about its use and effectiveness in post-registration nurse education. Objectives: The purpose of this review was to critically analyse studies using OSCEs in post-registration nurse education and to explore the use and effectiveness of OSCEs in this cohort. Design: This review was conducted using the Whittemore and Knafl's framework for integrated reviews. Data sources: Using the search terms OSCE OR OSCA OR objective structured clinical examination AND nursing NOT undergraduate, a comprehensive review was conducted using CINHAL and MEDLINE. Methods: The initial search located 173 studies. After screening and checking eligibility 19 studies were critically appraised. The final number of studies included in this review was 16. Results: Three themes were generated: (i) Application of OSCEs in post-registration level nursing (ii) OSCEs more than an exam: Learning enhancements and (iii) Participant perceived impact of OSCEs. Conclusion: OSCEs for post-registration nurses have evolved from the original OSCE design and have been adapted to a wide range of clinical settings and specialities. OSCEs were recognized as a valuable learning and assessment tool across the world for post-registration nurses. OSCEs offered strengths in terms of learner satisfaction and increased self-efficacy for this cohort. There was limited evidence supporting the effects of OSCEs within post-registration nursing education in comparison with other educational tools. Further research is needed to explore whether the knowledge gained in OSCEs is translated into clinical practice and whether simulation-based education is more effective in achieving enhanced knowledge compared to traditional-based education. Future research is required using RCT methods to compare the impact of OSCE to traditional-based education.