The document discusses Objective Structured Clinical Examination (OSCE) and Objective Structured Practical Examination (OSPE) as assessment tools for evaluating clinical skills. It defines OSCE and OSPE, describes their methodology using examples of stations, and discusses their advantages and disadvantages. The document also covers the Semantic Differential Scale used to measure psychological meanings and attitudes towards concepts using bipolar adjective scales. It discusses the history, methodology, usage and factors of the Semantic Differential Scale.

1. SEMINAR
ON
OSCE/OSPE,DIFFERENTIAL SCALE
SAKSHI RANA
M.Sc NURSING

2. OSCE

3. (OSCE)
INTRODUCTION: An OSCE is an;
• O bjective
• S tructured
• C linical
• E xamination

4. Contt..
• Objective : examiners use a checklist for
evaluating the trainees
• Structured: trainee see the same problem and
performs the same tasks in the same time
frame
• Clinical: the tasks are representative of those
faced in real clinical situations
• Examination: a test check the person's
knowledge or proficiency in a subject or skill.

5. Contt..
DEFINITION:
OSCE is an assessment tool in which the components of
clinical competence such as history taking, physical
examination, simple procedures, interpretation of lab results,
patient management problems, communication, attitude etc.
are tested using agreed check lists and rotating the student
round a number of stations some which have observers with
cheek lists.

6. Contt..
OBJECTIVES:
• The aim in the examination is to produce a profile for
each candidate rather than a single composite mark.
A candidate, For example, may be competent in
physical examination techniques, but have an
unsatisfactory attitude and may be lacking in
interpersonal skills.

7. Contt..
• The examination tests a wide range of skills
thus greatly reducing the sampling error. This
very significantly improves the reliability of the
examination.
• All students face the same tasks.
• Candidates see a number of examiners in the
course of the examination

8. Contt..
PURPOSES OF OSCE:
• Variability
• Defects in competencies examined
• Difficulties in conducting Exams

9. Contt..
PRINCIPLE:
• Skill to be tested is given in form of a specific
question
• To be answered in 4-5 minutes
• Each question is a station or each question
(station) a check list is prepared in advance
• Check list prepared by breaking the skill to be
tested into its vital components and
precautions to be observed

10. Contt..
METHODOLOGY:
The OSCE examination consists of about 15-
20 stations each of which requires about 4-5
minutes of time. All stations should be capable
of being completed in the same time. in which
each candidate is examined on a one-to-one
basis with one or two impartial examiner. The
students are rotated through all stations and
have to move to the next station at the signal.

11. Contt..
Example of a procedure station;
Task - Examine the scrotal swelling in patient.
Points in the check list:
1. Does he explain to the patient what he is going to do?
2. Does he take permission?
3. Does he provide a screen?
4. Does he ask the patient to expose the whole abdomen and genitalia?
5. Does he examine both sides of the scrotum?

12. Contt..
6. Does he take care not to cause discomfort?
7. Does he palpate the spermatic cord?
8. Does he palpate the abdomen (for lymphnodes in
case it is a patient with a testicular tumour)
9. Does he palpate the supraclavicular nodes?
10. Does he thank the patient?

13. Contt..

15. Contt..
ADVANTAGES:
• All components of clinical Exams are assessed so
more
• Valid examination
• Used as summative as well formative
• Can be used with larger number of students
• Components of clinical Skills& standards of
competencies are predetermined So Objectivity &
Reliability is higher

16. Contt..
• Provides unique programmatic evaluation
• Objectivity and validity are highly ensured in
OSCE
• A wide range and variety of facts can be tested
at a time.
• Contains detailed feedback for students and
teachers.

17. Contt..
DISADVANTAGES:
• Knowledge and skills are tested in
compartments & not tested in ability to look at
the Pt. as a whole, So long case may also
needed
• The OSCE may be demanding for both
examiners and patients
• More time in setting it up

18. Contt..
• Shortage of examiners
• Might be quite distressing to the student
• Expensive.
• Takes long time to construct a case and a
scoring checklist.

