Bridging Self-Assessment Gaps: The Impact of Objective Structured Clinical Examination (OSCE) on Nursing Students'...

Self-assessment is critical in nursing education, enabling students to reflect on their cognitive and clinical skills while helping educators identify gaps in competencies. Combining subjective self-assessment with the objectivity of Objective Structured Clinical Examinations (OSCEs) supports learning adjustments. This study explores the impact of OSCEs on nursing students' self-assessment of practical competencies.

A quasi-experimental pre-post study was conducted with a convenience sample of 229 third- and fourth-year nursing students at a Spanish university. Only students who had not previously taken an OSCE were included. A 10-station OSCE was implemented, and the Self-Assessment Competence Scale (SACS) evaluated perceived competence levels. Data analyses included descriptive statistics, sensitivity testing, t-tests, and ANOVA (tertile analysis) with size effect for group differences, and regression analysis to detect the Dunning-Kruger effect.

Fourth-year students scored significantly higher on OSCEs than third-year students. Female and male students had similar OSCE results, though fourth-year students demonstrated higher self-perception of competence than their third-year peers. The mean of self-assessment scores is similar for men and women, but disaggregating scores by competences shows significant differences. Interestingly, students with higher self-perceived competence often achieved lower OSCE scores, revealing discrepancies attributed to the Dunning-Kruger effect. Post-OSCE, students adjusted their self-perception more closely to their actual performance.

OSCEs effectively identify and address discrepancies between self-assessment and objective performance, fostering critical self-awareness among nursing students. By revealing overconfidence in less skilled students, these findings highlight the importance of integrating structured OSCEs into nursing curricula. Educators can use these insights to develop targeted programs that enhance competency development, reflective learning and patient safety.