Exploring Undergraduate Nursing Students' Perceptions of Objective Structured Clinical and Practical Examinations (OSCE and OSPE): A Qualitative Study

Abstract

Background: Objective Structured Clinical Examination (OSCE) and Objective Structured Practical Examination (OSPE) are competency-based assessment methods used to evaluate clinical knowledge, psychomotor skills, communication, and professional competence in nursing education. Compared with traditional assessment methods, they offer greater objectivity, standardization, and reliability. Objective: To explore undergraduate nursing students' perceptions and experiences regarding the use of OSCE and OSPE as clinical assessment methods in nursing education. Methodology: A qualitative descriptive study was conducted among Bachelor of Science in Nursing students at Northwest Nursing College and NCS University System, Peshawar, Pakistan. Participants were recruited through purposive sampling based on prior OSCE and OSPE experience. Individual semi-structured interviews were conducted from March to April 2024 until data saturation was achieved. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed using Braun and Clarke’s six-phase thematic analysis. Trustworthiness was enhanced through reflexive journaling, researcher triangulation, member checking, peer debriefing, and an audit trail. Results: Eight undergraduate nursing students participated. Six major themes emerged: promotion of learning, development of clinical confidence, perceived limitations, examination-related stressors, coping strategies, and perspectives on grading. Participants considered OSCE and OSPE effective for promoting active learning, improving psychomotor skills, and enhancing clinical confidence. However, they reported challenges related to examination organization, limited resources, scheduling delays, examiner behavior, perceived grading inequities, and psychological stress. Students managed these challenges through preparation, self-confidence, and prior clinical exposure. Conclusion: Undergraduate nursing students generally perceived OSCE and OSPE as valuable educational and assessment strategies that facilitate competency development and clinical preparedness. Nevertheless, concerns regarding examination logistics, transparency of grading, and examination-related stress require institutional attention. Keywords: Clinical Competence, Nursing Education, Objective Structured Clinical Examination, Objective Structured Practical Examination, Pakistan, Qualitative Research, Undergraduate Nursing Students.