PRESENTATION

NURSING EDUCATION
Rating scale ,checklist ,OSCE/OSCP ,Critical
incident techniques .
SUBBMITED TO : Respected Mrs Parminder
kaur Madam

Submitted by : parminder kaur

Msc (N) 1st year
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  Characterstics should be educationaly significant .

 Characterstic should be directly observable .

 Characterstics and points on the scale should be provided .

 Between three and seven rating position should be provided and

raters should be permitted to mark at intermediate points .

 Raters should be instructed to omit rating when they feel

unqualified to judge .

 Rating from several observers should be combined whenever

possible .

TYPES OF RATING SCALES

One of the simplest types of rating scales is that in which the rater puts a
check (x) or circles a number to indicate the degree to which a
characterstics is present .Typically ,each of a series of numbers is given a
verval description that remains constant from one characterstic to another .

 GRAPHIC RATING SCALE.

 DESCRIPTIVE RATING SCALE.

 NUMERICAL RATING SCALE.

 COMPARATIVE RATING SCALE .

 In this scale ,the performance is printed horizontally at various

points from lowest to highest .It includes the numerical points
on the scale .It is anchored by two extreme presented to
respondents for the evaluation of a concept or object

 DESCRIPTIVE RATING SCALE .

This type of rating scale does not use number but divide the assessment
into a series of verbal phrases to indicate the level of performance .
 RELEVANCE .

 OBJECTIVITY .

 USEFUL .

 PRECISION .

 UNIQUENESS .

 CLARITY

The rating scale must be constructed using short ,concise

statement in simple and unambiguous language.

VARIETY

While deveopling the rating scale ,monotony of the statement

must be avoided and varirty in different statement must be
ensured .

OBJECTIVITY

The statement formed in a rating scale must be objective in

nature so that it is convient for the rater to judge the attributes
or performances of the subject under study .

RELEVANCE

The statement designed in rating scale should be relevant to

the phenomenon and should be exactly in a accordance with a
variables under study .

UNIQUENESS

Each statement constructrd in a RATING scale must be unique

in itself so that the attributes can be judged appropriately .

ADVANTAGES OF RATING SCALES

 Rating scales are easy to administer and score the

measured attributes .
steps ,activities or behaviours the observer recods when an incident occurs
.The observer has to judge whether a certain behaviour has taken place .

DEFINITION

A checklist is a simple instrument consisting prepared list of expected

items of performance or attributes ,which are checked by a evaluator for
their presence or absence .

Or

Checklist is basically a method of recording categorically whether a

behaviour or

TYPES OF CHECKLIST .

1. SIGN SYSTEM .

2. CATEGORY SYSTEM .

1. SIGN SYSTEM ;---- The recorder makes no attempt to record how

frequently any one sign is observer during a period , only whether it
was seen at all .

2. CATEGORY SYSTEM ;----- In this the observer must record every

within a prespecified domain that occur during the pre specified
time period .

PURPOSES OF CHECKLIST

 To determines the job competene that is t judge whether the employer

are performing at acceptable levels .

 To enhance staff development and motivate personnel towards higher

achievements .

 To discover an employee’s aspiration and to recognize his/her

accomplishment (completeness ).

 To improve performance
CONSTRUCTION OF CHECKLIST
 They allow inter-individual comparisons .
 Checklist have objectivity to evaluate characterstics .
 Decrease the chances of error in observation .
DISADVANTAGES OF CHECKLIST
 Checklist do not indicate quality of performance so that usefulness of

 checklist only a limited component of overall clinical perform can be

evaluated .Only a limited component of overall clinical performance can
be evaluated .

 Only the presence or absenceof an attribute ,behaviour or performance

parameter may be assessed .

 It has limited use in qualitative observation .

 Checklist are not easy to prepare .

OBJECTIVE STRUCTURED CLINICAL EXAMINATION

INTRODUCTION ;-IT is a modern type of examination often used in

health sciences to assess clinical skill performances and competence in
skill such as communication ,clinical examination ,medical and nursing
procedure ,exercise prescription ,techniques and interpretation of results
.

DEFINITION OF OSCE

Objective structured clinical examination is a form of performance

–based testing used to measure candidates’ competence .During an
osce ,candidate are observed and evaluated as they go through a series
of station in which they interview , examine and treat standardized
patients who present with some type of medical problem .

