NMC TEST OF COMPETENCE

HOW TO PREPARE FOR YOUR OSCE

Version 2 | How to Prepare for your OSCE

WELCOME
This booklet has been produced to support candidates preparing for Part 2 of the NMC Test of
Competence.

This information compliments the Candidate Information Booklet and Moodle Learning
Resources. It will be updated regularly to ensure candidates receive the most current information.

The most recent version can be found on our

website at:
https://www.brookes.ac.uk/nmc-test-of-
competence/support/

CONTENTS
BEFORE THE OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE)
HOW DO I PREPARE FOR THE OSCE? 1
WHAT TO EXPECT IN THE TEST CENTRE 3
EQUIPMENT 3
THE OSCE 4
CLINICAL SKILLS 7
COMMON MISTAKES/ERRORS 8
MARKING AND MODERATION 9
RESULTS 9
HOW TO INTERPRET FEEDBACK 10
GENERAL TIPS AND ADVICE 10

Version 2 | How to Prepare for your OSCE

BEFORE THE OBJECTIVE STRUCTURED
CLINICAL EXAMINATION (OSCE)
INTRODUCTION
The Nursing and Midwifery Council (NMC) introduced a Test of Competence for internationally
registered nurses and midwives in October 2014. The Test of Competence assesses candidates
against the current UK pre-registration standards.

Nursing in the UK is made up of separate and distinct fields of practice, each requiring three
years of pre-registration undergraduate education.

The distinct nursing fields of practice are:

Adult Nursing
Childrens Nursing
Learning Disability Nursing
Mental Health Nursing

In the UK, midwifery is a separate and distinct profession, also requiring three years of pre-
registration undergraduate education.

The Test of Competence is specific to a field of nursing practice or midwifery and consists of two
parts:
Part 1Multiple Choice Computer Based Test (CBT), which can be undertaken globally.
Part 2Observed Structured Clinical Examination (OSCE) which must be undertaken in
the UK, in one of the NMC approved test centres.

This handbook provides information on how best to prepare for the Part 2 of the Test of
Competence.

General information about preparing for the OSCE is available on the website of your chosen
NMC approved test centre site. You are encouraged to read the How to Prepare for your OSCE
booklet thoroughly to plan your preparation and to maximize your changes of passing this
examination.

The links to NMC approved test centre sites

can be found on the NMC website:
https://www.nmc.org.uk/registration/joining
-the-register/trained-outside-the-eueea/ Tip: Remember that you
will have done many of
these nursing skills
Once you have chosen where you wish to take your several times before!
OSCE, you will need to choose a date and make
payment. You will then receive access to our internal
learning platform which holds a range of useful information
and preparation materials to support and prepare you for
the exam.

This information booklet is in addition to these materials.

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HOW DO I PREPARE FOR THE OSCE?
The OSCE is designed to assess your ability to competently apply your professional nursing or
midwifery skills and knowledge in the UK. It is set at the level expected of nurses and midwives
as they enter the profession (at the point of registration - not advanced skills). This
means that 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 of 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.

A reading list and further examples are on the learning platform.

Tip: Example exam paperwork can be

found on the learning platform.
We recommend a minimum of 14 days
to review the content of the learning
resources on Moodle. Many candidates
have highlighted that more time is
neededmake the most of Moodle!

Tip: Read the candidate

handbookit is full of
lots of useful information
and further helpful tips!

Tip: You are being assessed at UK

pre-registration entry level; no ad-
vanced nursing skills are required to
pass the OSCE. If you know the basic
skills of nursing or midwifery care, the
scenario you are given will not matter.

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WHAT TO EXPECT IN THE TEST CENTRE
The test centre is a full mock-up of a hospital ward with two patient at home bays. Each bay is
set up for individual station scenarios. The examination area of the centre is overseen by an
invigilator. The invigilator will welcome you to the test centre and oversee your movements
through the examination process. Please direct any questions, queries or requests to the
invigilator. The assessor within the station will be able to answer any clinical questions. The lead
assessor is there to coordinate the marking and moderation process.
Each station hosts a camera in the corner of the bay; we record the assessment for moderation
and review purposes only.

