International Journal of Health Sciences and Research

www.ijhsr.org ISSN: 2249-9571

Original Research Article

Assess and Compare Objective Structured Clinical Examination (OSCE)

Versus Traditional Clinical Examination (TCE) Regarding Denver
Developmental Screening Test (DDST II) in Terms of Preference
Chetna Kumari1, Yogesh Kumar2, Srinivasan P3
1
M.Sc. Nursing in Child Health Nursing Dept, 2Associate Professor in Child Health Nursing,
3
Assistant Professor in Psychiatric Nursing,
Maharishi Markandeshwer College of Nursing, MMU, Mullana, Haryana.
Corresponding Author: Chetna Kumari

Received: 04/06/2016 Revised: 20/06/2016 Accepted: 24/06/2016

ABSTRACT

Background: Using the right method of evaluation plays a considerable role in getting the
appropriate result and making the right judgment.
Aim and objectives: Present study aimed to assess and compare the preference among undergraduate
nursing students regarding Denver Developmental Screening test II as evaluated by OSCE and TCE
in Group I and Group II and to associate preference score with selected variables in both the groups.
Methods: A Quantitative research approach with non experimental Descriptive Comparative design
was used. Further cross over design was used in this non experimental study to nullify the carry over
effect.160 B.Sc. Nursing students were selected as a sample in the study. Group I included 80 students
from B.Sc. Nursing 3rd year and Group II included 80 students from B.Sc. nursing 4th year from
M.M. College of Nursing Mullana, Haryana who were selected by using Total Enumerative sampling
technique. Structured Preference rating scale was used. The calculated Cronbach‟s reliability value for
the scale in OSCE was 0.74 and in TCE 0.78. In Group I implementation of OSCE and TCE regarding
DDST II and In Group II implementation of TCE and OSCE regarding DDST II in terms of students‟
preference was carried out (Cross over). OSCE was carried out with video based station and TCE was
carried out on children confined to 3-4 years (36-48 months).
Results: Findings of the study indicate that OSCE was effective in terms of students‟ preference
within groups [„t‟ (79) =2.71,‟t‟ (79) =4.19 (p<0.05)] and between groups [„t‟ (79) =2.74,‟t‟ (79)
=1.26 (p<0.05)]. There was no significant association of preference with selected variables.
Conclusion: OSCE was effective in terms of students‟ preference regarding DDST II.

Key words: Objective Structured Clinical Examination (OSCE), Traditional Clinical Examination
(TCE), Denver Developmental Screening Test (DDST II), Preference.

INTRODUCTION Evaluation is an organized

Screening can be defined as a assessment of the values or level of some
concise, legal, systematize assessment that object. Evaluation is also a systematic
assists during the early identification of process of determining the extent to which
patients at danger for a developmental the pupils are able to achieve educational
and/or behavioral disorder. [1] Several objectives. The process of evaluation
developmental screening tests are available includes selecting the appropriate methods,
in the pediatrics which can be used in techniques, administration and interpretation
infants and children. [2] of results to improve learning of leaner.

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Vol.6; Issue: 7; July 2016
Chetna Kumari et al. Assess and compare objective structured clinical examination (OSCE) versus traditional
clinical examination (TCE) regarding denver developmental screening test (DDST II) in terms of preference

