The development and validation of a standardised eight-station OSCE for registration of undergraduate nursing students: A Delphi study.

AIM: To develop and validate a set of OSCEs for use as a nationally applicable final exam of undergraduate nursing students' clinical and professional competencies. BACKGROUND: Tertiary recommendations for nursing registration require student achievement of a prerequisite level of both nursing knowledge and skill. Assessment of nursing skills prior to provision of nursing registration is an increasingly important focus of university nursing education. Objective Structured Clinical Examinations (OSCEs) are an appropriate tool for assessing the competencies of nursing students, but the mode and content of OSCEs varies widely. Thus, for nationally-based registration, development of a standardized set of OSCEs to determine the clinical competence of nursing students is important. DESIGN: A modified Delphi study, informed by a systematic scoping review of relevant literature. METHODS: A two-phase study was conducted. Initially, a scoping review was conducted to establish internationally agreed competences for graduating nursing students. These were included in an online questionnaire send to national experts to develop a validated and accepted nursing competency framework and associated implementation strategies. This was round 1 of a three-round modified Delphi study. A Content Validity Index (CVI) was calculated and thematic analysis was used to analyze the experts' opinions. RESULTS: Details of a set of OSCEs for final exam of undergraduate nursing students were developed and validated. These OSCEs included nine competencies addressed in eight 10-minute stations. CONCLUSION: A 'best-practice' OSCE evaluation system, designed from both international literature and the opinions of nation-wide experts was achieved. This well-designed OSCE was shown to be a reliable and valid method for assessing the clinical competence of nursing students. It reflected global procedures as well as the local conditions and Iranian expectations. The results of this study can be used by nursing schools across the country. They can also be used to model equivalent development of locally relevant OSCEs in countries around the world.

Promoting evidence-based nursing through journal clubs: an integrative review.

Background: The journal club has been proposed as a tool to fill the gap between theory and practice. Aim: The present research is an integrative review of studies focussing on journal clubs. Methods: An integrative review. We searched the databases during 2010-2019 to find papers using the keywords journal club, nursing, evidence-based practice. The modified version of Cooper's five-stage integrative review was applied. Results: The results are presented in two sections - the benefits and challenges of nursing journal clubs and an outline of presentation guidelines. We also discuss the effectiveness of journal clubs in the promotion of evidence-based nursing. Conclusions: The purpose of the nursing journal club is to review existing literature, discuss the latest information and evidence and identify practical changes required to ultimately improve patient outcomes. Further studies are needed to evaluate the effectiveness of journal clubs in patient care.

Challenges of objective structured clinical examination in undergraduate nursing curriculum: Experiences of faculties and students.

BACKGROUND: Assessment of clinical competence of nursing students is necessary to ensure safe practice and the realization of professional clinical standards. An Objective Structured Clinical Examination (OSCE) is commonly used internationally in nursing education programs to assess clinical competence, but is a new process in Iranian nursing curricula. OBJECTIVE: The aim of this study was to explore and describe challenges associated with OSCE implementation based on the experiences of faculty members and nursing students, with the objective of further improving the assessment of clinical competence in nursing education. DESIGN: This study used a qualitative approach that included thematic analysis of the transcribed interviews. SETTING: Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences (TBZMED), Tabriz, Iran. PARTICIPANTS: Purposive sampling was used to select eighteen faculty members and fifteen students from those interested. These participants represent a reasonable cross-section of those who had participated in the OSCE. METHODS: A pre-developed interview guide was used to inform semi-structured in-depth interviews. These were recorded and analyzed using the 6-phase thematic analysis method as described by Braun and Clarke (2013). Themes were independently verified. RESULTS: Challenges identified by participants around OSCEs as part of undergraduate nursing education were extracted from the interview data. Two main themes were evident from the data: 1) shortcomings in executive and technical infrastructure, 2) shortcomings in educational infrastructure. These themes reflected both student and faculty experiences. These also aligned with themes that commonly emerge in related literature. CONCLUSION: The study findings illustrate several key challenges associated with organizing and implementing OSCEs and so provides unique insights into the development of strategies to implementing and promoting OSCEs in nursing education. We recommend that managers and authorities in nursing education focus on these challenges and explore processes to successfully introduce this exam for assessment of nursing student capacity.

Novel single-chain antibodies against highly conserved epitopes in the hemagglutinin of influenza A viruses: Promising agents for universal therapies.

OBJECTIVES: Development of new antibodies with broad activity would provide anti-influenza prophylaxis and treatment. Human single-chain variable fragments (scFvs) are considered effective agents against viruses. In this study specific human scFvs against highly conserved epitopes in the hemagglutinin (HA) of influenza A viruses were selected and their neutralizing activity was evaluated. MATERIALS AND METHODS: Bioinformatic methods were used to evaluate HA epitopes. The panning process selected specific clones from a scFv library. PCR and DNA fingerprinting differentiated the common patterns. Soluble forms of scFvs were produced and evaluated using Western blot analysis. The neutralizing effects of anti-HA scFvs were assessed by microneutralization assay using MDCK cells. Real-time PCR was done to determine the exact copy number of the virus following neutralization. RESULTS: Bioinformatic evaluation confirmed the antigenicity and accessibility of the epitopes. Four specific anti-HA scFvs, scFvs I, II, I', and II' were selected. The scFvs neutralized 2009 H1N1 pandemic and 83.34%, 79.17%, 75%, and 62.5% reduction in the virus titers were obtained following treatments with scFv-II', I, I', and II, respectively. Real-time PCR demonstrated 98.6%, 95.7%, 95.26%, and 91.19% reductions in virus numbers following neutralization with scFv-II', I, I', and II, respectively. CONCLUSION: Anti-HA scFvs selected against highly conserved HA of influenza A virus with high neutralizing effects, offer novel human antibodies for prophylaxis and treatment of a wide range of influenza viruses including different subtypes of H1N1, H3N2, and H5N1 influenza A virus. The antibodies have the potential to be used for universal therapy.