title: Tools to reduce first year nursing students' anxiety levels prior to undergoing objective structured clinical assessment (OSCA) and how this impacts on the student's experience of their first clinical placement.
abstract: BACKGROUND
  One form of assessment that tests students' theoretical skills and confidence in their clinical practice is known as the Objective Structured Clinical Assessment (OSCA). Traditionally it was first launched from medical education, and is now being incorporated by other disciplines, such as nursing.
  
  
  OBJECTIVE
  This review seeks to present the best available evidence into strategies that help reduce first year nursing students' anxiety levels prior to undergoing OSCA and clinical placement.
  
  
  METHODS
  A systematic literature search was performed using Medline and CINAHL.
  
  
  METHODS
  This review considered any English language original research published between 2005 and 2013.
  
  
  RESULTS
  A literature search located 117 articles. Eight articles were identified as meeting the inclusion in criteria. Majority of studies reported simulation session prior to the OSCA increased students confidence and reduced their anxiety levels. This resulted in students' reporting that they valued the OSCA as a worthwhile assessment. However there were four major themes: that students were anxious about attending the OSCA; that adequate preparation was seen as a coping strategy; that simulation was a further cause for anxiety; and that the simulation experience could also be used as an OSCA tool.
  
  
  CONCLUSIONS
  Students who have been exposed to simulation scenarios before the OSCA are able to cope much better during the OSCA. Therefore, it is highly recommended to incorporate simulation scenarios into the nursing curricula for first year nursing students' clinical units to help reduce their anxiety levels prior to OCSA.
authors.affiliation: School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith, NSW, Australia. Electronic address: A.Stunden@uws.edu.au.
authors.forename: Annette
authors.initials: A
authors.lastname: Stunden
authors.affiliation: School of Nursing & Midwifery, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia. Electronic address: ehalcombe@uow.edu.au.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Halcomb
authors.affiliation: School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith, NSW, Australia. Electronic address: D.jefferies@uws.edu.au.
authors.forename: Diana
authors.initials: D
authors.lastname: Jefferies
mesh_terms: D001007:Anxiety / Q000517:prevention & control*; D002983:Clinical Competence; D004508:Education, Nursing, Baccalaureate; D004521:Educational Measurement; D006801:Humans; D011231:Preceptorship; D000066908:Simulation Training / Q000379:methods; D013338:Students, Nursing / Q000523:psychology*
keywords: Clinical placement; Clinical simulation; First year nursing students; Nursing; Objective structured clinical assessment; Systematic review