Objective structured clinical evaluation of clinical competence: an integrative review

Title. Objective structured clinical evaluation of clinical competence: an integrativereview. Aim. This paper presents an integrative literature review conducted to describe the utility of the objective structured clinical evaluation (OSCE) as a strategy of measuring one form of clinical competence in nursing. Background. The emergence of the OSCE, one form of evaluation of clinical competence used in medicine, is gaining more scrutiny and consideration in nursing education. Data sources. The review was conducted through an initial search of computerized databases CINAHL, Cochrane Database of Systematic Reviews, Academic Search Premier and MEDLINE for the period from 1960 to 2008. Methods. An integrative review was performed and 41 papers met the inclusion criteria. Results. The complexities of evaluating clinical competence can be addressed through use of an OSCE process. Concerns related to the conceptual limitations and the lack of psychometric properties of the tools available for measurement in nursing education have been identified. Conclusion. Major gaps exist in the nursing literature regarding the examination of the psychometric properties of the OSCE, the suitability of the design of the OSCE structure and tools for nursing to measure clinical competency, and the associated costs in the application of this evaluative method. Research conducted on the psychometric properties of the OSCE tool used and correlations to other evaluative methods currently used to evaluate nursing clinical competence would inform educational practices.