Adie L, Lloyd M, Beutel D. Identifying discourses of moderation in higher education. Assessment and Evaluation in Higher Education. 2013; 38:(8)968-977

Asikainen H, Gijbels D. Do students develop towards more deep approaches to learning during studies? A systematic review on the development of students' deep and surface approaches to learning in higher education. Educational Psychology Review. 2017; 29:(2)205-234

Aronowitz T, Aronowitz S, Mardin-Small J, Kim B. Using objective structured clinical examination (OSCE) as education in advanced practice registered nursing education. J Prof Nurs. 2017; 33:(2)119-125

Barratt J. A focus group study of the use of video-recorded simulated objective structured clinical examinations in nurse practitioner education. Nurse Educ Pract. 2010; 10:(3)170-175

Bastable S, Sopczyk D, Gramet P, Jacobs K. Health professional as educator: principles of teaching and learning, 2nd edn. Beaverton (OR): Ringgold Inc; 2019

Benner PE. From novice to expert: excellence and power in clinical nursing practice.Menlo Park (CA): Addison-Wesley; 1984

Biggs JB, Tang C. Teaching for quality learning at university: what the student does, 4th edn. Maidenhead: McGraw-Hill Education/Open University Press; 2011

Bloom BS., Engelhart MD, Hill WH, Krathwohl DR. Taxonomy of educational objectives: the classification of educational goals.New York (NY): Longman; 1954

Bloom BS. Reflections on the development and use of the taxonomy. In: Anderson LW, Sosniak LA (eds). Chicago (IL): University of Chicago Press; 1994

Brown C, Ross S, Cleland J, Walsh K. Money makes the (medical assessment) world go round: the cost of components of a summative final year objective structured clinical examination (OSCE). Med Teach. 2015; 37:(7)653-659

Charted Society of Physiotherapy. Physiotherapy framework: putting physiotherapy behaviours, values, knowledge & skills into practice. 2020. (accessed 9 February 2022)

Cuschieri A, Gleeson FA, Harden RM, Wood RAB. A new approach to a final examination in surgery. Use of the objective structured clinical examination. Ann R Coll Surg Engl. 1979; 61:(5)400-405

Dale E. Audio-visual methods in teaching.New York (NY): Holt, Reinhart & Winston; 1969

Daniels VJ, Pugh D. Twelve tips for developing an OSCE that measures what you want. Med Teach. 2018; 40:(12)1208-1213

Darling-Hammond L, Hyler ME. Preparing educators for the time of COVID … and beyond. Eur J Teach Educ. 2020; 43:(4)457-465

Department of Health. Liberating the NHS: delivering the health care workforce. From design to delivery. 2012. (accessed 9 February 2022)

Experience and education. 1938. (accessed 9 February 2022)

Fuller R, Homer M, Pell G, Hallam J. Managing extremes of assessor judgment within the OSCE. Med Teach. 2017; 39:(1)58-66

Gardner G, Gardner A, O'Connell J. Using the Donabedian framework to examine the quality and safety of nursing service innovation. J Clin Nurs. 2014; 23:(1-2)145-155

Gates B, Statham M. Lecturers and students as stakeholders for education commissioning for learning disability nursing: focus group findings from a multiple method study. Nurse Educ Today. 2013; 33:(10)1119-1123

Gibson S, Leinster S. How do students with dyslexia perform in extended matching questions, short answer questions and observed structured clinical examinations?. Adv Health Sci Educ Theory Pract. 2011; 16:(3)395-404

Hagler D, Morris B. Teaching methods. In: Oermann M (ed). New York (NY): Springer; 2015

Harden RM., Lilly P, Patricio P. The definitive guide to the OSCE: the objective structured clinical examination as a performance assessment.Edinburgh: Elsevier; 2015

Health Education England. Multi-professional framework for advanced clinical practice in England. 2017. (accessed 9 February 2022)

Hughes S, Quinn F. Quinn's principles and practice of nurse education.Boston (MA): Cengage Learning; 2013

Iblher P, Zupanic M, Karsten J, Brauer K. May student examiners be reasonable substitute examiners for faculty in an undergraduate OSCE on medical emergencies?. Med Teach. 2015; 37:(4)374-378

Jasper M, Rosser M, Mooney G (2013) Professional development, reflection and decision-making in nursing and health care.Chichester: Wiley-Blackwell; 2013

Kendall L. Supporting students with disabilities within a UK university: lecturer perspectives. Innovations in Education and Teaching International. 2018; 55:(6)694-703

Khan R, Payne MWC, Chahine S. Peer assessment in the objective structured clinical examination: a scoping review. Med Teach. 2017; 39:(7)745-756

Kreitzer AE, Madaus GF. Empirical investigations of the hierarchical structure of the taxonomy. In: Anderson LW, Sosniak LA (eds). Chicago (IL): University of Chicago Press; 1994

L'Ecuyer KM. Clinical education of nursing students with learning difficulties: an integrative review (part 1). Nurse Educ Pract. 2019; 34:173-184

The objective structured clinical examination. 2014. (accessed 9 February 2022)

Maslow AH. A theory of human motivation. Psychological Review. 1943; 50:(4)370-396