The centre uses both professional actors and manikins in order to conduct
the assessments and make them as real life as possible.

Tip: Remember to interact

with the manikin during the
assessment. The examiner
will speak on their behalf,

The video link below explains the importance of communicating with your patient and gives you
examples of this skill:
https://northampton.mediaspace.kaltura.com/media/Support+Video-
+Soft+Skills/1_adcf8tqr

EQUIPMENT
You will be provided with all the equipment needed to complete the station successfully. Below
are pictures of just some of the equipment you can expect to see in the bays which you may use

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throughout the examination. A full equipment list can be found on our Moodle site and in the
Candidate Information Booklet

All our equipment is standardised to mirror those used within a medical environment. If you see
any equipment either here or on the internal learning site that you do not know how to use, do not
worry as your assessor will explain the equipment at the start of each station. You will be given
an orientation in each bay before your assessment starts, where you will have an opportunity to
familiarise yourself with the equipment required for the particular bay you are in.

The video link below gives you a tour of our test centre which will help you familiarise yourself
with the environment:
https://northampton.mediaspace.kaltura.com/media/Support+Video-
+Competency+Test+Centre+Tour/1_1icft3e7

THE OSCE
The OSCE is made up of six stations, each lasting between 10 and 20 minutes.

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The OSCE is a scenario based approach which includes the following:
A - Patient Centred Assessment
P - Planning Care
I - Implementation
E - Evaluation

There are also two skill stations which you will be tested on. The skills are based on the list
provided in the Candidate Information Booklet (also see page 9 in this document).

In each station you will be given information about what is expected of you and patient
information for you to follow. Please read this information and ensure you understand what is
expected of you within the station. Focus on the task and follow the requirements set out on the
information sheet.

There are timers on the wall so you can keep

track of your time. Within this time, you must
demonstrate safe practice and
competencies within each station. Any
activity outside of the allocated time will not be
assessed, so please ensure you do
everything within the time frame. You will be
given prompts as to how much time you have
left to help you manage your time within the

During each of the stations you need to verbalise what you are doing to the assessor.
We introduce new scenarios and skills regularly so there is no guarantee you will sit the same
scenario as a colleague or friend. We plan the examination to ensure
candidates receive a variety of different scenarios and skills.

Tip: If you make a mistake do not panic!

Make sure you tell the examiner within
the assessment time. Share what you
would do to correct it and this will be tak-
en into account. However, verbalisation
will not overturn a critical fail.

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THE OSCE EXAM
There are four nursing stations which are scenario based:

Assessment (A):
Your verbal communication and non-verbal communication will be assessed in this station and
the ability to establish a rapport based on the 6Cs with your patient during the assessment
station. You will be given 5 minutes to read the pre-filled admission form. This can provide you
with a structure and systematic approach so use this to help you. You will need to take
observations of the patient and record them on an observation chart (NEWS, Glasgow Coma
Score etc) prior to completing the assessment station. You will need to verbalise this score to the
assessor within this station. It is important to complete and record all observations before the time
has run out in order to pass. You will then need to consider Activities of Daily Living within this
station as this information will help you with the ongoing stations.

Planning (P):
This is a silent writing bay and you will be monitored
by the invigilator. You will have 15 minutes to write Tip: Ensure you are
2 relevant aspects of care related to the scenario familiar with observation
from Assessment which should include associated/ charts.
relevant self-care. Make sure you familiarise Eg. NEWS, Glasgow
Coma Score
yourself with the template provided on
Moodle. Please note - you will be required to complete
this form in a black pen which will be provided.

Implementation (I):
In this bay you will be implementing care such as drug administration
or other nursing implementation. You will have 15 minutes to complete this station. In this bay
your patient will be a mannequin and the assessor will respond to you as though they are the
patient from a script. Please remember that your verbal and non-verbal
communication will be assessed in this station. Communicate with the mannequin
NOT the assessor as you would with a real patient.

