Hospice nurses require a range of clinical skills to meet the varying needs of their patients. These skills ensure safe, effective and timely care, however, there can be limited exposure in clinical practice therefore Observed Structured Clinical Examinations (OSCE) were introduced at St Giles Hospice as a way of bridging this gap. An OSCE is a simulated assessment used widely in healthcare education (Hensler, 2013) and is recognised nationally as a model for evaluating clinical competencies (McWilliam & Botwinski, 2014). Preparing and conducting an OSCE is resource-intensive (Ahuja, 2009) and can provide some evidence of competence (Hensler, 2013) especially in environments where clinical learning opportunities can be limited (McWilliam & Botwinski, 2014).
Four OSCE subjects were chosen and performance criteria devised. These criteria were then available for the participating registered nurses. The participating nurses were given two months’ notice of the date of assessment. The standard operating procedures for each skill and additional resources were also made available for the participating nurses prior to the assessments. Thirty minutes was allocated for each skill which included time for feedback.
The registered nurses who took part in the OSCEs were asked to complete a questionnaire one month after. Overall both the examiners and participating registered nurses found the OSCEs to be a positive experience; they helped to increase confidence, acted as a refresher and highlighted areas for further learning on a personal and team level. However, it is important to remember that performance in the simulated environment may not be easily transferred to the clinical environment (Hensler, 2013). Following these OSCEs, the performance criteria have been split into procedure and knowledge to better identify where further learning is required. It was also decided that OSCEs would be implemented annually and also incorporate Health Care Assistants.
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