Abstract

Background

    The current pandemic has led to unprecedented scenarios worldwide. In this context, educational institutions had to move abruptly from in-person to online classes, having to be flexible and innovative, one of the main concerns being the semester-end examinations in practical modules.

Objective

     This study aimed to explore nursing students’ perceptions of the use of a serious game-like model in their final online objective structured clinical examination (OSCE).

Design

     An exploratory phenomenological study was conducted during the COVID-19 pandemic, in particular during June 2020.

Settings

     This study took place at the University of Almeria with nursing students enrolled in a clinical placement module.

Participants

Eighty-nine fourth-year nursing students took part in this study.

Methods

     Following the educational principles of the OSCE, a virtual OSCE was designed, using the Genially platform, an online platform for creating interactive content, to set up an assessment as a story-telling game-like model. A total of 5 focus groups (FGs) were conducted afterwards via the GoogleMeet platform. In addition, 30 semi-structured interviews were performed via the same platform. The data was analysed using a content analysis approach and supported by the ATLAS.ti 8.4 software.

Results

     Our finding revealed 2 main themes and 4 sub-themes. The two main themes were (i) generating emotions and feelings in times of virtuality; including emotions and feelings experienced by students during their online assessment process, and (ii) online assessment: a potential alternative to educational barriers; describing the variability of traditional modality, its implications for learning and the acquisition of competences.

Conclusions

      Serious game-like models, such as the story-telling game proposed, as part of their online OSCE assessment appear to be an appropriate alternative assessment method for face-to-face approaches. This paper adds new evidence on the use of innovative and state-of-art resources as part of nursing OSCE assessments in a new reality for most students and teachers. Serious game-like models in online OSCE may empower students and help them to remove perceived barriers in face-to-face assessments.

Introduction

     Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread, which began in December 2019, has produced an unprecedented global scenario (Choi et al., 2020). Not only did the pandemic pose a challenge to all healthcare systems worldwide, but also to other key sectors, such as economics and education (Ceylan et al., 2020). In this sense, educational institutions had to move abruptly from in-person to online classes, affecting more than 1.5 billion students in 191 countries (World Health Organization, 2020). As in other countries, all educational institutions were closed down and all clinical practices were suspended as a preventive measure for health students when Spain officially decreed lockdown on 15th March (Ministry of the Presidency, 2020).

      In this manner, universities have had to be innovative, flexible and agile in a short period of time to decide how to continue their students’ education. Although online training is not a novel method of delivery for many universities, it raised a number of concerns related to the semester-end final examinations (Jones et al., 2020). This transition has therefore been particularly challenging for some health-related degrees, such as medicine and nursing, which include some practical modules that have been traditionally assessed by the Objective Structured Clinical Examination (OSCE) approach (Prior et al., 2020). This approach measures clinical competence through different scenarios and, consequently, its challenge was to creatively restructure them in order to reduce the disruption of the curriculum (Kakadia et al., 2020).

Conclusion

     Serious game-like models, such as the story-telling game proposed, as part of their online OSCE assessment appear to be an appropriate alternative assessment method for face-to-face approaches. Serious game-like models in online OSCE could be seen as a realistic assessment environment that allows students to handle all patient details at their own pace and helps them to get rid of nervousness related to the feeling of being observed like in face-to-face assessments, revamping their clinical-decision making skills. Similarly, online OSCE using storytelling game-like models seems to strongly favour learning and reflection, aspects that the participants do not perceive as such in face-to-face approaches. In this sense, the participants consider this state-of-the-art approach to be more objective and equal, since the inter-evaluator variability does not influence their assessment.