Structured objective structured clinical examination workshop to improve preparation and reduce anxiety in Doctor of nursing practice students: A quality improvement project

Objective structured clinical examinations (OSCEs) are widely used in competency-based education (CBE) to assess clinical competencies in Doctor of Nursing Practice (DNP) students. However, OSCE-related anxiety can hinder performance and affect competency evaluation. This quality improvement (QI) project implemented a structured OSCE preparation workshop in an advanced health assessment (AHA) course to improve preparation, reduce anxiety, and enhance performance. The workshop incorporated three evidence-based activities: video case evaluation, a structured clinical reasoning exercise, and mock OSCEs. A pre-/postsurvey design assessed changes in preparedness and anxiety, and students rated the usefulness of each activity. Objective structured clinical examination performance and remediation rates before and after implementation were compared. Across three semesters, 181 DNP students participated. After the workshop, preparedness significantly increased ( p < .001), anxiety significantly decreased ( p < .001), and mean OSCE scores significantly improved ( p = .002). Remediation rates declined from 7.6% to 3.3%. Student feedback was overwhelmingly positive, with mock OSCEs rated as the most beneficial component. This structured OSCE preparation workshop improved student preparation, reduced anxiety, and enhanced performance, supporting its potential as a sustainable, evidence-informed QI initiative in AHA and other clinical courses. Limitations include self-reported measures, unmatched pre- and postsurvey responses, and a single-institution setting. Building on the success of the workshop, this model is highly scalable for other DNP programs. The low-cost, evidence-based activities can be adapted to diverse curricula, resources, and learner needs, making it a sustainable strategy for supporting CBE.