OSCEs--seven years on the bandwagon: the progress of an objective structured clinical evaluation programme

The original purpose of Objective Structured Clinical Examination (OSCE), as first described in the medical literature [Harden, R.M., Stevenson, M., Downie, W.W., Wilson, G.M., 1975. Assessment of clinical competence using objective structured examination. British Medical Journal, 1, 447-451], provided a means of examining the skills acquisition of medical students. A review of the literature, since that time, provides the background to the development of OSCEs into pre-registration nursing curricula, with the OSCE programme at the University of Salford presented here as a case study. The original student sample was a mixture of 150-250 adult, child and mental health students in each of seven cohorts over a period of four years. Each student undertook a 30-min formative, simulated patient, holistic care OSCE in their second year of the programme. Later developments included one remote workstation connected to and as part of the holistic patient care encounter. In subsequent curricula, the larger cohorts of around 250-300 students were accommodated in a formative rotational three-workstation OSCE, based on clinical skills to be acquired prior to their first clinical placement. A summative patient-centred OSCE was undertaken in practice at a later date. The educational and practice value of OSCEs regarding their clinical content and context in nursing curricula now and in the future are explored, along with the practicalities of implementation.