19. ENTRY
STATION
1
STATION
2
STATION
3
STATION
4
STATION
6
STATION
7
STATION
9
STATION
15
STATION
14
STATION
13
STATION
12
STATION
11
STATION
10
STATION
9
STATION
5
EXIT EXAMPLE
OF
OSCE

20. OSPE

21. (OSPE)
INTRODUCTION: An OSPE is an:
• O bjective
• S tructured
• P ractical
• E xamination

22. Contt..
DEFINITION:
Objective structured practical examination
(OSPE) is a new pattern of practical
examination, in which each component of
clinical competence is tested uniformly and
objectively for all the students who are taking up
a practical examination at a given place.

23. Contt..
FEATURES:
• The stations are short i.e. the task at each
station
• Does not exceed 4 – 5 minutes.
• The stations are numerous ranging from 12 –
20 stations as desired.
• The stations are very highly focused.

24. Contt..
• Pre-structured check list / marking schemes
are used.
• Scoring is objective, since standards of
competence are pretested and agreed check
lists, used for scoring.
• Simulations / models can be used for acute
cases.
• There is reduced examiner / patient input thus
increasing the validity of the examination

25. Contt..
METHODOLOGY:
The OSPE examination consists of about 15-20
stations each of which requires about 4-5
minutes of time. All stations should be capable
of being completed in the same time. in which
each candidate is examined on a one-to-one
basis with one or two impartial examiner.

26. Contt..
Example of an OSPE
Task - Examine the specimen of urine provided for
proteins.
Check list
1. Does he take a urine sample to 2/3 level in the test tube?
2. Does he boil upper 1/3 of the column?
3. Does he add 2% acetic acid drop by drop?
4. Does he compare change in the top layer with the bottom layer of
urine?

27. Contt..

28. Contt..
ADVANTAGES:
• Large samples of students’clinical abilities can be
assessed.
• The examiner can specify in advance what has to be
assessed.
• The use of checklist encourages a more objective
assessment.
• Each student has a number of examiners.
• All students have the same, nearly identical patients.

29. Contt..
DISADVANTAGES:
• It's very resource intensive.
• Long time planning is required.
• care must be taken to organize the stations.
• External examiners need to be convinced/
(trained will be more appropriate) for the process.
• Proper look up for routine entries like roll. no.
etc.
• Examines in components, not holistic.
• Observer fatigue.

30. ENTRY
STATION
1
STATION
2
STATION
3
STATION
4
STATION
6
STATION
7
STATION
9
STATION
15
STATION
14
STATION
13
STATION
12
STATION
11
STATION
10
STATION
9
STATION
5
EXIT EXAMPLE
OF
OSPE

31. DIFFERENTIAL
SCALE

32. DIFFERENTIAL SCALE
INTRODUCTION:
• Semantic differential scale or the S.D. scale
developed by Charles E. Osgood, G.J. Suci and P.H.
Tannenbaum (1957), is an attempt to measure the
psychological meanings of an object to an individual
surveys using Semantic Differential Scale is the most
reliable way to get information on people’s emotional
attitude towards a topic of interest.

33. Contt..
• This scaling consists of a set of bipolar rating
scales, usually of 7 points, by which one or
more respondents rate one or more concepts
on each scale item.

34. Contt..
DEFINITION:
The Semantic Differential Scale is a seven-point
rating scale used to derive the respondent’s
attitude towards the given object or event by
asking him to select an appropriate position on a
scale between two bipolar adjectives (such
as “warm” or “cold”, “powerful” or “weak”,
etc.)

35. Contt..

37. Contt..
HISTORY OF SEMANTIC DIFFERENTIAL:
• Semantic Differential was developed by C.E. Osgood
in 1957 precisely to measure the connotative meaning
of cultural objects. The use of semantic differential
questions have been seen in various social sciences,
market research, and therapy.

