UK NMC Part 2 test of competence (OSCE)

OSCE – The Objective Structured Clinical Examination is the NMC’s part 2 test of competence for nurses and midwives trained outside of the European Union (EU) / European Economic Area (EEA) in the Nursing and Midwifery Council registration process. From the employment start date noted on the certificate of sponsorship (CoS) Overseas Nurses has up to three months (12 weeks) to sit for the OSCE. During this period, applicants can be legally employed as a pre-registration candidate.

Applicants must receive decision letter from the NMC to begin the OSCE stage of the overseas registration process. Candidates must complete the OSCE in the UK at an approved test center. Cost of part 2 test of competence (OSCE) is £794. Candidates are provided with 3 attempts to pass the OSCE. There are 3 universities which are approved as OSCE test centers, and provide a choice of 4 locations to attend the OSCE.

Approved OSCE test centers

What is involved in the OSCE?

The OSCE is practical examination based on UK pre-registration standards. Candidates are required to act the scenarios that nurses or midwives are likely to encounter when assessing, planning, delivering and evaluating care.

The OSCE is made up of 6 separate stations each stages lasting 15 minutes.

4 stations will be scenario based and relate to:

       1) Assessment- holistic patient centered

       2) Planning

       3) Implementation

       4) Evaluation

All of which are stages of nursing and midwifery care. Two stations will be testing practical clinical skills.

Typical skills, which may be tested either on their own or within a nursing/midwifery scenario include:

       1) Vital signs

       2) Calculating drug dosages

       3) Subcutaneous & Intramuscular injections

       4) Basic Life Support – cardio-pulmonary resuscitation (adult, child, baby)

       5) Safe disposal of sharps

       6) Medication administration

       7) Peak Expiration Flow Rate (PEFR)

       8) Wound care

       9) All aspects of Urinary catheterisation & care

     10) Hand hygiene

      11) Palpation (Midwifery)

     12) Auscultation of fetal heart (Midwifery)

     13) New born examination (Midwifery)

     14) Communication skills

Communication is central to nursing and midwifery practice and will continually be assessed during the OSCE’s. 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 manikin) and the nursing or midwifery documentation in each station will be assessed.

The NHS constitutional values and the 6Cs of nursing are assessed throughout the OSCE at all stations.  Make sure that you read the station instructions carefully. Do not be afraid to look at them again if you are unsure. You will not be penalized for this.

According to the Northampton University, the examiner will assess candidates approach to the patient all through the examination, and they will award marks for skills such as:

Communication

  • 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 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 behavior
  • Professional attitude

Candidate should speak to the simulated patient as you are meeting the patient for the first time.  If assessed using a nursing manikin, please remember to verbalize your actions and reasons for actions in the same way you would treat a real patient and the assessor will answer accordingly. 

Approach to the Patient

  • 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-judgmental and maintain the patient’s dignity
  • Be empathic and acknowledge the patient’s emotions or concerns and show sensitivity to any discomfort
  • Be sensitive to personal space – sit at an appropriate distance from the actor and be aware of their body language.  If you move too close and the role player moves back, you are too close

  • Treat a nursing manikin as you would a real patient.

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 the patient can understand
  • Remember to always check if the patient has any questions
  • Offer appropriate reassurance
  • Do not alarm the patient but you must be able to explain the need for urgent action if it is required.
  • Always check the patient has understood
  • Do not routinely over-simplify names for parts of the body. It is reasonable to expect most people will know common body name such as ‘bladder’, ‘ovary’, ‘womb’ and ‘vein’.  If you doubt a patient’s understanding, check and alter your approach to meet the patient’s individual needs. This is an important skill.

  • Treat a nursing manikin as you would a real patient

Involving patient in management

  • Respect patient autonomy and help the patient to make a decision based on available information and advice. This includes competent explaining skills as above
  • Explain information and its implications so the patient can make an informed choice about any nursing or midwifery actions.
  • 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 a nursing manikin as you would a real patient

Nursing or Midwifery Assessment

Candidate should be able to undertake an accurate nursing or midwifery assessment and make a reasoned plan of care if required. You should be able to:

  • Assess the patient’s nursing or midwifery problems accurately.
  • Listen attentively to the patient’s problems and concerns
  • Use clear language and question at a comfortable pace
  • Clarify and check information and summaries understanding
  • Be able to plan holistic safe and effective care based on your nursing or midwifery assessment and best practice.