The assessment of clinical skills competencies is an essential part of the midwifery curriculum to ensure women's safety in the clinical environment. An Objective Structured Clinical Examination (OSCE) is one form of assessment used to test clinical skills, performance and competence, increasingly used by many universities.
The OSCE is an exam where students demonstrate competence under simulated conditions (Watson et al, 2002). It simulates a clinical environment and scenarios that registered midwives are likely to encounter when they assess, plan, implement and evaluate care. The student is expected to utilise a contemporary evidence-base and effectively demonstrate safe practical application of midwifery skills. During an OSCE, the examiner will assess knowledge and understanding underpinning the skill, the technical aspects of the skill, affective aspects such as professional attitude and how the student approaches the skill in terms of being systematic, logical and organised (Bloomfield et al, 2010).
Recently, I experienced my first OSCE. It was a bit nerve-racking, but I remained focused and have passed with a good result. The OSCE is a very individual experience, and it is likely that those who have done well will view it more favourably than those who have not. While it is helpful to get feedback from other students, it is also important to remain calm and positive about your own experience. Moreover, there are things you can do to maximise your chances of success.
Preparation is key
To reduce stress and avoid panic, preparation is crucial. This may seem obvious, but it is worth remembering that effective studying really does need time. By giving yourself at least a month, you will have time to question new knowledge and deepen your understanding of different concepts and ways of doing things. It is also useful to familiarise yourself with the OSCE process.
Apply knowledge to practice
According to Miller (1990), to demonstrate competency, ‘knows’, ‘knows how’, ‘shows how’ and ‘does’ are necessary. It is important that you have an appropriate knowledge that underpins practice. This includes understanding the anatomical, physiological, psychological and emotional aspects of the scenario. You should also understand how to do something and know why it should be done in a certain way; this requires communication skills and knowing how to interpret data from provided documents. Then there is the demonstration, performed in a systematic and structured manner. Finally, the performance of using the skill is the most important element, integrating the previous points and resulting in performing the skill in a professionally competent way (Bloomfield et al, 2010).
Record-keeping and communication
The need for accurate record-keeping cannot be underestimated. It is a crucial part of the OSCE as it shows your understanding of the importance of written communication. Effective verbal and non-verbal communication should also be demonstrated during the OSCE.
Essential principles
Although clinical scenarios used for OSCE can differ, some principles apply to all of them. In providing care to women and their families, you must ensure that you act in accordance with the Code (Nursing and Midwifery Council (NMC), 2015) and scope of midwifery practice as outlined in Rule 5 of the Midwives rules and standards (NMC, 2012). You should adhere to national and local policies and guidelines. Maintaining a safe environment and infection control are essential, and risk assessment should be undertaken before engaging in care activities or performing clinical skills. It is also vital to ensure that equipment is in working order and is used correctly.
Dignity, respect and consent
You must maintain women's dignity and privacy, and be able to demonstrate these values throughout the OSCE process. This must be evident in your interactions with the role-player and examiner. Showing dignity and respect will involve communicating in a respectful way, presenting evidence-based information, enabling informed decisions and obtaining valid consent.
KMAS
Knowledge, motor skills, attitude and structure (KMAS) are four distinct elements of the assessment during OSCE examination (Bloomfield et al, 2010). In order to pass and achieve a good grade, you should revise the key principles of the clinical skill and be able to demonstrate it. Moreover, you should display a positive professional attitude and be able to perform the skill within the time limit, demonstrating to the examiner a systematic and logical approach to the clinical skill.
Finally, be confident, prepared, practised and calm. Good luck!