Evaluation helps the learner to know what standardized, 143 (91.7%) felt it is a
they should learn and provides information practical and useful experience and 135
about their progress and helps to recognize (86.5%) felt student‟s personality, ethnicity
the areas of difficulties in learning. [3] and gender will not affect OSCE scores. [7]
Traditional tests mainly concentrated
additionally on students' knowledge based MATERIALS AND METHODS
on their retention and the evaluation skills This study was conducted in a
such as problem solving skill, critical nursing college with the approval of ethical
thoughts and communicating skills with the committee of the university. A written and
patient or client. Effective and correct informed consent was obtained from the
method of scientific evaluation should students. A Quantitative research approach
enterprise to all nursing faculties and with non experimental Descriptive
clinical instructors. Performance based Comparative design was used. Further cross
assessment is a type of assessment which over design was used in this non
meets theses criteria, and example of a experimental study to nullify the carry over
performance-based assessment is “Objective effect.160 B.Sc. Nursing students were
Structured Clinical Examination” (OSCE). selected as a sample with an inclusion
[4]
criteria that either male or female and able
The Objective Structured Clinical to speak and understand both English and
Examination acquires a number of intrinsic Hindi. Group I included 80 students from
assistance. Students interpersonal and B.Sc. Nursing 3rd year and Group II
communication skills, problem-solving included 80 students from B.Sc. nursing 4th
abilities, teaching and assessment skills and year from M.M. College of Nursing
decision making skills are basically Mullana, Haryana who were selected by
evaluated by OSCE. By giving importance using Total Enumerative Sampling
to individual competencies both the process technique. Structured Preference rating
and the product are been tested. [5] scale was used. The calculated Cronbach‟s
As compare to the traditional reliability value for the scale in OSCE was
examination OSCE covers a broad range of 0.74 and in TCE 0.78. OSCE was carried
clinical skills. OSCE is a method in which out with video based station and TCE was
the specific components are divided into carried out on children confined to 3-4 years
stations and the components can take in the (36-48 months).
form of small scenarios, simulations, case The videos regarding Denver
studies, multiple choice questionnaires or Developmental Screening Test II was
short theoretical questions. [6] prepared by researcher on different children
A cross-sectional descriptive study confined to 3-4 years (36-48 months) in the
conducted to assess nursing student‟s following place like Hospital, School and
perception and preference of OSCE over Anganwadi. The videos were in Hindi
TCE.A sample of156 students who had been language and 10 sets of videos on 10
previously exposed to TCE and OSCE were different children regarding DDST II were
participated in the study. The result of the made to prevent contamination of batches
study concluded that majority of the and these videos were randomly assigned to
students 136 (84%) felt that TCE is more each student in the batch. The duration of
difficult whereas 20 (12.8%) felt OSCE was each video is 10-15 minutes.
more difficult. Majority of the students The videos include all the four
(95.5%) preferred OSCE for assessment. In domains/stations regarding DDST II
relation to validity and reliability of OSCE, including: Personal social development,
124 (79.5%) of all the students felt it Fine motor development, Language
provides a true measure of essential clinical development, Gross motor development.
skills, 130 (83.3%) felt its scores are

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Vol.6; Issue: 7; July 2016
Chetna Kumari et al. Assess and compare objective structured clinical examination (OSCE) versus traditional
clinical examination (TCE) regarding denver developmental screening test (DDST II) in terms of preference

Group I undergone Video Based The undergraduate nursing students‟

OSCE for 2 days. Participants were shown preference on OSCE 45 (56.25%) had
with the video before completing DDST II preferred, 33 (41.25%) were uncertain and 2
test. Soon at the completion preference scale (2.5%) had not preferred whereas on TCE
was filled up. For the next 8 days the same 37 (46.25%) had preferred, 38 (47.5%) were
group undergone DDST II test by TCE uncertain and 5 (6.25%) had not preferred in
method where participants performed the Group I. In Group II shows that majority of
test on individual child. Soon at the undergraduate Nursing students 41
completion preference scale was filled up. (51.25%) had preferred, 37 (46.25%) were
The same procedure was repeated for the uncertain and 2 (2.5%) had not preferred on
second group where the implementation of TCE whereas on OSCE more than half 58
TCE was done before OSCE (Cross over) to (72.5%) had preferred, and 22 (27.5%) were
nullify the carryover effect. uncertain. The mean, median, standard
deviation, standard error of mean and„t‟
RESULTS value were calculated within the group and
The personal characteristics of both between the group as per standard criteria
the profiles were comparable. The computed (table 1, 2 & 3).
chi square value for the selected variables in The calculated„t‟ value within group
group I and II for age (0.66), religion (1.8), for both the groups were 2.71 and 4.19
place of residence (2.31), percentage of which is statistically significant at 0.05 level
marks in previous year (2.54), percentage of of significance. Concludes OSCE was
attendance in growth and development preferred more than TCE (Table-1)
classes (10.70) and hobbies (14.09) were The calculated„t‟ value between
found to be non significant at 0.05 level of group for both the groups were 2.74
significance. Hence it was revealed from the (significant at 0.05 level) and 1.26 (non
findings that group I and II were significant at 0.05 level). Cross over
homogenous with regard to these selected concludes TCE had an influence for OSCE
variables except gender which was but no influence of OSCE on TCE (Table-
statistically significant at 0.05 level of 2).
significance