38. Contt..
• Osgood performed research on large collections of
semantic differential scales and found that three
dimensions of affective meaning were universal
across cultures, despite those cultures’linguistic
differences:
• Evaluation: pairs like ‘good-bad.’
• Potency: pairs such as ‘powerful-weak.’
• Activity: includes pairs like ‘active-passive’.

39. Contt..

40. Contt..
FACTORS OF EVALUATION, POTENCY, AND
ACTIVITY:
Osgood and his colleagues performed a factor
analysis of large collections of semantic differential
scales and found three recurring attitudes that people
use to evaluate words and phrases: evaluation,
potency, and activity. Evaluation loads highest on the
adjective pair 'good-bad'. The 'strong-weak' adjective
pair defines the potency factor. Adjective pair 'active-
passive' defines the activity factor.

41. Contt..
METHODOLOGY:
(1) Bipolar adjective scales are a simple, economical
means for obtaining data on people's reactions. With
adaptations, such scales can be used with adults or
children, persons from all walks of life, and persons
from any culture.
(2) Ratings on bipolar adjective scales tend to be
correlated, and three basic dimensions of response
account for most of the co-variation in ratings. The
three dimensions, which have been labeled Evaluation,
Potency, and Activity (EPA), have been verified and
replicated in an impressive variety of studies.

42. Contt..
3) Some adjective scales are almost pure measures of the
EPA dimensions; for example, good-bad for Evaluation,
powerful-powerless for Potency, and fast-slow for
Activity. Using a few pure scales of this sort, one can
obtain, with considerable economy, reliable measures
of a person's overall response to something. Typically, a
concept is rated on several pure scales associated with
a single dimension, and the results are averaged to
provide a single factor score for each dimension.
Measurements of a concept on the EPA dimensions are
referred to as the concept's profile.

43. Contt..
(4) EPA measurements are appropriate when one is
interested in affective responses. The EPA system is
notable for being a multi-variate approach to affect
measurement. It is also a generalized approach,
applicable to any concept or stimulus, and thus it
permits comparisons of affective reactions on widely
disparate things. EPA ratings have been obtained for
hundreds of word concepts, for stories and poems, for
social roles and stereotypes, for colors, sounds,
shapes, and for individual persons.

44. Contt..
USAGE:
The semantic differential is today one of the most
widely used scales used in the measurement of
attitudes. One of the reasons is the versatility of
the items. The bipolar adjective pairs can be
used for a wide variety of subjects, and as such
the scale is nicknamed "the ever ready battery”
of the attitude researcher.

45. Contt..
ADVANTAGES:
• Theory suggests that the semantic differential is one of the
most appropriate techniques to assess the intensity and
direction of the meaning of concepts, opinions, and
attitudes. The advantages of the semantic differential are
also backed by empirical results. the semantic differential
has been demonstrated to function effectively as a short-
form scale format to reduce survey completion time.
• Elements of a semantic differential include the concept to
be measured, a negative polar, a positive polar, and a
scale connecting both polar.

46. Contt..
• The primary advantage of semantic differential
scale is that it is easy to understand the scale
and rate correctly and its popularity makes it
very familiar with responders. This makes
information collected very reliable.
• Another advantage is in the versatility of
semantic differential scale type questions, they
have been successfully used in satisfaction
scientific behavioral analysis.

47. Contt..
DISADVANTAGES:
• Semantic differential suffers from a lack of
standardization.
• The numbers of divisions on the scale are a problem.
If too few divisions are used, the scale is crude and
lacks meaning; if too many are used, the scale goes
beyond the ability of most people to discriminate.

48. Contt..
• In this we use ranges there is no one correct answer,
which makes it difficult to identify the knowledge level
of the responder. So, some preparatory questions to
categorize the responder into knowledge levels is
recommended.
• Identifying the correct number of points on the scale
can be tricky and highly dependent on question type.
Just remember that too few points on the scale means
you may not capture the emotional range felt by the
responder, while too many points might seek
information that is not there.