Guide to Administering Competency-Based Clinical Exams

MCSP focuses on maternal, newborn, and child health, immunization, family planning and reproductive health, nutrition, health systems strengthening, water/sanitation/hygiene, malaria, prevention of mother-to-child transmission of HIV, and pediatric HIV care and treatment. The program also emphasizes household and community mobilization, gender integration, and digital health. The MCSP is supported by the United States Agency for International Development (USAID) under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The program's goal is to strengthen midwifery as a profession through the regulation of midwives and nurses in Myanmar. The Myanmar Nurse and Midwife Council (MNMC) is responsible for registration and licensure, and for ensuring that midwives and nurses demonstrate essential competencies to practice. The competency-based licensure approach for midwifery was discussed with and endorsed by the MNMC and the Ministry of Health and Sports (MOHS). This approach involves setting up the Clinical Skills Standardization and Assessment Center (CSSAC) and building the capacity of MNMC members in clinical skills assessments. The main aims of setting up the CSSAC are to use it for skills assessments during the licensure process, for in-service trainings, and for Continuing Professional Education trainings. The process for administering competency-based clinical exams involves several key steps. First, the Examination Committee decides which competencies will be assessed and under which testing circumstances. The Committee may prioritize competencies to reflect the most critical maternal and newborn health issues. Critical competencies for midwives typically include postpartum hemorrhage, newborn asphyxia, cardiopulmonary resuscitation, and normal labor and delivery. Critical competencies for nurses include infection prevention and control and shock management. The Examination Committee also determines how applicants who fail will access coaching support, when re-testing may be scheduled, and the number of times that applicants may re-take the exam. Prior to the day of an exam, the Examination Committee develops checklists for the selected competencies in line with the time allowed as well as the passing score for each skills checklist. They also develop instructions and scenarios for the assessors and applicants. The competency-based clinical exam process involves several key steps, including deciding the competencies and skills to be assessed, deciding the number of stations and time limit for each station, developing checklists for Objective Structured Clinical Examination (OSCE), deciding the passing score for each skills checklist, listing the resources needed, developing instructions for assessors and applicants, orienting all assessors to the checklists and instructions before the test, assigning assessors, runners, and timekeepers, orienting applicants to the OSCE stations and their sequence, and documenting the applicant's score without giving feedback. The Clinical Skills Standardization and Assessment Center (CSSAC) provides a setting for administering competency-based clinical exams for licensure or relicensure. The CSSAC is equipped with skills labs and assessment tools to evaluate the competencies of midwives and nurses. The center is used for skills assessments during the licensure process, for in-service trainings, and for Continuing Professional Education trainings. The competency-based licensure approach for midwifery has been endorsed by the MNMC and the MOHS. This approach involves setting up the CSSAC and building the capacity of MNMC members in clinical skills assessments. The main aims of setting up the CSSAC are to use it for skills assessments during the licensure process, for in-service trainings, and for Continuing Professional Education trainings. The CSSAC will also serve as a model site for replication at the state and regional level.