Introduction of an objective structured clinical exam on midwifery life saving skills, and examinees satisfaction

Introduction. Training midwives on life saving skills is one of the most important strategies in preventing maternal and neonatal mortality, especially in areas that physicians are absent. The effectiveness of each training program must be evaluated. Objective structured clinical evaluation can be applied to evaluate the learner skill improvement on special tasks with lowest skill evaluation bias. This study was conducted to determine the satisfaction of examinees that contribute in an examination designed to evaluate the midwives’ skills before and after a training course on midwifery life-saving skills, in Taibad and Torbate-jam, 2001. Methods. All of 63 village midwives of Taibad and Torbate-jam, contributeed in this study. In order to evaluate midwifery skills, an examination in 11 stations (question and performance) with content of history taking, diagnose, management and refferal in maternal bleeding, pre and post natal, hypertensive disorders in pregnancy, post parttum infection and obstructed labor, was structured. Educations was performed based upon structured course plan and using models, mulajs and film demonstration and real samples. Data was gathered by questionnaires, chek lists and rating scales which was applied in different stations, and their validity and reliability was assessed in a pilot study. Difficulty and discriminative indexes were calculated which were .71 and .56. Exams reliability, using alpha-cronbach test was .82. Correlation co-efficient was 80 for check lists scores, recorded by two observers in stations, and .92 for scores gained by questionaires. Descriptive statistics was used in data analyzing. Results. In the opinion of 79.4% of the examinees, OSCE was a beneficial manner for evaluation of midwifery skills and 68.3 % believed that this examination gave a correct estimation on skills achieved by contributors and 88.9 % believed that this examination must be applied in assessing effectiveness of all of midwifery courses. 84.1% were completely satisfied by detailed explanation of expected performance in each of stations, 85.7% from the time allocation and 95.2% from the place considered in this regard. Conclusion. Results indicate highly satisfaction of examinees in this objective structured clinical evaluation, administered before and after a midwifery life-saving training course. Difficulty and discriminative indexes and reliability of this examination were highly acceptable. In spite of the need to more facilities and equipments, which can easily be prepared, it is a reliable exam for assessing the improvement in cognition and skills of village midwives who contribute in life saving skills training courses.