Table-1: Mean, Mean difference, Standard deviation of difference, Standard Error of mean difference and “t” value within Group I
and II. N=160
Groups Preference Mean MD S.DD SEMD “t” value p value
Group I (n=80) OSCE 15.15 0.64 0.21 0.02 2.71 0.008*
TCE 14.51
Group II (n=80) TCE 15.07 1.13 0.65 0.07 4.19 0.001*
OSCE 16.20
“t”(79)=1.64 *Significant (p<0.05)

Table-2: mean, Mean difference, Standard deviation, Standard Error and “t” value between Group I and II. (Cross over) N=160
Method of evaluation Students’ preference Mean MD S.DD SEMD “t” value P value
OSCE Group I (n=80) 15.15 1.05 0.55 0.06 2.74 0.008*
Group II (n=80) 16.2
TCE Group I (n=80) 14.51 0.56 0.11 0.01 1.26 0.21NS
Group II (n=80) 15.07
“t”(79)=1.6 *Significant (p<0.05) NS= Not Significant (p>0.05)

Table-3: The mean, Mean difference, Standard deviation of difference, Standard Error of mean difference and “t” value between
Group I and II. (Non- cross over) N=160
Method of evaluation Groups Mean MD S.DD SEMD “t” value p value
OSCE Group I(n=80) 14.66 1.93 0.53 0.05 6.65 0.001*
TCE Group II(n=80) 12.73
TCE Group I(n=80) 11.78 3.24 0.03 0.00 10.15 0.001*
OSCE Group II(n=80) 15.02
“t”(79)=1.64 *Significant (p<0.05)

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Vol.6; Issue: 7; July 2016
Chetna Kumari et al. Assess and compare objective structured clinical examination (OSCE) versus traditional
clinical examination (TCE) regarding denver developmental screening test (DDST II) in terms of preference

The calculated „t‟ value between preference score within and between both
group for both the groups were 6.65 and the groups. Hence research hypothesis was
10.15 which was significant at 0.05 level. accepted and null hypothesis was rejected.
Non Cross over concludes OSCE was Frequency and percentage
highly preferred than TCE between both the distribution of item wise preference scale
groups (Table-3). analysis on OSCE and TCE among both the
Table 1, 2 and 3 concludes that there groups are described as per the standard
was a significant difference in mean criteria (table 4 and 5).
Table-4: Item wise frequency and percentage of Group I. n=80
Sr. No Preference Items OSCE TCE
Agree Neutral Disagree Agree Neutral Disagree
f (%) f (%) f (%) f (%) f (%) f (%)
1 Exam well administered 62(77.5) 15(18.75) 3(3.75) 60(75) 19(23.75) 1(1.25)
2 Exam less stressful 41(51.25) 25(65) 14(17.5) 27(33.75) 39(48.75) 14(17.5)
3 Examination well structured and sequenced 57(71.25) 19(23.75) 4(5) 44(55) 30(37.5) 6(7.5)
4 Highlighted areas of weakness 36(45) 35(43.75) 9(11.25) 37(46.25) 39(48.75) 4(5)
5 Students provided level of information needed 53(66.25) 23(28.75) 4(5) 50(62.5) 28(35) 2(2.5)
6 Wide knowledge area covered 49(61.25) 29(36.25) 2(2.5) 51(63.75) 21(26.25) 9(11.25)
7 Exam consistent /reliable 49(61.25) 26(32.5) 5(6.25) 44(55) 29(36.75) 7(8.75)
8 Exam were suitable for different student level 57(71.25) 23(28.75) 0 46(57.5) 31(38.75) 3(3.75)
9 Exam relates theory with practical 55(68.75) 20(25) 5(6.25) 57(71.25) 17(21.25) 6(7.5)
10 Fair method of evaluation used in examination. 56(70) 22(27.5) 2(2.5) 42(52.5) 34(42.5) 4(5)

