Competency development in early nursing training: a cross-sectional OSCE study of self-assessment versus examiner ratings

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BACKGROUND: Accurate self-assessment is a core function of self-regulated learning: learners monitor their performance and adjust strategies accordingly. In nursing education, however, students often misjudge performance, especially in interpersonal communication, indicating gaps in calibration accuracy, the alignment between self- and examiner ratings. Although self-other discrepancies are reported in medicine and allied health, domain-specific patterns early in nursing training remain underexplored. We therefore examined calibration accuracy in first-year students' OSCEs across professional knowledge/analytical, methodological/procedural, and social/communication domains, and tested whether age, gender, or prior healthcare training were associated with these discrepancies. METHODS: In this cross-sectional study, a complete cohort of 109 first-year nursing students undertook a standardized OSCE at the end of the second semester. The OSCE was conducted under summative assessment conditions and included stations assessing professional knowledge/analytical skills, methodological/procedural skills, and social/communication skills. Each domain was examiner-rated and self-rated immediately post-exam. Of 109 students, 102 provided complete data for analysis. Discrepancy scores (self minus examiner) were analyzed using repeated-measures ANOVA, paired t-tests, and linear regressions with demographic predictors. RESULTS: A significant interaction between rating type and competence domain was observed (η²ₚ = 0.42, p < .001). Calibration was domain-specific: Students calibrated accurately in professional knowledge and methodological skills (both ns), but strongly overestimated social/communication skills, with a large effect size (mean difference - 0.14, d = - 0.99, p < .001). Age negatively predicted overestimation in social/communication skills (R² = 0.07, p = .006), while gender and prior healthcare training showed no associations. CONCLUSION: First-year nursing students calibrated well in technical and analytical skills but overestimated interpersonal communication. In SRL terms, transparent checklist criteria support monitoring, whereas implicit interpersonal standards are harder to judge. Age, rather than gender or prior healthcare training, was associated with smaller social-domain gaps. These findings align with prior work and point to interpersonal competence as a cross-disciplinary calibration challenge. Feasible, theory-aligned steps, facilitated video review against checklists, standardized vignette calibration with expert anchors, and pre- to post-feedback self-ratings, should be piloted and evaluated longitudinally before broader adoption.

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