Assessment of breastfeeding clinical skills among nursing students using the Objective Structured Clinical Examination (OSCE)

Evaluación de las habilidades clínicas de lactancia materna entre los estudiantes de enfermería utilizando el Examen Clínico Objetivo Estructurado (ECOE)
Natalia Villegasaa, Rosina Cianellia,b, Madeline Fernandeza, Shakira Hendersona,c, Solange Sierraa, Yarilys Alfonsoa, Crystal Jacksona

a School of Nursing and Health Studies, University of Miami
b Escuela de Enfermería Pontificia, Universidad Católica de Chile
c Nursing and Health Science Research for Nursing Administration, Vidant Medical Center, North Carolina

Recibido el 5 de enero de 2016; aceptado el 13 de abril de 2016

Palabras Clave

Lactancia, ECOE, Estudiantes de Enfermeria, Planes de Estudios de Pregrado.


Breastfeeding, OSCE, Nursing students, Undergraduate curricula.


Introduction: Insufficient education and training in nursing programs has led to nurses in the field knowing very little in order to assist a breastfeeding mother. Several studies recommend implementation of effective breastfeeding training in all undergraduate curricula that lead to nursing and other healthcare degrees.

Objective: To analyze the development of an objective structured clinical examination (OSCE) to measure breastfeeding clinical skills and the preliminary outcomes of its implementation.

Method: Participants for this pilot study were 23 undergraduate nursing students. The breastfeeding OSCE consisted of 10 stations where students performed different clinical skills under a simulated environment. The clinical skills being assessed in each station ranged from performing proper manual milk expression to correctly using a breast pump on a mannequin's breast. Observers in each station completed a checklist which assessed each student's clinical ability to complete that task correctly. Students conducted an evaluation of the training immediately after completing the OSCE using a structured online questionnaire.

Results: The stations with the highest score were: interventions for sore, leaking, and inverted nipples (station 4, M=2.57, SD=.843, range 1–3) and indicators of adequate latching (station 6; M=7.09, SD=1.443, range 4–8). The stations with the lowest scores were: pump set up to breast and how to remove the infant from the breast (station 1, M=7.96, SD=1.745, range 4–10), and breastfeeding positions (station 5, M=1.65, SD=.714, range 0–2).

Conclusion: The OSCE has been positively evaluated for objectivity in student assessment and provides a ‘hands on’ approach to assessing clinical competence. Scores and student feedback suggests that the OSCE can be a valuable tool to be used in courses of any nursing or health-related undergraduate curriculum.