title: How to maintain equity and objectivity in assessing the communication skills in a large group of student nurses during a long examination session, using the Objective Structured Clinical Examination (OSCE).
abstract: BACKGROUND
  While development, testing, and innovation of the Objective Structured Clinical Examination (OSCE) are common in the international literature, studies from the United States of America (USA), Australia, and the United Kingdom (UK) predominate. There is little known about OSCE use in European countries, such as Italy, where other than cost analysis, there is little reporting of OSCE use or validation.
  
  
  OBJECTIVE
  This paper reports on one Italian initiative, which evaluated the equity and objectivity of the OSCE method of assessing communication skills.
  
  
  METHODS
  An OSCE method was used to assess the communication skills of first-year students of the Degree Course in Nursing. A method of simulation was implemented through role-playing with standardized patients. An observational method was used to collect data.
  
  
  METHODS
  Four hundred and twenty-one first-year undergraduate nursing students at one university site in Italy took part.
  
  
  METHODS
  Ten examination sessions were carried out. The students' performances were assessed by two examiners who used a structured observation grid and conducted their assessment separately. A situation simulated by four nurses with experience as actors was used as the topic for the students' examination.
  
  
  RESULTS
  Calculation of the daily rate of students who passed the examination revealed a random distribution over time. The nonparametric correlation indexes referring to the assessments and to the scores assigned by the two examiners proved statistically significant (P≤0.001).
  
  
  CONCLUSIONS
  The study confirmed the validity of the OSCE method in ensuring equity and objectivity of communication skills assessment in a large population of nursing students for the purpose of certification throughout the duration of the examination. This has important implications for nurse education and practice as the extent to which OSCE approaches, while deemed objective, are culturally sensitive or valid and reliable across cultures is not clear. This is something that requires further research and examination in this field.
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy. Electronic address: Annamaria.bagnasco@unige.it.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Bagnasco
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy. Electronic address: angela.tolotti@unipv.it.
authors.forename: Angela
authors.initials: A
authors.lastname: Tolotti
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, I-56100 Pisa, Italy. Electronic address: nicola.pagnucci@for.unipi.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Pagnucci
authors.affiliation: School of Medical and Pharmaceutical Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy. Electronic address: gctorre@unige.it.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Torre
authors.affiliation: School of Nursing, Trinity College, College Green, Dublin 2, Ireland. Electronic address: Fiona.Timmins@tcd.ie.
authors.forename: Fiona
authors.initials: F
authors.lastname: Timmins
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy. Electronic address: giuseppe.aleo@edu.unige.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Aleo
authors.affiliation: Department of Health Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy. Electronic address: l.sasso@unige.it.
authors.forename: Loredana
authors.initials: L
authors.lastname: Sasso
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D004508:Education, Nursing, Baccalaureate; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D016544:Patient Simulation; D015203:Reproducibility of Results; D013338:Students, Nursing
keywords: Communication skills; Educational measurement; Inter-rater evaluation; OSCE; Patient simulation; Reproducibility of results; Role-play