The Objective Structured Clinical Examination in evolving nurse practitioner education: A study of students' and examiners' experiences

Assessment of advanced clinical competence is essential for safe practice and achieving international standards for nurse practitioners. It is of particular interest for countries that have recently been introduced to advanced nursing roles to investigate examination forms that ensure quality in nurse practitioner education. The aim of this study was to explore and describe the nurse practitioner students' and examiners' experiences with Objective Structured Clinical Examination, which is an exam form for assessing clinical competence. Five focus groups, consisting of 15 nurse practitioner students (n = 15) and five individual interviews with examiners (n = 5), were conducted in June 2016 and analysed using thematic analysis. The nurse practitioner students and examiners experienced the exam as an appropriate method of assessment for advanced clinical competence, although they experienced some challenges with its form. Consequently, the results of this study advocate for a course design that includes: constructive alignment between the course and the exam, more training with real patients, use of formative and summative assessment and a second exam with a real patient after the student's clinical placement. The lack of a clear nurse practitioner role in countries with evolving advanced nursing roles can challenge the expected level of advanced clinical competence in an educational context.