Comparing formative and summative simulation-based assessment in undergraduate nursing students: nursing competency acquisition and clinical simulation satisfaction.

BACKGROUND: Formative and summative evaluation are widely employed in simulated-based assessment. The aims of our study were to evaluate the acquisition of nursing competencies through clinical simulation in undergraduate nursing students and to compare their satisfaction with this methodology using these two evaluation strategies. METHODS: Two hundred eighteen undergraduate nursing students participated in a cross-sectional study, using a mixed-method. MAES© (self-learning methodology in simulated environments) sessions were developed to assess students by formative evaluation. Objective Structured Clinical Examination sessions were conducted to assess students by summative evaluation. Simulated scenarios recreated clinical cases of critical patients. Students´ performance in all simulated scenarios were assessed using checklists. A validated questionnaire was used to evaluate satisfaction with clinical simulation. Quantitative data were analysed using the IBM SPSS Statistics version 24.0 software, whereas qualitative data were analysed using the ATLAS-ti version 8.0 software. RESULTS: Most nursing students showed adequate clinical competence. Satisfaction with clinical simulation was higher when students were assessed using formative evaluation. The main students' complaints with summative evaluation were related to reduced time for performing simulated scenarios and increased anxiety during their clinical performance. CONCLUSION: The best solution to reduce students' complaints with summative evaluation is to orient them to the simulated environment. It should be recommended to combine both evaluation strategies in simulated-based assessment, providing students feedback in summative evaluation, as well as evaluating their achievement of learning outcomes in formative evaluation.

High-Fidelity Virtual Objective Structured Clinical Examinations with Standardized Patients in Nursing Students: An Innovative Proposal during the COVID-19 Pandemic.

In response to the cancellation of in-person objective structured clinical examinations (OSCEs) prompted by confinement due to the COVID-19 pandemic, we designed a solution to adapt our traditional OSCEs to this new reality in nursing education. We implemented an innovative teaching proposal based on high-fidelity virtual OSCEs with standardized patients. The purposes of our study were to describe this innovative teaching proposal and compare nursing competence acquisition in final year nursing students through virtual and in-person OSCE modalities. The study included 234 undergraduate students: 123 students were assessed through high-fidelity virtual OSCEs during May 2020, whereas 111 students were assessed through in-person OSCEs during May 2019. The structure of OSCEs, including its stations, clinical simulated scenarios, and checklists, was the same in both OSCE modalities. The effect size of the differences among the competence categories of checklists, including their total scores, was small. Regarding our virtual OSCEs was similarly successful to in-person OSCEs, this online format was found to be useful, feasible, and cost-saving when in-person OSCE was not possible. Therefore, high-fidelity virtual OSCEs with standardized patients could be considered as another choice of OSCE not only in the current COVID-19 pandemic but could also be extended to normal situations, even post-pandemic.