2019 Volume 33 Issue 2 Pages 200-212
Objectives
We investigated an OSCE for evaluating delivery practices during the completion of a midwifery course (below, “pre-graduation”) and implemented trials for pre-graduation students to analyze the validity of this OSCE.
Methods
We implemented a two-stage development process during the period from March 2017 to March 2018. In Stage 1, we planned an OSCE that evaluated the clinical reasoning tasks. For scenarios, we set four scenes and eight tasks as excerpts from the stretch of time between when a pregnant woman enters the hospital and the completion of childbirth. The evaluation chart was based on the Japan Society of Midwifery Education's (2016) “Factual Survey of Midwifery Student Degree of Learning of Delivery Care Abilities” and was completed after running a pilot test. In Stage 2, we ran trials for pre-graduation midwifery students, with two lanes of two student test subjects and six evaluating instructors in teams of three, and we aggregated the trial data and extracted items that were consistent or different among the evaluations of the evaluators. We also conducted focus-group interviews of the evaluators, analyzed the content, and integrated it with quantitative data to analyze the results. This study obtained the approval of the affiliated institution's ethics review committee.
Results
The items of the evaluators' evaluations that were in agreement were “prediction of progress status,” “delivery preparation timing,” “torso delivery,” and “judgment of hemorrhage.” Conversely, the evaluations varied for the following items: “psychological support,” “support for accelerating delivery progress,” “assistance of child's first respiration,” “identification of external deformities,” and “precautions against abnormalities.” The evaluators opinions were that the diagnostic skills appeared well, that it was difficult to standardize the evaluation of behavioral aspects, and that detailed standards were needed regarding technical aspects.
Conclusion
This OSCE aims to evaluate students' abilities to gather information, to conduct all kinds of medical examinations for pregnant women visiting hospitals and to make decisions about care plans and put them into practice. In the trial, students' clinical reasoning was made apparent, and the results suggested that the trial had high validity as an evaluation method for the comprehensive practical abilities of pre-graduation students. In the future, it will be necessary to accumulate and study data, while further increasing validity by improving on topics such as evaluator consistency, standardization of evaluation standards, number of cases, number of tasks, time required, and number of evaluators.
