Abstract
Given the complex clinical situations and the dynamic nature of nursing, the greatest challenge for nursing educators is performing objective evaluation of students’ clinical competence. The Objective Structured Clinical Evaluation (OSCE) is designed to address this challenge and it has been widely used in nursing education. However, its implementation in nursing education in Taiwan has been limited. Accordingly, a quasi-experimental design was utilized to examine students’ clinical performance and stress levels using a 12-station OSCE assessment. Further, we investigated the inter-rater reliability and internal consistency of the OSCE. After controlling for scores of clinical performance, overall differences in pre- and post-practicum stress in the OSCE group were significantly higher than in the control group (F (1, 89) = 4.89, p = 0.03). There was no group effect on practicum performance after controlling for grade point average (F (1, 89) = 2.69, p = 0.14). Cronbach’s alpha for 12 OSCE stations ranged from 0.22 to 0.80 and inter-rater reliability for all 12 stations showed Pearson’s r ranging between 0.76 and 1.00. Cohen’s kappa ranged from 0.70 to 1.00 (p
Highlights
Stress, which reflects a dynamic relationship between the individual and environment, is a multidimensional phenomenon [9]
There were no significant differences between groups on the six subscales of practicum stress before the practicum
The reduction in last-mile practicum stress levels was significantly greater for Group O than for Group C
Summary
Stress, which reflects a dynamic relationship between the individual and environment, is a multidimensional phenomenon [9]. Student nurses rate preceptorship as the most stressful clinical staff relationship [13]-[15]. The lack of experience, difficult patients, evaluation by faculty, and anxiety about dispensing the wrong medication or information foster stress among novice student nurses stressors, making practicum the most anxiety-inducing component of nursing programs [16]. The preceptorship is rated as the most stressful and challenging practicum experience because the preceptor and student, who are unlikely to be familiar with each other, must work together in arduous working environments [15]. The frustration associated with a difficult relationship could result in student stress, dissatisfaction in the nursing profession, and interference with learning and assimilation [15]. From a student-centric perspective, it is imperative to transform nursing education practices and reduce stressors, thereby facilitating student continuation and academic success during professional nursing development [17]
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