Challenges of objective structured clinical examination in undergraduate nursing curriculum: Experiences of faculties and students

Nurse Educ Today. 2021 Aug;103:104960. doi: 10.1016/j.nedt.2021.104960. Epub 2021 May 14.


Background: Assessment of clinical competence of nursing students is necessary to ensure safe practice and the realization of professional clinical standards. An Objective Structured Clinical Examination (OSCE) is commonly used internationally in nursing education programs to assess clinical competence, but is a new process in Iranian nursing curricula.

Objective: The aim of this study was to explore and describe challenges associated with OSCE implementation based on the experiences of faculty members and nursing students, with the objective of further improving the assessment of clinical competence in nursing education.

Design: This study used a qualitative approach that included thematic analysis of the transcribed interviews.

Setting: Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences (TBZMED), Tabriz, Iran.

Participants: Purposive sampling was used to select eighteen faculty members and fifteen students from those interested. These participants represent a reasonable cross-section of those who had participated in the OSCE.

Methods: A pre-developed interview guide was used to inform semi-structured in-depth interviews. These were recorded and analyzed using the 6-phase thematic analysis method as described by Braun and Clarke (2013). Themes were independently verified.

Results: Challenges identified by participants around OSCEs as part of undergraduate nursing education were extracted from the interview data. Two main themes were evident from the data: 1) shortcomings in executive and technical infrastructure, 2) shortcomings in educational infrastructure. These themes reflected both student and faculty experiences. These also aligned with themes that commonly emerge in related literature.

Conclusion: The study findings illustrate several key challenges associated with organizing and implementing OSCEs and so provides unique insights into the development of strategies to implementing and promoting OSCEs in nursing education. We recommend that managers and authorities in nursing education focus on these challenges and explore processes to successfully introduce this exam for assessment of nursing student capacity.

Keywords: Clinical competency; Education; Evaluation; Nursing; Objective structured clinical examination.

MeSH terms

  • Clinical Competence
  • Curriculum
  • Education, Nursing, Baccalaureate*
  • Educational Measurement
  • Humans
  • Iran
  • Students, Nursing*