Massey D, Byrne J, Higgins N Enhancing OSCE preparedness with video exemplars in undergraduate nursing students. A mixed method study. Nurse Educ Today. 2017; 54:56-61

Masters K. Edgar Dale's pyramid of learning in medical education: a literature review. Med Teach. 2013; 35:(11)e1584-e1593

Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990; 65:S63-S67

Morrow R, Torres CA. Social theory and education: a critique of theories of social and cultural reproduction.Albany (NY): State University of New York Press; 1995

NHS Employers. Advanced and enhanced clinical practice. 2021. (accessed 9 February 2022)

NHS England. Next steps on the NHS five year forward view. 2017. (accessed 9 February 2022)

NHS England, NHS Improvement. The long term plan. 2019. (accessed 9 February 2022)

Nursing and Midwifery Council. What is revalidation?. 2021. (accessed 9 February 2022)

Nursing and Midwifery Council. Quality assurance framework for nursing, midwifery and nursing associate education. 2019. (accessed 9 February 2022)

Parkin T, Collinson A. Observations on the relationship between the dietetic objective structured clinical examination and placement outcome. Nutr Diet. 2019; 76:(5)628-633

Peate I. Advancing advanced practice. Br J Nurs. 2019; 28:(6)

Pugh D, Bhanji F, Cole G Do OSCE progress test scores predict performance in a national high-stakes examination?. Med Educ. 2016; 50:(3)351-358

Royal College of Nursing. Royal College of Nursing standards for advanced level nursing practice. 2018a. (accessed 9 February 2022)

Royal College of Nursing. Advanced level nursing practice: introduction. 2018b. (accessed 9 February 2022)

Sastre-Fullana P, Morales-Asencio JM, Sesé-Abad A, Bennasar-Veny M, Fernández-Domínguez JC, De Pedro-Gómez J. Advanced practice nursing competency assessment instrument (APNCAI): clinimetric validation. BMJ Open. 2017; 7:(2)

Sawyer KR. The new science of learning. In: Sawyer KR (ed). Cambridge: Cambridge University Press; 2006

Setyonugroho W, Kennedy KM, Kropmans TJB. Reliability and validity of OSCE checklists used to assess the communication skills of undergraduate medical students: a systematic review. Patient Educ Couns. 2015; 98:(12)1482-1491

Schoonheim-Klein M, Hoogstraten J, Habets L Language background and OSCE performance: a study of potential bias. Eur J Dent Educ. 2007; 11:(4)222-229

Scott IM Beyond ‘driving’: the relationship between assessment, performance and learning. Medical Education. 2020; 54:(1)54-59

Schulte M. Adult learning degree and career pathways: allusions to Maslow's hierarchy of needs. Journal of Continuing Higher Education. 2018; 66:(1)62-64

Taylor D, Quick S. Students' perceptions of a near-peer objective structured clinical examination (OSCE) in medical imaging. Radiography (Lond). 2020; 26:(1)42-48

Sorrell J, Cangelosi P. Expert clinician to novice nurse educator: learning from first-hand narratives.New York (NY): Springer; 2015

The collected works of LS Vygotsky (1896-1934) volume 1. In: Reiber RW, Carton AS (eds). New York (NY): Plenum; 1987

World Health Organization. Framework for action on interprofessional education and collaborative practice. 2010. (accessed 9 February 2022)

Observed structured clinical examination as a means of assessing clinical skills competencies of ANPs

24 February 2022
12 min read
Volume 31 · Issue 4


Observed structured clinical examinations (OSCEs) are a common method of assessment within higher education to prepare for the advanced nurse practitioner (ANP) role. This article reviews a wide range of literature relating to OSCE assessment in the healthcare arena, from an ANP, interprofessional and advanced clinical practice perspective. Theories underpinning OSCE and advanced nursing roles are explored, with relevant supporting literature indicating how established OSCEs can become integrated with other methods to improve outcomes for this level of practice. Alternative assessments are explored with specific reference to the context of the education delivered, and the suitability for higher education today.

This article aims to critically evaluate the use of observed structured clinical examinations (OSCEs) to assess the clinical practice of post-registration nursing students training for advanced roles. It will demonstrate and analyse a rationale for the appropriateness of this pedagogy in education practice today. Reference will be given to the aptitude of this method when identifying areas for student development, with a focus on advanced nurse practitioners (ANPs) who require advanced assessment skills as part of their role.

The Multiprofessional Framework for Advanced Clinical Practice (Health Education England (HEE), 2017) stated that advanced practitioners need a high quality of training to provide enhanced patient care. The Royal College of Nursing (RCN) (2018a; 2018b) states that ANPs are experienced nurses who should be educated to master's level. ANPs must be able to evidence additional core capabilities across the four pillars: clinical practice, leadership and management, education and research (NHS Employers, 2021). NHS England's (2017) five-year plan to provide sustainability and partnership transformations identifies the importance of competence in clinical skills, which must be assessed, achieved and measured. However, Sastre-Fullana et al (2017) indicated that there is ambiguity within advanced roles and many different conceptual approaches. They argued that direct clinical assessment from superiors, peers and structured educational programmes must be used to assess learning outcomes.

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