A focus group study of the use of video-recorded simulated objective structured clinical examinations in nurse practitioner education Julian Barratt * London South Bank University, 103 Borough Road, Southwark, London SE1 0AA, United Kingdom article info Article history: Accepted 7 June 2009 Keywords: Objective structured clinical examination Video Nurse practitioner Focus group summary The objective structured clinical examination (OSCE) is a common method of clinical skills assessment used for advanced nurse practitioner students across the United Kingdom. The purpose of an advanced nursing OSCE is to assess a nurse practitioner student’s competence and safety in the performance of commonly used advanced clinical practice skills. Students often feel nervous when preparing for and par- ticipating in an OSCE. Consideration of these identified anxieties led to the development of an alternative method of meeting students’ OSCE learning and preparation needs; namely video-recorded simulated OSCEs. Video-recording was appealing for the following reasons: it provides a flexible usage of staff resources and time; OSCE performance mistakes can be rectified; it is possible to use the same video- recordings with multiple cohorts of students, and the recordings can be made conveniently available for students with video streaming on internet-based video-sharing sites or virtual learning environments. The aim of the study was to explore the value of using such recordings amongst nurse practitioner stu- dents, via online and face-to-face focus groups, to see if they are a suitable OSCE educational preparation technique. The study findings indicate that simulated OSCE video-recordings are an effective method for supporting nurse practitioner educational development. Ó 2009 Elsevier Ltd. All rights reserved. Introduction This paper presents a focus group study of a new piece of learn- ing material, which has been used for nurse practitioner students’ clinical skills preparation at a London university. This university, in common with other universities across the United Kingdom, tea- ches registered nurses wishing to practise nursing at a level be- yond which their initial training has prepared them for, via a well-defined undergraduate or postgraduate degree-level pro- gramme of post-registration advanced nursing education. These programmes usually comprise units pertaining to advanced clinical practice, which are assessed from a traditional academic perspec- tive. However, it is not sufficient to assess students’ attainment in these clinical units solely on an academic basis, as these units are specifically designed to help students develop practically-ori- entated advanced nursing skills, which are required for competent clinical practice as a nurse practitioner. Consequently, in addition to academic assessment of units, advanced nursing degree courses also use practical assessments of students’ acquisition of advanced clinical practice skills, and subsequent development of advanced practice competence, most often using university-based practical examinations. This practical method of clinical skills assessment for advanced nurse practitioner students is called the objective structured clinical examination (OSCE). An advanced nursing OSCE comprises a simulated clinical situation that assesses a student’s proficiency in the performance of the commonly used advanced clinical practice skills such as history taking and physical examina- tion (Ward and Barratt, 2005). I have noted in my role as a nurse practitioner-lecturer that stu- dents often feel anxious about their prospective performance in an impending OSCE, and accordingly my advanced nursing clinical academic team offers exam support for both first-year and final- year students, in the form of ‘OSCE Preparation Workshops’, where students can practise mock OSCEs under clinical academic staff supervision. A common student request at these workshops is for the lecturing team to perform a ‘live’ mock OSCE in class so the stu- dents can see how they can practically complete and successfully pass an OSCE. On face value this request would seem appropriate, however it is resource intensive to stage a mock OSCE as it requires at least two members of staff, and it can also be difficult to give a coherent ‘live’ OSCE performance in front of a typical group size of up 30 students. These difficulties led me to consider alternative methods of meeting students’ OSCE learning needs. Previously my advanced nursing clinical academic team had participated in video-recorded simulated clinical consultations for M.Sc. Nurse Practitioner stu- dents, which had been favourably evaluated. Given this success 1471-5953/$ - see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.nepr.2009.06.004 * Tel.: +44 20 7815 6178. E-mail address: barrattj@lsbu.ac.uk Nurse Education in Practice 10 (2010) 170–175 Contents lists available at ScienceDirect Nurse Education in Practice journal homepage: www.elsevier.com/nepr