Assessment of the Feasibility Of Objective Structured Practical Examination Among Final Year Diploma Nursing Students in Government and Private Colleges in Addis Ababa, Ethiopia.

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Addis Ababa University


Background The way clinical performance is assessed is one of the determinants affecting clinical skill training of nurses. The conventional method of clinical assessment is found to be subjective. Objective Structured Practical Examination (OSPE) has been introduced in many countries as a valid and reliable assessment tool. In Ethiopia, there is no experience in regard to the feasibility of OSPE and its use to assess clinical performance of students. Objective The main objective of this study was to assess the feasibility and the clinical performance of final year diploma nurse students using OSPE. Methods and Materials The study was done in Menlik II Health Science College and Central University located in Addis Ababa. The study populations were final year diploma nurse students. The design of study was descriptive cross-sectional. A total of 36 students 16 from Menilik II and 20 from Central University were enrolled. In Central out of 3 campuses, Lanchia Campus was selected randomly. Out of 35 students in Lanchia Campus 20 were chosen using simple random sampling. Data were collected through a structured questionnaire, checklist, focus group discussion and observation. The variables collected were age, clinical performance score, feasibility of OSPE, perception of study subjects and barriers to skill training. Result The mean age of the 36 students was 21.7 years. Out of 6 clinical competencies assessed managing 3rd stage of labor, clean wound dressing, managing airway obstruction and administering IM injection were poorly performed while that of measuring blood pressure was good. Of the expected 1872 tasks to be performed by the 36 students in the 6 clinical procedures 886(47.3%) were correctly performed. In addition, out of 52 steps expected to be performed by a student in the 6 procedures, the maximum steps performed by a student correctly were 35(67.3%). Among major deficiencies observed in the management of 3rd stage of labor was inability to palpate the abdomen to rule out the presence of another baby 35 (97.2). In addition, 31(86.1%) and 27(75.0%) of the students were unable to read the growth monitoring chart and interpret temperature of a patient respectively. Furthermore, instructors and students attitude towards OSPE was highly positive. Feasibility study showed in each demonstration room a maximum of 10 stations could be organized. The amount of time to conduct OSPE in each site was 290 minutes. OSPE was found feasible in a small set up with few numbers of students. The result also showed the main barriers to clinical training were instructors’ competency, coaching process, close supervision and inadequate learning facilities. Conclusion Objective Structured Practical Examination is feasible in a small setup where the numbers of students to be assessed are few. When the numbers of students are many, additional resource is required. OSPE has demonstrated the clinical performance of the students to be weak. Recommendation Objective Structured Practical Examination was found feasible and should be introduced as an additional clinical assessment tool



Nursing Students, Government and Private Colleges