Uploaded bySmriti Arora
OSCE paeds.pptx
The document describes how to plan and implement an objective structured clinical examination (OSCE) for assessing pediatric nursing students. It discusses: - The OSCE model based on Miller's hierarchy of clinical competence using simulated practice. - Skills that can be assessed including clinical skills, decision making, communication, and time management. - Locations for the OSCE including clinical areas with real patients or simulated labs. - Steps for planning including time allotted, staffing needs, station types and content, and evaluation criteria. - Types of stations such as manned stations where students perform skills and unmanned stations involving cases, images, and written responses. - Examples of station content covering various pediatric topics, skills
More Related Content
Similar to OSCE paeds.pptx
OSCE paeds.pptx
- 1. OSCE/OSPE in Pediatric Nursing Prof.(Dr.)Smriti Arora smritiamt@msn.com
- 2. Introduction • a stepin the direction of competency-based evaluation • Inline with new BSc curriculum • With appropriate attention to design, acceptable reliability and validity can be achieved for the OSCE. • inspire students' critical thinking and promote students' communication skills
- 3. Hierarchical model ofdevelopment of clinical competence Miller’s model suggested that simulated practice could provide a good approximation to how students would behave in the real-world clinical setting, https://www.indianpediatrics.net/nov2010/nov-911-920.htm
- 4. WHAT IS ASSESSEDIN AN OSCE? Clinical Skills Decision making Clinical reasoning Communication skills Team work Time management
- 5. Where it canbe done ? • Clinical areas like wards- real patients can be used • Labs – simulated environment can be used
- 7. Before OSCE • Plantime – 60-120 mins, 5-10 mins at each station • Space with sound proof partition, table, chair, articles • Trained Manpower- examiners, simulated or real patients, helpers • Plan stations (manned and unmanned) as per the objectives, curriculum. Ensure adequate no. of stations (10-12, increases validity and reliability) • Decide on Rotations • Make a rest station also. • Give clear instructions to students and examiners about rotations, time limit and evaluation criteria • Stationery- answer sheets, drop box, paper, calculator • Validated Checklists with scoring criteria; answer key for unmanned stations • bell, timer • Camera for feedback
- 8. Blueprint of OSCE Sl. No. AreasType of station Items Competency assessed Criteria for evaluation Articles required for each station 1 Newb orn care Unmanned Case based scenario Decision making 2 CNS Unmanned Images of congenital disorders Comprehension 3 Basic pediat rics Unmanned Drug calculation Problem solving 4 CVS Unmanned ABG report Data interpretation 5 GI Manned NG tube insertion Clinical skill 6 Respir atory Manned History collection Communication 7
- 9. After OSCE • Compilethe scores • Give Feedback • Verbally • Video recording
- 10. Manned stations • Askthe student to perform at each station • Mannequin, simulated or real patients can be taken. • Ensure all articles needed for the procedure are present. • Evaluator at a station is must • Have prepared checklist to evaluate the procedure • Maintain time limit
- 11. Manned stations Procedures whichcan be done at manned stations • Station 1- Insert ET tube, NG tube • Station 2- perform Oral /ET suctioning • Station 3- perform cord care • Station 4- Anthropometric measurements – Assess height, weight, HC, CC • Station 5- IM injection • Station 6- Eliciting Neonatal reflexes • Station 7- Neonatal resuscitation • Station 8- PBLS • Station 9- Asses communication • Station 10- History collection, physical examination
- 12.
- 14.
- 15. Unmanned stations • Theevaluator is not present • Student reads the instructions and writes the answers on coded sheets. Examples: • Case based scenarios- to assess critical thinking • Calculations- Drug calculations, Drop rate calculation, BSA, BMI • Image/video based questions- disease condition, s/s, Mx • Identification of equipment or Parts of Equipment, their uses • Interpretation of lab reports- LFT, KFT, CBC, ABG
- 16. Examples of UnmannedStations • Fill in Growth charts • Show Video clips- students record their responses • Filling of APGAR score, BALLARD scoring
- 17. Station 1 Case basedscenarios Instruction for examinee- Read the following scenario. Write the answer and drop the answer sheet in the box. Scenario- A neonate aged one month whose mother was having covid last week has reported to hospital with Temperature- 39 degree C, RR – 65 breaths/min, spO2 -92% 1. What is the category of Covid 19 ?- symptomatic/mild/moderate/severe 2. Where will he be treated ? – home care / district hospital 3. What should be given for fever ? antibiotics/paracetamol/corticosteroids
- 18. Station 1 Answer Keywith scores Sl. No. Answer Score 1 Moderate 2 2 District hospital 2 3 Paracetamol 2 Total 6
- 19. Station 2 • Scenario– As shown in the image, 2 year old Rajani, female child 3 hours post partial thickness scald burn due to spillage of boiling water. The burns are on the anterior trunk and neck, right upper extremity and the right side of the face. There are large blisters on the trunk and upper extremity. In addition, there are splash marks on the left lower and upper extremities without blisters and have intact skin. Weight of the child is 12 kgs. 1. Estimate the percentage of burns using Lund and Browder burn chart and calculate the fluid to be replaced.
