The OSCE is designed to assess your ability to competently apply your professional Nursing skills and knowledge in the UK. It is set at the level expected of nurses as they enter the profession (at the point of registration). This means you must show that you are capable of applying knowledge to the care of patients at the level expected of a newly registered nurse or midwife.
The examination is testing your ability to apply knowledge to the care of patients rather than how well you can remember and recite facts. All the scenarios and any questions relate to current best practice and you should answer them in relation to published evidence and not according to local arrangements.
- Oxford Brookes
- University of Northampton
- Ulster University
The OSCE comprises different stations, each lasting between 8-15 minutes. Four stations will be scenario based and relate to four stages of the nursing and midwifery care process:
- Assessment- holistic patient-centred
Typical skills which may be tested either on their own or within a nursing scenario include:
- Administration of Inhaled Medication (AIM)
- Aseptic Non-touch Technique (ANTT)
- Catheter Specimen of Urine (CSU)
- Fluid Balance chart (FBC)
- In-hospital resuscitation (without defibrillation) (IHR)
- Intramuscular injection (IM)
- Mid-stream Urine and Urinalysis (MSU)
- Peak Expiration Flow Rate (PEFR)
- Removal of Urinary Catheter (RUC)
- Subcutaneous injection (SC)
- Calculating drug dosages
- Hand hygiene
- Medication administration
- Physiological observations
- Safe disposal of sharps
- Wound care
- Fine bore nasogastric tube insertion
- Visual infusion phlebitis (VIP) assessment and intravenous cannula flush
- Pressure ulcer assessment
- Evidence Based Practice
- Professional behaviour
Communication is central to nursing practice and will be assessed continually during the OSCE. They assess the full range of communication skills (verbal, non-verbal and written) by observing the interaction between the candidate and a simulated patient (this may be an actor or a manikin) and also by assessing your nursing documentation in each station.
The major assessment points are
Clearly explaining care, diagnosis, investigations and/or treatments.
- Involving the patient in decision-making.
- Communicating with relatives and health care professionals.
- Seeking and obtaining informed consent.
- Active listening.
- Dealing appropriately with an anxious person or anxious relatives.
- Providing clear instructions on discharge.
- Providing advice on lifestyle, health promotion or risk factors.
- Demonstrating compassion and care during communication.
- Clear documentation which meets the requirements of the NMC (2018) the Code.
- Professional behaviour.
- Professional attitude
Approaching the patient/manikin
- Introduce yourself and explain or clarify the purpose of the nursing or midwifery encounter.
- Check what the patient wants you to call them.
- Be polite, respectful, non-judgemental and maintain the patient’s dignity.
- Be empathic and acknowledge the patient’s emotions or concerns and show sensitivity to any discomfort.
- Ensure you gain consent from the patient prior to undertaking any procedures.
- Be sensitive to personal space, stand or sit at an appropriate distance from the actor/manikin and be aware of their body language. You are too close if the actor moves back or recoils.
- Treat a manikin as you would a real patient. B. Explaining and advising
- Establish what the patient already knows and/or wants to know.
- Explain clearly what you are going to do and why, so that the patient can understand.
- Remember to always check if the patient has any questions and understands.
- Offer appropriate reassurance.
- Do not alarm the patient but you must be able to explain the need for urgent action if it is required.
- Do not routinely over-simplify names for parts of the body. It is reasonable to expect that most people will know common body names such as 'bladder', 'ovary', 'womb' and 'vein'. If you doubt a patient’s understanding, check and alter your communication to meet their individual needs.
- Treat the manikin as you would a real person.
Involving the patient in management
- Respect the patient’s autonomy and help them to make a decision based on available evidencebased information.
- Explain information and its implications so that the patient can make an informed choice about their care.
- Check the patient’s understanding and feelings about the proposed nursing or midwifery interventions. They may not always agree with your proposed plan of care.
- Treat the manikin as you would a real person. D. Nursing or midwifery assessment
- You should be able to undertake an accurate nursing or midwifery assessment and develop a plan of care.
- Identify the patient’s nursing or midwifery care needs accurately.
- Listen attentively to the patient’s problems and concerns.
- Use clear language and questions at a comfortable pace.
- Clarify and check information and summarise understanding.
- Be able to plan safe and effective person-centred care based on your nursing assessment and evidence-based best practice