The Application Of OSCE Model In The Evaluation Of Clinical Nursing Practice Ability Of Nursing Students In Higher Vocational Colleges

ObjectivesTo investigate the mechanism of the disease,In order to explore the feasibility of OSCE model in the evaluation of clinical nursing practice ability of higher vocational nursing students,this study constructed a scientific OSCE model for the evaluation of clinical nursing practice ability of higher vocational nursing students,and carried out the teaching intervention and examination of OSCE model in the comprehensive intensive training of nursing skills for the "2+ 3" five-year higher vocational nursing students in a medical college,so as to provide a reference for the evaluation mode of comprehensive quality and ability of higher vocational nursing students in medical colleges,and promote the reform of nursing teaching.Methods1.After consulting a large number of literatures,the research group preliminarily designed the OSCE assessment mode for higher vocational nursing students.According to the proposed OSCE assessment mode,the expert inquiry form was made,and the Delphi method was used to consult 16 domestic experts in related fields on the site setting,assessment time,assessment content,assessment method,SP demand and general situation of the experts.When the consensus of experts is high,the consultation is ended.The assessment contents with the average value of importance assignment greater than 3.5 and the coefficient of variation less than 25% are retained.Finally,the OSCE assessment mode of higher vocational nursing students was established.2.According to the OSCE assessment content of higher vocational nursing students constructed by Delphi method,the research group combined with clinical real cases to compile nursing standardized cases and formulate relevant scoring standards,which were modified by nursing education experts for training and assessment.At the same time,related questionnaires were prepared.Recruit and train TSP,assessor and examination staff.Randomly selected 30 higher vocational nursing students for pre experiment,in order to optimize and improve the OSCE assessment program and process.3.In the comprehensive intensive training of nursing skills before internship,two classes of grade 2019 "2 + 3" five-year higher vocational nursing students in a medical college were selected as the research objects,and they were divided into experimental group and control group by coin tossing method.The control group was taught by traditional teaching method,while the experimental group was taught by OSCE mode with TSP full participation.Before and after the comprehensive intensive training,two groups of nursing students were organized to test their nursing theoretical knowledge and critical thinking ability.The nursing students in the experimental group participated in the OSCE assessment before and after the intervention,and the teachers and students who participated in the teaching and assessment of OSCE mode were investigated by questionnaire.SPSS21.0 software was used for statistical analysis of the examination results and questionnaire survey results.Results1.After two rounds of consultation,10 experts from five Grade-A teaching hospitals and 6 experts from three medical colleges and universities reached a consensus and stopped the consultation.The positive coefficient of experts in the two rounds of inquiry is 100%,and the average coefficient of experts’ authority is 0.870.The coefficient of variation of OSCE station setting for two rounds of expert consultation is 5-10.49 and 0-4.9 respectively;the coefficient of variation of OSCE site assessment content of two rounds of expert consultation is6.78-19.61 and 0-13.35 respectively.Finally,according to the results of the inquiry,the OSCE model was established for the evaluation of clinical nursing practice ability of higher vocational nursing students,including nursing evaluation station,nursing diagnosis and planning station,nursing skills implementation station,health education station and 35 assessment contents.2.The OSCE model established after expert consultation was applied in the comprehensive and intensive training of nursing skills for higher vocational nursing students before internship.Before the implementation of teaching intervention,the scores of nursing theoretical knowledge test and critical thinking ability test of the control group and the experimental group were p >0.05,and the differences were not statistically significant.After the implementation of teaching intervention,the scores of theoretical test and critical thinking ability of the experimental group were significantly higher than those of the control group,and the difference was statistically significant.By analyzing the OSCE examination results of the experimental group before and after the implementation of OSCE mode teaching,the scores of nursing students in the four examination stations were improved,and the differences were statistically significant,especially in the nursing diagnosis and planning station and Health Education station.The results of the questionnaire survey show that most candidates,teachers,standardized patients and examiners think it is necessary to promote OSCE assessment and teaching mode.3.The average difficulty of OSCE mode in this study is 0.685,which indicates that the difficulty of OSCE assessment is more appropriate.The average discrimination of the two assessments before and after the OSCE teaching intervention is 0.625,which indicates that the OSCE assessment scheme has a good discrimination(see table 20 for details).Conclusions1.The OSCE model established by Delphi method can scientifically,comprehensively and truly evaluate the comprehensive clinical nursing ability of nursing students,which has certain feasibility.2.Using TSP to participate in OSCE teaching and assessment in the whole process makes up for the lack of clinical practice opportunities,shortens the gap between teaching and clinical practice,and is more conducive to cultivate and evaluate the comprehensive quality of higher vocational nursing students,such as communication ability,humanistic care ability,theoretical knowledge transformation ability and clinical thinking ability.It is worth using for reference in secondary and higher vocational colleges and hospitals,so as to promote the reform and development of nursing education.3.OSCE mode provides new ideas and methods for the cultivation and evaluation of clinical nursing practice ability of higher vocational nursing students.However,the comprehensive improvement of clinical nursing practice ability education of higher vocational nursing students needs further OSCE teaching intervention in lower grades and multi disciplines,and further refinement of OSCE teaching and training program is needed.