This topic focuses on objective structured clinical examination.Brief idea may clarify all the doubts about the topic.

1. PRESENTATION
ON
OBJECTIVE STRUCTURED
CLINICAL EXAMINATION
Mrs. Manimozhi, M.Sc Nursing,
HOD,
Medical and Surgical Dept,
Kongunadu College of Nursing.

2. OSCE
 Objective :
Examiners use a checklist for evaluating the
trainees.
 Structured :
Trainee sees the same problem and perform the
same tasks in the same time frame.
 Clinical :
The task are representative of those faced in real
clinical situation.

3. ….Cont/.
 OSCE is a modern type of examination often used in
health sciences ( eg. Medicine, dentistry, nursing,
pharmacy, and physiotherapy) to assess clinical skill
performance and competence in skills such as
communication, clinical examination, medical and
nursing procedures/ prescription, exercise prescription,
joint mobilization/ manipulation techniques and
interpretation of results.

4. History of OSCE
 OSCE was developed in university of Dundee ( Dundee,
Scotland) in the early 1975 by Dr. Harden and his colleagues.
 After some modification it was described in detail on 1979.
 This method was the subject of an international conference in
Ottawa in 1985 and experience were exchanged about OSCE
& OSPE.
 More than 50 countries accepted it.
 Globally using now.

5. DEFINITION OF OSCE
 OSCE is a form of performance – based testing to measure
candidate’s clinical competence.
 During OSCE, candidates observed and evaluated as they go
through a series of stations in which they interview, examine
and treat standardized patients who present with some type of
medical problems.

6. Definition of OSCE
“ The OSCE is an approach to the assessment of
clinical competence in which the components of
competence are assessed in a planned or structured
way with attention being paid to the objectivity of the
examination.”
-Harden

7. PURPOSES OF OSCE
According to Boursicot, Ware, and Hazllet(2011):
 Measure clinical skills.
 Match assessment to intended constructs.
 Promote structured interaction between student and
examiner.
 Make structured marking scheme possible.
 Present all candidates with the same test.
 Promote objectivity.

8. USES OF OSCE
Generally, the following range of practical skills are
typically assessed in nursing using OSCE:
 Interpersonal and communication skills
History taking skills
Physical examination of specific body systems
Mental Health Assessment.

9. …CONT/-
 Clinical problem – solving skills
 Interpretation of clinical findings and investigations
 Management of a clinical situation, including treatment and
referral
 Patient education
 Health promotion
 Acting safely and appropriately in an urgent clinical situation
 Basic and advanced nursing care procedure practices.

12. THE COMPONENTS OF OSCE
 The examination coordinating committee
 The examination coordinator
 Lists of skills, Behaviors and Attitude to be assesses
 Criteria for scoring the assessment ( marking scheme of
checklist)
 The examinees
 The examiners
 Examination site

13. ….CONTD/-
 Examination stations:
 Time and time allocation between stations
 Anatomic models for repetitive ( Breast, pelvic/ Rectum)
 Couplet station
 Examination questions
 Environment of exam station
 Examination station circuit

14. ….CONT/-
 Patient (real/ stimulated)
 Time keeper/ time clock& time signal
 Contingency plans
 Assessment off the performance of the OSCE
 Viva – voce / oral examinations

15. ORGANIZATION THE OSCE
The OSCE examination consists of about 10-15 stations, each
of which requires about 4-5 minutes. The number of stations
and time spent on each station may vary based on needs of
evaluation.
all stations should be capable of being completed in the same
time.
the students are rotated through all stations and have to move
to the next station at the signal.
As the stations are generally independent, students can start at
any procedure stations and complete the cycle.

16. ….CONT/-
Thus, using 15 stations of 4 minutes each, 15 students can complete
the examination within 1 hour.
Each station is designed to test a component of clinical competence.
At some stations, called the procedure stations, students are given
tasks to perform on patients or simulators. At all such stations there
are observers with agreed upon checklists or rating scales to score the
student’s performance.
At other stations called response stations, students respond to
questions of the objective type or interpret data or record their
findings of the previous procedure stations.

17. PROBLEMS OF USING IN THE INDIAN
SCENARIO
Lack of feasibility due to time constrains.
Shortage of training for use of OSCE.
shortage of observers.
lack of interest in examiners
lack of enforced guidelines for practical examination
by universities.

18. ADVANTAGES OF OSCE
More valid than the traditional approach to clinical
examinations.
Examiners can decide in advance what is to be tested
and can then design the examination to test these
competencies.
Examiners can have better control on the content and
complexities.
More reliable.
More practical because it can be used with a large
numbers of students.

19. ….CONT/-
Emphasis can be moved away from testing factual
knowledge to testing a wide – range of skills
including advanced clinical skills.
the use of checklists by examiners and the use of
multiple choice questions results in a more objective
examination.

20. DISADVANTAGES OF OSCE
Students knowledge and skills are tested in
compartments and they are not their ability to look at
the patient as a whole.
Demanding for both examiners and patient.
examiners are required to pay close attention to the
students repeating the same task on a number of
occasions.
The time involved in setting up the examination is
greater than for the traditional examination.
maintaining uniform difficulty levels is not always
possible.