Correlation of OSCE Scores with Preceptor Ratings as a Measure of Clinical Competence

One of the most challenging tasks today in advanced nursing education is to evaluate or assess clinical competence objectively.  Traditional methods of assessment such as written exams do not necessarily correlate well with clinical ability and skill.  Currently, faculty members supervising nurse practitioner students rely on individual preceptors and periodic site visits to evaluate student performance in the clinical setting.  A lack of standardization between mentors, the vast differences in patient encounters, and the tendency of preceptors to give hyper-inflated marks hamper the objectivity of this measure for clinical competence.  Objective structured clinical examinations (OSCE) provide a reliable and equitable measure of student performance and clinical proficiency.  Using Benner’s Novice to Expert model, faculty members translate both preceptor ratings and OSCE scores into descriptors: each nurse practitioner student is rated as a beginner, competent, proficient, or expert practitioner.  Faculty members at a Midwest University Family Nurse Practitioner program compared preceptor ratings of students with the students’ OSCE scores to determine if there was any correlation between the two variables.  A Spearman rho correlation coefficient determined a weak positive correlation between preceptor ratings and OSCE scores. Results suggest that OSCE scores are a reliable measure of student clinical proficiency.  Histograms give visual evidence of preceptor hyper-inflation of ratings.  Findings indicate that OSCEs can be used for objective student measurement of clinical competence when travel to clinical sites is hampered by distance, time, and low client census.