Table-5: Item wise frequency and percentage of Group II. n=80

Sr. no Preference Items OSCE TCE
Agree Neutral Disagree Agree Neutral Disagree
f (%) f (%) f (%) f (%) f (%) f (%)
1 Exam well administered 62(77.5) 16(20) 2(2.5) 74(92.5) 6(7.5) 0(0)
2 Exam less stressful 37(46.25) 22(27.5) 21(26.25) 37(46.25) 25(31.25) 18(22.5)
3 Examination well structured and sequenced 51(63.75) 25(31.25) 4(5) 70(87.5) 10(12.5) 0(0)
4 Highlighted areas of weakness 30(37.5) 44(55) 6(7.5) 29(36.25) 46(57.5) 5(6.25)
5 Students provided level of information needed 57(71.25) 17(21.25) 6(7.5) 63(78.75) 16(20) 1(1.25)
6 Wide knowledge area covered 49(61.25) 28(35) 3(3.75) 56(70) 21(26.25) 3(3.75)
7 Exam consistent /reliable 52(65) 26(32.5) 2(2.5) 64(80) 15(18.75) 1(1.25)
8 Exam were suitable for different student level 45(56.25) 32(40) 3(3.75) 54(67.5) 23(28.75) 3(3.75)
9 Exam relates theory with practical 53(66.25) 23(28.15) 4(5) 57(71.25) 21(26.25) 2(2.5)
10 Fair method of evaluation used in examination. 56(70) 21(26.25) 3(3.75) 61(76.25) 16(20) 3(3.75)

DISCUSSION Present study reveals that the

Present study reveals that majority calculated “t” value of Group I and II i.e.
undergraduate nursing students‟ preference 2.71 and 4.19 is more than the table value at
on OSCE 45 (56.25%) had preferred, 33 df (79) at 0.05 level of significance. This
(41.25%) were uncertain and 2 (2.5%) had shows that difference in mean score on
not preferred whereas on TCE nearly half undergraduate nursing students‟ preference
38 (47.5%) were uncertain, 37 (46.25%) had regarding DDST II as evaluated by OSCE
preferred and 5 (6.25%) had not preferred in and TCE in Group I and II are true and not
Group I. In Group II shows that majority of by chance. This indicates that OSCE was
undergraduate Nursing students 41 effective in terms of Undergraduate nursing
(51.25%) had preferred, 37 (46.25%) were students‟ preference regarding DDST II in
uncertain and 2 (2.5%) had not preferred on both Groups. This finding is consistent with
TCE whereas on OSCE more than half 58 the study conducted by Hala M. M.
(72.5%) had preferred, and 22 (27.5%) were Bayoumy and Hanaa Yousri, (2012)
uncertain. These finding is consistent with Students‟ perception on objective structured
the study conducted by Nkeiruka Ameh, clinical examination (OSCE) and TCE
Mohammed A (2015) Majority of the ranged between 2.84±1.19 to1.85±0.99. [8]
students (95.5%) preferred OSCE for Majority of the students in group I
assessment. [7] 62 (77.5%) on OSCE had agreed regarding
exam well administered, 57 (71.25%)

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Vol.6; Issue: 7; July 2016
Chetna Kumari et al. Assess and compare objective structured clinical examination (OSCE) versus traditional
clinical examination (TCE) regarding denver developmental screening test (DDST II) in terms of preference

agreed that examination well structured and we acknowledge that the above research was
sequenced and 57 (71.25%) agreed that original work of authors.
questions were suitable for different student
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clinical examination (TCE) regarding denver developmental screening test (DDST II) in terms of preference

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How to cite this article: Kumari C, Kumar Y, Srinivasan P. Assess and compare objective
structured clinical examination (OSCE) versus traditional clinical examination (TCE) regarding
denver developmental screening test (DDST II) in terms of preference. Int J Health Sci Res.
2016; 6(7):237-242.

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