Evaluation (E):
This bay is a silent writing bay and you will be moni-
tored by the invigilator. You will have 15 minutes to
write a transfer/discharge or other form of nursing
Tip: Ensure you are evaluation in this station related to the scenario from
familiar with observation the previous stations. You will have access to all
charts. your previous written notes in this station to help
Eg. NEWS, Glasgow you. Make sure you familiarise yourself
Coma Score
with the template provided on Moodle. You
should avoid using unfamiliar abbreviations that are
not universally recognised within this station. Please
note, you will be required to complete this form in a
blue pen (not black), this will be provided for you.

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CLINICAL SKILLS
You will be assessed on two clinical skills, typical skills which you could be tested on, within a
nursing/midwifery scenario include but are not limited to:
Vital signs
Calculating drug dosages
Intramuscular and subcutaneous injections
Basic life support - cardio-pulmonary resuscitation (adult, child, baby)
Safe disposal of sharps
Medication administration
Peak expiratory flow rate
Wound care
Urinary catheterisation including insertion, catheter care, obtaining a specimen of urine,
removal of a catheter etc
Hand hygiene
Palpation (Midwifery only)
Auscultation of fetal heart (Midwifery only)
New born check (Midwifery only)

All clinical skills and how to conduct them are in the Royal Marsden Manual of Clinical
Procedures (9th Edition), we recommend you read this. More detailed information can be found
on the Moodle site. You will have access to the online learning platform for your chosen OSCE
centre for a minimum of 14 days once you have registered and paid for your OSCE.

We assess the full range of communication skills (verbal, nonverbal and

written) by observing the interaction between the candidate and a simulated
patient (this may be an actor or a nursing mannequin) and also by assessing
your nursing or midwifery documentation. It is essential that you demonstrate
all elements of the 6Cs within your exam.

The examiner will assess your approach to the simulated patient throughout the examination, and
they will award marks for communication skills such as:
Clearly explaining care, diagnosis, investigations and/or treatments Intervention?
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 patient or anxious relatives
Giving clear instructions on discharge
Giving advice on lifestyle, health promotion or risk factors
Demonstrating compassion and care during communication
Clear documentation which meets current NMC guidelines
Professional behaviour

Further information on this can be found in the Candidate Information Booklet.

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COMMON MISTAKES AND ERRORS
We thought it would be helpful to provide you with some common things candidates often forget
or miss during the OSCE examination to aid you in your preparation.

For all stations:

Lack of communication verbal, non-verbal, not listening to patient
Not reading the scenarios or instructions accurately.
Not completing the paperwork or assessment requested within the 15 minutes
Touching the patient before conducting hand hygiene techniques
Not checking for allergies
Not checking patient identity
Not gaining consent from patient
Not ensuring patient safety
Not completing the station within the timeframe

Assessment
Not completing the vital signs accurately
Not completing the documentation adequately

Planning
Evaluation date not within the prescribed time frame
Incomplete documentation
Not considering elements of self-care for the patient
Illegible documentation
Abbreviations not recognised
Errors not dealt with correctly

Implementation Tip: This is a test of

Not checking the expiry date on drugs patient safety and
public protection.
Not reading the medication chart properly
Overdose/under dose patient
Signing for medication prior to administration

Evaluation
Reason for admission or date of admission omitted
Illegible documentation
Abbreviations not recognised
Errors not dealt with correctly
Clinical Skills
Contamination of sterile field
Chest compressions are not deep enough or too fast or too slow
Chest compressions not timely
Discarding ampoule prior to administration of injection
Incorrect documentation
Breaching sterile field

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MARKING AND MODERATION
The university has robust quality assurance processes, which we must adhere to. These are also
independently verified and validated by the QAA and NMC to deliver the Test of Competence
Part 2.

When you enter a work station there will be an area for the assessor to mark you during your
assessment. You will be marked only on your competences demonstrated during the
assessment. All our assessors are fully qualified nurses or midwives with full sign off mentorship
registration and undergo full training prior to joining the assessor team for the OSCE.

Each OSCE station has a unique 20 criterion based assessment sheet which is matched to the
scenario or skill being assessed, examiners will score each criteria. The 20 criterion is mapped
against the NMC standards for Pre-Registration Education 2010 and the NMC Code
2015.

The skills assessments are also mapped against the above but also mapped against the Royal
Marsden Manual of Clinical Procedures (9th Edition). An e-book is available on
Moodle.