OR

OSCE is an assessment tool in which the components of clinical

competence such as history taking ,physical examination , simple
procedure ,interpretation of lab result ,patient management problems
,communication ,attitude etc .are tested using agreed check lists and
This is one of the controversial issues; however ,most of the clinicians
support real –life osce station for procedure .A study conducted on the
preference and efficacy of simulation vs .real-life OSCEstation revealed
that students preferred and felt comfortable in simulated station .but
candidates who performed better over simulators were not found to be
confident real-life practitioners .however ,simulators and real-life OSCE
stations have their unique positive aspect as discussed below ;

The positive aspect of simulated OSCE station are as follows ;

 They are controlled and safe .

 Feedback from modern sophisticated simulators can be obtained .

 Simulators are readily available when required .

 Simuated station can be tailored to the level of skill to be assessed

Scanarios that are distressing to real patients can be simulated .

 In simulated station ,the patient variable in examination is uniform

across trainees .

THE POSITIVE ASPECT OF REAL LIFE OSCE STATION ARE AS

FOLLOWS

 REAL-life station provide actual competence of a person on

performances because idealized ‘textbook’ scenarios may not mimic
real-life situation .

They allow assessment of complex skills which may not be possible

at simulated stations .

Real-life situation may be more cost-effective .

HOW IS THE OSCE DONE ? THE EXAM DAY .

  Instructed about your starting station and how to proceed .

 Your question will be answered .

 ESCORTING TO EXAM POSITION

Now it is exam time .You will be escorted to your station .you will stop by
the assigned room door until a long bell /buzzer announces the start of the
exam .

 STATION INSTRUCTION TIME

 This is one or two minutes to read the instruction about this station
,patient ,and required tasks .read carefully .At the next bell/buzzer
enter the room .

 THE ENCOUNTER

Start your encounter with the SP .This is a 5-20 minutes encounter

.perform the required tasks .stop at the next bell/ buzzer .

 POST ENCOUNTER PERIOD ;-

Next is a question period .There are some differences here . Some

OSCEs will have no post encounter periods . some will one or two
minutes of the encounter periods assigned to an oral question asked
by the examiner inside the exam room .No more communication is
allowed with the SP. Others have written question to be answered on
paper or computer outside the exam room for 5-10 minutes .

 REPEAT STEPS 4 TO 6

Step 4 to 6 will be repeated until you have been in all the station
.some OSCEs will offer one or two short rest periods .

 EXAM ENDED / ESCORTING TO DISMISSAL AREA ;-

The exam is over .

You will be escorted back to the dismissal area for signing out .
you will be asked to handle back all what you had received on
 The main reason OSCE has not become a routine assessment
method for clinical examination nursing students either for formative or
summative evaluation in india are as follows ;-


LACK of feasibility due to time constrains

Shortage of training for use of OSCE .

Shortage of observerse / examiners .

Lack of interest in examiners .

Lack of enforced guidelines for practical examination by universities

( number of students examined and format of evaluation used ) .

ADVANTAGES OF OSCE

More valid than the traditional approach to clinical examiner .

Examiners can decide in advance what is to be tested and can then

design the examination to test these competencies .

Examiners can have better control on the content and complexities .

Provide more insight about students clinical and interactive

comprtencies

Test not only skills and knowledge but attitudes also .

Test the students ability to integrate knowledge clinical skills and

communication with the patient .

Provides unique programmatic evaluation .

Valid examination .

Summative and well formative .

Can be used with large number of students .

Less complexity .
BIBLIOGRAPHY

Shebeer .P.Basheer ,text book of nursing education,” As per INC ,”Syllabus

nd
.edition 2 .EMMESS Publisher ,page no 234-235 ,238-239 ,236-237 .

Sharma .K.suresh .communication and educational technology in nursing

nd
,edition 2 publisher ,:Elsevier :,page no 397-403 ,390-
practical skills through practical examination.A final practical examination
is conducted by state nursing councilor university with the school or
college is affiliated.

PURPOSES OF PRACTICAL EXAMINATIONS:

1.To check the procedural skill of student in practical situations than on

paper.

2.To evaluate attitude of the students towards the patients ,adapt to

individual patients family need.

3.To assess the ability of the student to identify patient needs/problems

and give the best nursing care possible according to the facilities available
in field and provide need based health education.

4.To check the skill in proper recording and reporting.

