Improvement of the Quality of Basic Clinical Skills Training and Evaluation of the Efficacy of Objective Structured Clinical Examination (OSCE): An Action Research with a Mixed Method

Abstract

Background: One of the main goals of action research is to improve the quality of education at both individual and organizational levels. Management enables organizations to improve their performance in areas, which have the greatest impact on students’ learning and empowerment, without compromising the quality of education. Objectives: In this study, we aimed to improve the quality of basic clinical skills training for nursing students in an action research, using the available resources. Methods: In this action research, a sequential mixed method was applied. The participants in the qualitative phase included experts in the field of education, students, and stakeholders responsible for training at the nursing skills, midwifery, and medical-surgical nursing units of Razi Faculty of Nursing and Midwifery in Kerman, Iran. Assessment of facilities and resources in the quantitative phase was also carried out using a data collection form, a student survey form, and a checklist of basic clinical skills. The stages of action research included action planning for problem-solving, implementation, evaluation, and reflection. The students’ problems with the basic clinical skills and their possible causes were also identified. The most effective and practical solutions for quality improvement included improvement of the educational environment of skill laboratories, followed by the enhancement of skills assessment process using an objective structured clinical examination (OSCE). Results: The conventional method failed in the assessment of students’ competence and lacked adequate objectivity and reliability. A significant difference was observed in the mean scores of basic clinical skills (e.g., injection, measurement of vital signs, and dressing) between the conventional method and OSCE (P < 0.05). From the viewpoint of students, OSCE is more reliable and accurate than the conventional method and uses more suitable educational materials and facilities. Conclusions: Based on the findings, by improving the educational environment of clinical skills laboratories and implementation of OSCE, nursing students can translate their knowledge of basic clinical skills into practice. We can also improve the quality of health services and clinical care for patients and reduce the incidence of practical errors made by nursing students.