The Objective Structured Clinical Examination (OSCE) as a strategy for assessing clinical competence in midwifery education in Ireland - A critical review

Sep 20, 2026

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In Ireland, all student midwives must be judged competent to practice as part of midwifery education and preparation for registration. Multiple assessment methods are used, including observed practice, clinical interviews, reflective portfolios, written examinations, and the Objective Structured Clinical Examination (OSCE). This paper presents a critical review of OSCE use in one Irish third level institution, illustrating its application to lactation and infant feeding. The discussion evaluates OSCE advantages, disadvantages, validity, and reliability, and considers it as a valuable strategy alongside other assessments for supporting diversity in training.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Introduction

Competency in midwifery education and assessment strategies

Aim and scope of the critical review

The OSCE: origins and background

Nurse Education in Practice 12 (2012) 242e247 Contents lists available at SciVerse ScienceDirect Nurse Education in Practice journal [homepage: www. elsevier. com/nepr](homepage: www. elsevier. com/nepr) The Objective Structured Clinical Examination (OSCE) as a strategy for assessing clinical competence in midwifery education in Ireland: A critical review Valerie Smith*, Kathryn Muldoon, Linda Biesty School of Nursing and Midwifery, University of Dublin, Trinity College Dublin, 24 D ’Olier Street, Dublin 2, Ireland a b s t r a c t In Ireland, to register as a midwife, all student midwives must be deemed competent to practice with the assessment of competence an essential component of midwifery education. A variety of assessment strategies, including observed practice, clinical interviews, portfolios of reﬂection, the Objective Structured Clinical Examination (OSCE) and written examination papers, are utilised to assess midwifery students’ clinical competence. In this paper, a critical review of the OSCE as a strategy for assessing clinical competence in one third level institution in Ireland is offered. Although utilised for assessing competence across a range of areas (e.g. obstetric emergencies and pharmacology/drug administration), the use of the OSCE for assessing midwifery students’ competence in lactation and infant feeding practices, as an example for this paper, is described. The advantages, disadvantages, validity and reliability of the OSCE, as an assessment strategy, are critically explored. Recognising that no single assessment strategy can provide all the information required to assess something as complex as clinical performance, the OSCE, when viewed alongside other forms of assessment, and with relevance to the topic under examination, may be considered a valuable strategy for enhancing the assessment of students’ clinical competence, and for embracing diversity within midwifery education and training. 􀀁 2012 Elsevier Ltd. All rights reserved. Introduction The International Confederation of Midwives’ (ICM) ‘Essential Competencies for Midwifery Practice’ (International Confederation of Midwives, 2010) and ‘Global Standards for Midwifery Education’(International Confederation of Midwives, 2011) strongly emphasise competency as a core tenet of midwifery education and practice. In Ireland, to register as a midwife, all student midwives must be deemed competent to practice with the assessment of competence an essential component of midwifery education. Deciding on an appropriate strategy to assess clinical competence has long been central to nursing and midwifery education (Bujack et al., 1991 ; Worth-Butler et al., 1996) and is, at times, fraught with difﬁculty due to a lack of consensus on a precise deﬁnition for competence (Cowan et al., 2005 ; Butler et al., 2008 ; O’Connor et al., 2009 ; Nultyet al., 2011). Benner (1982), for example, describes nursing competence as being able to perform tasks with desirable outcomes under the diverse circumstances of the real world. Benner (1984) describes the progression of nurses as a continuum * Corresponding author. Tel.: þ353 1 8964031. E-mail addresses: [smithv1@tcd.ie](smithv1@tcd.ie) (V. Smith), [kmuldoon@tcd.ie](kmuldoon@tcd.ie) (K. Muldoon), biestyl@tcd.ie (L. Biesty). 1471-5953/$ e see front matter 􀀁 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.nepr.2012.04.012 from novice to expert with competence placed ﬁrmly in the middle (Fig. 1). An Bord Altranais (the Irish Nursing Board) alternatively provides for a broader deﬁnition describing competence asa ‘complex and multidimensional phenomena’ with the registered nurse or midwife deemed competent once he or she achieves ‘the ability. to practice safely and effectively, fulﬁlling his or her professional responsibility within his or her scope of practice’ (An Bord Altranais, 2000, p. 4). In this sense, competence extends beyond simply excellence in clinical skill acquisition; rathe

FAQs

Why is clinical competence assessment essential in Irish midwifery education?

To register as a midwife in Ireland, student midwives must be deemed competent to practice, and assessment of competence is an essential component of education.

What assessment strategies are used to assess midwifery students’ clinical competence?

Assessment strategies include observed practice, clinical interviews, reflective portfolios, the Objective Structured Clinical Examination (OSCE), and written examination papers.

How does the paper use the OSCE to illustrate assessment of competence?

It describes OSCE use as an example for assessing competence in lactation and infant feeding practices, while also noting OSCE assessment across other areas such as obstetric emergencies and pharmacology/drug administration.

Sep 20, 2026

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