5.To assess the development in affect domain of students by observing

their reactions to real-life or simulated situations.

6.To assess how well the students are successfulin transforming their
theoretical knowledge in practice.

7.To assess multiple performance tasks such as assessment, planning ,

implementation ,communication and evaluation.

8.Toaseess the ability to give need based health education.

PLACE FOR PRACTICAL EXAMINATION:

It is always preferable and recommended by Indian Nursing Council that

the practical examination should be conducted in clinical area of hospital
or centre associated with the students of own school of nursing or college
or college of nursing.If the students have practical examination is in
community health , then the family chosen should be familiar to them.This
the cooperation of staff select and arrange the centre for examination.

2.Selection:The wards ,departments ,centres ,clinics which are to be utilized

for exam should be selected in advance.Examinationcentres should be
selected in advance depending upon the specialiiesoffered.

3Information :Community health personnel working in the centre clinics

etc.should be consulted and prior information of the examination should be
taken.

4.Theequipements and supplies for the nursing procedure should be

available and being easily accessible to the student at the ime of
examination.

5.The chart and records of the records of the patient, family should be kept
up to date as far as possible.

PROCEDURE OF PRACTICAL EXAMINATION:

1.Examiner should arrive a day earliest of the day of examination. This is

helpful because they can visit the areas selected , hold discussion with
ward sister regarding nursing care situations.

2.Examiner must prepare a written plan of assignments , areas which they

planned to give to students.

3.Students should be examined in wards, home and families and health

centres where they are friendly working , if is not possible then they should
be posted to one of the examination area 2 to 3 days in advance , they
must be allowed to visit the areas several times to become familiar with
the patients condition and with the physical setting.

4.Each student should be examined for 20-30 minutes and each examiner
should examine 10-15 students per day.

5.Examiner will allow the students to do systematized care based on

nursing process.
4.Transport facility for the students and examiners.

5.Number of students appearing for practical examination should have roll

no and necessary document with them.

6.Arrange for same refreshment for the examiner ,helpers and students.

7.Take the examiner to the place , call the students to get necessary
instructions from examiner regarding exams.

8.Examiner should create a situation free for the student.

AFTER THE EXAMINATION:

1.Students performance should be discussed along the examiner, weak

areas are pointed out , suggestions to be marked or discussed.

2.Marks scored by each student is written in words as well as in figures on

the sheet of paper and examiner prepare abrief report on the performance
of students,outline the weak areas and suggestive to improve the
deficiency.

ROLL NO. MARKS(FIGURES) MARKS(WORDS) PERCENTAGE(%)

3.All the documents are signed by both the examiner ,put it into the envelop
, marks as confidential and sealed and dispatch to the concerned authority.

ADVANTAGES:

1.Provide opportunity to test the skill.

2.The examiner can observe and check the performance of students.

 CRITICAL INCIDENCE TECHNIQUES

Introduction
• Method for collecting purely factual (accurate) information.
• Critical incident is any important observable part of human behavior
• To allow conclusion made out from person performing act
• Evaluator records effective or ineffective behavior

Definition
A critical incident as one that makes a significant difference in the outcome of an
activity. It may be the positive factors that contribute towards the cusses of the
behavior or it may be negative factors that interfere with completion of assignments.
- Fivers and Gosnell

History
• Psychologist John Flanagan first introduced use of critical incident during World War II
while attempting to evaluate men in armed forces.
SOME EVENTS

Refuse to with subordinates obey orders

Refused to follow clear cut instructions

Suggested a method that causes changes in production

Got angry over work or Refuse to with subordinates

Unwilling to attend further training

Refuse to co-operate with other employeed

EffectiveBehaviors

It includes positive behaviors that to the patient care services

Ineffective behaviors

These are negative behaviors which interfere with good nursing care or lead to poor
nursing care

Criteria for using critical incident

• The actual behaviors must be reported rather than general features/characteristics.

• The behavior must be actually observed .

All relevant factors in the incident must be given.

• The observer must make a definite judgment about the behavior that is considered to
be critical.

• A collection of critical incidents is made on the basis of day to day observation of

nurses in providing nursing care, as soon as possible after they occur .Determine &
review the incident

• After gathering all information , need to identify which issues are faced by persons in a

particular incident. Identify issues

• It includes finding out possible solutions &how to resolve an issues based on various
possible solutions .Determine ways to resolve issues