Your entire exam will be digitally recorded and assessed in live time and you will be marked as
either a pass or a fail. Once your full assessment has been completed, documents and videos
are moderated by an independent examiner and confirmed by the Lead Assessor or Test Centre
Manager before a final decision is made.

RESULTS
All results will be emailed by the NMC to your personal email address (as registered with the
NMC) within 5 working days of your examination.

Pass = Candidates who pass all six scenarios and skills stations at the first attempt

Partial Fail (APIE) = Candidates fail a single scenario but pass ALL skills stations (Fail and
will require a partial Re-sit at 50% cost) Therefore you will need to sit all APIE stations at your
resit. You will be required to sit an entirely new scenario, not just the specific station(s) you have
failed.

Partial Fail (Skills) = Candidates pass all scenario stations but fail one or more skills station
(Fail and will require a partial Re-sit at 50% cost) Therefore you will need to sit 2 skills at your
resit. You will be required to sit the station you failed to show competence in, plus another from
the list of skills in your handbook.

Full Fail (1st attempt) = Candidates who fail more than one scenario or skills station (Fail
and will require full Re-sit at full cost) Therefore you will need to sit all APIE & 2 skills stations
at your resit.

Full Fail (Re-sit) = Candidates who fail either or both APIE or skills on their resit attempt will
require 6mths to elapse before sitting the OSCE again (Full cost) in its entirety by way of a
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reapplication to the NMC.

Re-sit results are always a Pass or a Full Fail and the next OSCE attempt always requires a
full re-sit.

If you have failed your re-sit, your NMC application closes and you will need to re-apply. Please
contact [email protected] if you wish to re-apply. You will have to sit all
6 OSCE stations at your next attempt, regardless of whether you have had a partial or full re-sit.

HOW TO INTERPRET FEEDBACK

You will receive an email from the NMC as outlined above. You will receive standardised
feedback on the areas you fail. The feedback will not tell you how to make it right but it will tell
you what areas you failed in and why, and if appropriate, will recommend resources to review to
help you improve a specific area. This is to ensure consistency and equality in all candidate
feedback and also aid you in preparation for your resit should you need to undertake one.

For example, if a candidate failed ANTT for contaminating their yellow bag when setting up the
field, the feedback would read as follows:
ANTT: You failed to show competence in this station. When setting out your sterile field you
contaminated the yellow bag and as a result contaminated your sterile field. This is a patient
safety risk resulting in a fail.

GENERAL TIPS AND ADVICE

Try not to be nervous, stay calm - you know this
Read, read and read again the paperwork for the stations and make sure you
understand fully what is expected of you during the assessment.
There is lots of information for you to help you when preparing for the OSCE the
Candidate Information Booklet and the MOODLE site has important information which will
help you.
You need to bring your passport and required documentation for your ID check by the
NMC.
Water is available throughout the centre and exam if needed
If you dont have a fob watch or forget to bring one, dont worry we have spares at the test
centre which you can use.
Ensure you are presented as you would need to be in practice. This includes: no jewellery,
long hair tied up, no nail polish, flat shoes and short sleeves. You can arrive in your work
tunic/scrubs if you wish. Refer to the Candidate Information Booklet for further details.
Make sure you have eaten before your OSCE assessment. You may be in the test
centre for up to 4 hours; once you are registered you are not allowed to go outside of the
centre.
Arrive in plenty of time to allow for traffic. It is recommended that you give yourself at least
30 minutes before the examination time to relax and find the centre
Keep an eye on Moodle, this is where you will be able to see any announcements,
updates or changes to our guidance
Reading tip The assessment is based on the Royal Marsden, we advise you to read
elements of this for reference purposes

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 Make sure you prepare for your OSCE at the appropriate level, remember the
OSCE is set at the level expected of nurses and midwives as they enter the profession.
Be aware you are asked to sign the Declaration of Confidentiality at the start of the OSCE.
You must not discuss any elements of the OSCE with colleagues or friends.
You must not talk to other candidates whilst you are within the test centre.

We wish you the very best of luck

in your OSCE and look forward to
welcoming you to the NMC
COMPETENCE TEST CENTRE at
OXFORD BROOKES UNIVERSITY.

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