- 21. Answer key • TBSA-13% • 4ml/kg/%TBSA= 624 ml for 24hours
- 22. Station 3 -Image based Instructions for examinees- See the following image carefully . Write the answers in the response sheet and drop in the box 1. Identify the diagnosis 2. List 3 main symptoms 3. Name the surgery which can be done ?
- 23. Station 3 Answer Key Sl.No. Answer Score 1 Hydrocephalus 2 2 Sunset eyes, enlarged head, visible scalp veins 2 3 VP Shunt 2 Total 6
- 24. Station 4 Instructions- Lookat the following medicines and answer the following : 1. Mention the indication for this drug 2. Write 2 main side effects 3. List any 3 important nursing responsibilities while administering this drug
- 25. Station 5 Drug calculation •The pediatrician has prescribed IV ringer lactate , 1 litre for 8 hours. IV set to be used is calibrated at 10 drops/ml. 1. What will be the flow rate in ml/ hr ? 2. What will be the drop rate per minute ?
- 26. Station 5 Answer key •Flow rate - 1000/8= 125 ml/hr • Drop rate/min – 125/60= 20.8 drops/min= 21 drops/min
- 27. Station 6 Instructions -Look at the equipment and answer the following 1. Identify the equipment ………………….. 2. Name the parts ……………………….. …………………………………………………….. …………………………………………………….. 3. Write indications • ……………………….. • …………………………..
- 28.
- 29. Station 7 -Interpreting reports • This is the lab report of a child aged 13 years admitted with complains of lethargy and fever. Write the interpretation in the answer sheet. Sl. No. Test Findings Interpretation/ Remarks 1 Serum potassium 3.6 meq/L 2 Serum sodium 140 meq/L 3 Hemoglobin 7 gm/dl 4 Platelets 50,000 5 WBC 20,000
- 31. Station 8- Useof Growth charts • A baby aged 10 years, weight is 35 kg, height 140 cm. Plot on the chart and comment. • ………………………………… ………………………………… ………………………………… …………………………………
- 32. Growth charts 1. Identifythis chart …………………….. 2. It can be used for which age group ? ……………………….. 3.What 4 parameters can be checked through this chart ? ……………………………………………………………… ……………………………………………………………… …………………………..…………
- 33. Station 9 -Video clips • Show the video clips of a child with chest retractions and nasal flaring/tet spell 1. What is the finding ? ……………………………… 2. What is the probable diagnosis of the child ? ………………………… 3. What are the nursing interventions for this child ? …………………………………………………………………………………………………………… …………………………………………………………………………………………………………… ……………………………………………………………………………………..
- 34. Station 10-Identification ofcongenital anomalies MM 2x5=10 Fig 1 Fig 2 Fig 3 Fig 4 Fig 5
- 35.
- 36. Summary • Chung-Pei Fuet al examined the satisfaction and the influences of OSCE in pediatric occupation therapy 60 examinees and 44 child patients. 88.3% of the examinees reported that the OSCE was helpful for their upcoming clinical training. 73.3% preferred the OSCE over the written exam. 60-93.4% considered the implementation appropriate. • Ali Emadzadeh et al determined the challenges of the OSCE National Board Exam in Iran for final-year pediatrics and gynecology residents. The main complaint reported was the disproportion of the allowed time and the task load in the exam stages. • Fu CP, Yeh JH, Su CT, Liu CH, Chang WY, Chen YL, Yang AL, Wang CC. Med Teach. 2017 Aug;39(8):851-858. doi: 10.1080/0142159X.2017.1320540. Epub 2017 Apr 27.PMID: 28449609 • https://pubmed.ncbi.nlm.nih.gov/28607655/
- 37. Well Plan ishalf work done ! Thank you !
Editor's Notes
- #4 Miller’s pyramid model divides the development of clinical competence into four, hierarchical processes.1 On the lowest level of the pyramid is ‘knowledge’, tested by written exams and traditional multiple-choice questions (MCQs).2 The next level stands for ‘application of knowledge’, assessed by essays, clinical problem-solving exercises and extended MCQs.2 The third tier of the pyramid represents ‘clinical skills competency’, assessed by standardized patient exercises, simulations and clinical exams.2 Finally, on top of the pyramid is ‘clinical performance’, assessed by direct observation in real clinical settings.2 The lower level processes account for the cognitive components of competence and involve classroom-based assessments, while the two higher tiers of the pyramid account for the behavioural components of clinical competence, which involve assessment in simulated and real clinical settings.3 By placing the observable behaviour at the apex of the hierarchy, Miller’s pyramid implies a preference towards the behaviourist tradition, as opposed to cognitive perspectives. Miller’s model suggested that simulated practice could provide a good approximation to how students would behave in the real-world clinical setting, and therefore firmly argued for the introduction of performance-based assessments.