The Design, Implementation, and Evaluation of a Virtual Objective Structured Clinical Examination as a Tool for Assessing Clinical Competence in Nursing Students

Abstract

Background: The objective structured clinical examination (OSCE) is a well-established and dependable method for evaluating clinical skills. Recently, there has been a growing body of literature exploring the feasibility and potential benefits of adapting the OSCE format to a virtual environment, particularly in light of the increasing prevalence of telehealth practices. This adaptation, known as the virtual OSCE (VOSCE), is gaining recognition as a valuable tool in the context of expanding telehealth services. Objectives: The current research is designed to develop, implement, and evaluate a VOSCE to assess nursing students’ clinical competence. Methods: This quasi-experimental study, conducted over six phases between February 2022 and February 2024, evaluated a VOSCE for senior nursing students at Abadan University of Medical Sciences. The phases comprised: (1) Defining exam specifications and design; (2) establishing validity and reliability; (3) piloting the VOSCE; (4) familiarizing students with the VOSCE format; (5) administering the exam; and (6) evaluating the exam and providing feedback. A total of 176 eligible senior nursing students participated in the study. A census sampling method was employed. The study compared student performance on the VOSCE with their scores on a traditional, in-person OSCE. The correlation between the two exam formats was also analyzed. Student satisfaction with the VOSCE was assessed via questionnaire at the conclusion of each semester. Exam results and survey data were presented to the faculty’s educational development office, where feedback was solicited and used to inform revisions and improvements to the VOSCE for subsequent semesters. Data analysis, performed using SPSS 20, included descriptive statistics (mean and standard deviation) and Pearson’s correlation coefficient. Results: The study population consisted of undergraduate students in their eighth semester. A majority of participants (n = 107, 61.14%) were female, while the remaining (n = 68, 38.86%) were male. The mean score achieved on the VOSCE was 17.35, compared to a mean score of 16.86 on the in-person OSCE. Statistical analysis revealed no significant difference between these mean scores. A direct significant correlation was found between the total scores of the VOSCE and the in-person OSCE (r = 0.893, P < 0.001). This significant correlation was maintained across all individual stations within both examination formats (P < 0.05). Furthermore, student feedback, gathered through surveys, indicated that the VOSCE experience promoted feelings of empowerment, self-confidence, and enhanced learning outcomes. Participants also expressed strong support for the continued implementation of the VOSCE in subsequent academic years. Conclusions: The VOSCE presents a practical substitute for traditional in-person OSCEs or can be incorporated as a component of them. The findings from this research can serve as a blueprint for other nursing departments in need of suitable planning and arrangements for the execution of clinical competence evaluations in virtual environments.