Reliability of Peer Assessed Medicine Management Objective Structured Clinical Examination (OSCE) for Pre-Registration Nursing Students: An Explanatory Sequential Mixed Methods Study.

Background: The Nursing and Midwifery Council stipulates that medicines management is one of the five essential skills to be achieved prior to registration. Nurse education programmes must use robust teaching and learning strategies to meet this requirement. One strategy in current use is the Peer Assessed Medicines management Objective Structured Clinical Examination [OSCE]; this approach as a tool for learning and assessment has not been evaluated. Aim: The aim of this study is to evaluate the reliability of peer assessed medicines management objective structured clinical examinations (PAMMO), undertaken in the simulated practice learning environment. Methods: Explanatory sequential mixed methods study. Phase 1, sixty six third year student nurses assessed the safety of peer students medicines management, via video vignettes, using the PAMMO assessment tool. The efficacy of the PAMMO assessment was evaluated using the Simulation Effectiveness Tool [SET], Phase 2 twenty two students from phase one of the study participated in three focus groups interviews. They discussed the basis for their judgements of safe MM practice, using the PAMMO assessment tool. Findings: Phase 1: The PAMMO tool demonstrated satisfactory levels of inter-rater reliability. Criteria requiring subjective assessment judgements of communication and caring and global judgements of safety [safe, unsafe, borderline] demonstrated the lowest levels of inter-rater reliability. The PAMMO increased students learning, confidence and satisfaction in medicines management. Phase 2: students judgements of safe medicines management were based upon prescriptive and descriptive judgement processes Conclusions: PAMMO offer a reliable learning and assessment strategy for medicines management. The PAMMO improved students’ self-rated medicines management learning and confidence. Their assessments of safe MM used intuition, reflection, peer, systems, research and experiential evidence aided judgement