Abstract
Background: Objective Structured Practical Examination (OSPE) and Objective Structured Clinical Examination (OSCE) are recognized assessment techniques employed in nursing education to test the clinical competence of the candidates in an objective manner. Though OSPE/OSCE is an essential assessment technique in nursing education, it is considered to be stressful to nursing students, especially to the first-year students who lack experience in performance-based clinical components of OSPE/OSCE. It is recognized that high levels of stress in OSPE/OSCE can result in the psychological impairment of students’ performance. There is no documented literature on the relationship of stress to OSPE/OSCE among first-year students in the District of Swat in Pakistan.
Objective: To assess the level of perceived stress and identify factors associated with OSPE/OSCE examinations among first-year nursing students in District Swat.
Methodology: The study was a descriptive cross-sectional survey conducted on a sample of 152 first-year nursing students chosen from different nursing colleges in District Swat. The study used a structured perceived stress scale after procuring a consent form and ethical permission. The scores on perceived stress were divided into low levels of stress, moderate levels of stress, and higher levels of stress. The analysis of the results was carried out using IBM SPSS version 27 software. The analytical tool used was descriptive statistics for demographic variables as well as levels of stress. The analysis also used descriptive and inferential statistics like correlation analysis for exploring any correlation between stress and other relevant factors.
Results: The participants had a mean age of 20.84 ± 1.612 years. The participants also reported moderate perceived stress in majority (59.9%), low perceived stress (23.7%), and high perceived stress (16.4%). The overall scale of perceived stress scored a mean of 18.49 ± 9.588 in a scale of 1 to 38. The sources of perceived stress in relation to OSCE included constraints of time taken in OSCE procedures, waiting anxieties prior to the examination, fear of error, and performance anxieties in front of assessors as well as peers. Inferential analysis showed that perceived stress related to OSPE/OSCE examinations was significantly associated with gender, with higher stress levels among female students (χ² = 7.21, df = 2, p = 0.027), while no significant association was found between stress level and residence status among first-year nursing students. Experience with mannequin simulations and having had previous OSCE experiences brought about lower levels of stress.
Conclusion: The conclusion that can be drawn from the thesis is that OSPE/OSCE exams cause, in general, a medium level of stress in first-year nursing students in District Swat. Time pressures, fear of anticipatory situations, and social evaluation have been shown to be the most salient contributors in stress levels. These points reveal the importance of careful preparation activities, practice simulations, as well as stress interventions in improving confidence levels as well as reducing stress levels.