A Practical Innovation in Scoring the Ottawa Resident Observation Form for Nurses (O-RON)

Background: The Ottawa Resident Observation Form for Nurses (O-RON) is increasingly used for workplace-based assessment, yet guidance on numerical scoring remains limited, potentially affecting interpretability and educational utility.Objectives: To explore an innovative, practical approach to numerical scoring for O-RON that balances reliability, discrimination, and usability in clinical education.Methods: Nine alternative scoring schemes were examined by varying the middle-category score between 1 and 9 while fixing extreme categories at 0 and 10. Thirteen nurses evaluated four first-year orthopaedic residents using the Chinese O-RON. Internal consistency, inter-rater reliability, criterion-related performance, and group discrimination were explored across scoring schemes.Results: Higher middle-category scores were associated with improved reliability but reduced discrimination. An equal-interval scoring scheme (0–5–10) demonstrated a favorable balance across measurement properties while offering intuitive interpretation for clinical educators.Conclusions: This innovation proposes a practical numerical scoring approach for nurse-based resident assessment that may enhance interpretability and educational usefulness, and warrants further investigation in larger, multi-institutional settings.