Nursing Students'Views on the Formative Assessment of the Objective Structured Clinical Examination Within a High-fidelity Simulation

The high-fidelity simulator and simulated patients (SPs) were used to design the objective structured clinical examination (OSCE) for enhancing the fidelity of scenarios. It is necessary for nursing educators to explore nursing students' responses to the formative assessment of objective clinical performance assessment. The descriptive study was conducted among 54 nursing students in Macao and 42 nursing students in Baotou, Mainland China. The OSCE Evaluation Questionnaire was used. It was a 29-item self-report Likert scale with a 5-point response from "5 strongly agree"to "1 strongly disagree". The value of content validity index tested by five experts was 0.96.The internal consistency (Cronbach's alpha) was 0.951. All participants were invited to response an open-ended question about their feelings of taking the OSCE exam. The overall item mean was scored from 3.14 to 5.00 with a mean of 4.32 (S.D. = 0.44). The high mean scores occurred on the items of knowledge application, recognition of strengths and weaknesses and motivation for deep learning. Macao students considered less appreciation of OSCE than Mainland (Baotou) students. Year 3 students expressed more appreciation of OSCE than year 2 students. Majority of students were satisfied with their performance in the OSCE and had a pleasant experience.Participants appreciated that the simulations provided realistic learning experiences, and particularly helped them think critically and improve the abilities to handle the emergencies. However, some students felt nervous during the exam, reported less confidence in communicating with patients and prioritizing problems. Findings from this study provide further evidence that the high-fidelity simulator and SPs can be used to design the OSCEs for competency assessment from the affective, cognitive and psychomotor domains. Considering how to assess the competency- based practice, it may be useful for other nursing programs.