Creating and implementing objective structured clinical exams for use in pediatric nursing education in Ghana: Reflections and lessons learned

The use of the Objective Structured Clinical Exam (OSCE) to measure the clinical competency of health care professionals is well established in many training institutions globally because of their high validity and reliability. In the context of a pediatric nursing partnership program in Ghana (the SickKids-Ghana Pediatric Nursing Education Partnership [PNEP]), we aimed to develop a national, accredited, competency-based curriculum. The integration of the OSCE into the curriculum was novel in the Ghanaian setting. It served as a standardized method for student assessment of higher clinical competencies, including both skills and attitudes, compared to conventional methods. Using mixed-methods, we previously found that the PNEP curriculum effectively increased graduates’ knowledge, confidence, and clinical skill in pediatric nursing. This manuscript aims to reflect on the development of the OSCE stations, case scenarios, and rating materials, with particular reference to the methodological approach and lessons learned. We further reflect on the feedback from faculty and students pertaining to the usefulness of the OSCE as an assessment tool and the inclusion of standardized patients to assess communication skills. Adaptations required to safely conduct the OSCEs in the context of the COVID-19 pandemic have also been highlighted. Our findings throughout the OSCE development, implementation, and testing processes in Ghana could aid and inform similar tool development for nursing education institutions in the West African region and other resource-limited settings.