IMPACT OF STRUCTURED SKILLS-LAB TRAINING ON OSCE PERFORMANCE IN UNDERGRADUATE NURSING EDUCATION AT JINNAH HOSPITAL, LAHORE

Abstract

Background: Objective Structured Clinical Examination (OSCE) is a cornerstone of clinical competence assessment in undergraduate nursing education. Despite its widespread adoption, inconsistent student preparedness and variability in psychomotor skill acquisition remain significant challenges, particularly in low- and middle-income countries. Structured skills-lab training has been proposed as a practical approach to standardize clinical exposure, enhance hands-on proficiency, and improve examination performance, yet local evidence from Pakistan is limited. Objective: To evaluate the effect of structured skills-lab training on OSCE performance among undergraduate nursing students. Study Design: Quasi-experimental study. Settings: Undergraduate nursing program at Jinnah Hospital, Lahore, Pakistan. Duration of Study: January 2025 to June 2025. Methods: A total of 90 undergraduate nursing students were enrolled and allocated into two groups: a structured skills-lab training group (n = 45) and a standard training group (n = 45). The intervention comprised a structured skills-lab program incorporating deliberate practice, standardized procedural checklists, supervised hands-on sessions, and formative feedback. The comparison group continued with routine teaching methods. OSCE performance was assessed before and after the intervention using standardized stations and validated scoring rubrics. Between-group comparisons were performed using appropriate inferential statistics. Effect size was calculated using Cohen’s d, and multivariable linear regression analysis was applied to adjust for baseline OSCE scores and relevant academic covariates. Results: Baseline OSCE scores were comparable between the two groups. Following the intervention, students in the structured skills-lab group achieved significantly higher mean OSCE scores than those in the standard training group (73.6 ± 7.5 vs. 66.5 ± 6.4; p < 0.001). The mean improvement in OSCE scores was also significantly greater in the intervention group (15.2 ± 6.8 vs. 7.4 ± 6.5; p < 0.001), demonstrating a large educational effect size (Cohen's d = 1.02). Station-level analysis revealed the most significant performance gains in psychomotor and safety-critical skills, including infection control, intravenous cannulation, and medication administration. Structured skills-lab training remained an independent predictor of higher post-intervention OSCE scores after adjustment for baseline performance and academic factors. Conclusion: Structured skills-lab training significantly enhances OSCE performance and clinical competence among undergraduate nursing students. Incorporation of structured skills-lab programs into undergraduate nursing curricula may strengthen assessment outcomes and better prepare future nurses for safe and effective clinical practice in resource-constrained healthcare settings.