The OSCE, also known as the Objective Structured Clinical Examination, is the part 2 and last part of the NMC Test of Competence. I have taken mine and fortunately passed so I am sharing how I prepared for my OSCE to help those who are about to take it.
Before I go on, let me just say that as much as I would like to, I cannot post specific information about the exam because prior to taking it, the NMC makes you sign a waiver saying that sharing information about the examination is prohibited and violating such rule will come with serious consequences. Should you have further questions, please don’t hesitate to send me an email.
Moving on, let me take you out of the dark first by letting you know what to expect with the OSCE Nursing. In order to pass, you have to at least have some idea on what to expect on your big day. I will be writing up some topics mostly asked about the OSCE and if you want to know more, you can post it on the comments or send me an email. I will decide if I am allowed to post it on here but nevertheless, I will still respond to your queries.
There are six of them which are grouped into two. One is the A.P.I.E. (Assessment, Planning, Implementation, Evaluation) and that is composed of four stations, one for each letter. You will be given an admission sheet that is filled up halfway and you will be given five minutes to go over it and prepare. There are a few possible cases you will get but nothing too complicated and that is where your plan of care will be based on. Let me give you a brief idea about the first four OSCE stations.
- Assessment – The only OSCE station with an actor/actress patient. Just as its category says, assessment. This is where you do your obs/vital signs and interview to complete the assessment stage. Time limit: 15 minutes.
- Planning – This is an unmanned station where you would have to sit down and write at least 2 care plans based on all the information you have gathered from the assessment station. Time limit: 15 minutes.
- Implementation – You will have to interact with a mannequin patient in this OSCE station as it is about dispensing medications. You will be assessed based on your knowledge and skills about medications and dispensing them safely but not to worry, there is a BNF available should you be unfamiliar with a certain medication. Time limit: 15 minutes.
- Evaluation – Another unmanned OSCE station. You will be sat down and asked to write a transfer of care letter for the same patient. They will give you all the forms you have filled up from the previous three stations to serve as your reference. Time limit: 15 minutes.
The last two stations are the skills section where you will be performing two random situations for you to demonstrate. Mine was BLS and ANTT (Aseptic Non-Touch Technique). These OSCE stations have videos on the NILE website which you will have access to once you have signed up to take the exam. I suggest you watch them as soon as you get your access to get yourself familiarized.
My OSCE Preparation
We all have our own styles of studying but it has also been proven that there is at least one that would work for the majority. I will be sharing how I prepared for the NMC OSCE hoping that it would work for you as well.
Step 1 Write a Script
This step is easier than you think. Think of the OSCE as a play where you’re the director and script writer, the OSCE stations are your set and the examiners are your critics. Do not over complicate things and make your sentences as short yet complete as you can. No need to use highly technical terms. That way, you can keep the conversation between you, the patient and the examiner brief. Write a script for every station from start to finish. This would not only include the things you would say but also the things you will do like “Perform handwashing…” so you can get yourself familiarized with the flow. Write a full script for every station that requires demonstration and an outline for stations that requires writing such as the Planning and Evaluation stations. I made sure I finished all of these before doing anything else. These scripts will serve as your guide throughout your studying. Do not worry about perfecting or editing it. That will happen as you go along with your OSCE practice.
Step 2 Time Yourself
Time pressure is one of the biggest enemy in the NMC OSCE for nurses. Twelve to fifteen minutes is just not enough to perform return demonstrations in an ideal manner. It is hard but one thing is for sure, it is possible with a huge amount of practice. By now you should have already written scripts and outlines for your OSCE station practice and it is time to put it to the test. Set your timer up for 12 minutes and recite your scripts and act out your demonstrations. It is alright if the timer alarms before you are finished. This way, you will figure out your speed of talking and your tempo. Keep practicing until you are able to finish everything within 12 minutes. Why 12 minutes? The stations are timed for 15 minutes each. If you get used to performing within 12 minutes then you will have 3 minutes left which is more than enough to correct your mistakes and say the things you missed to the examiner. It will take a couple of tries before it can get done but do not stop practicing until you are able to do it.
Step 3 Get the Royal Marsden Manual and READ It
Trust me when I say, this book will be a lot of help for you from the beginning of your application to be a nurse in the UK. The Royal Marsden Manual helped me with both the NMC CBT exam and the NMC OSCE. I was lucky enough to have my previous ward manager give me her own copy of this book and I could not thank her enough for it. Go ahead and get your hands on it. Borrow from someone you know who has it or you can also grab your own copy from here. It would cost quite a bit but it is worth it. It could go way further after you have passed the NMC exams because it is the backbone of the nursing practices in UK. If you are wondering how a certain skill should be done that is within the NMC code, then the Royal Marsden Manual is the best reference to use. Now, this is an enormously thick book and it is very easy to get carried away as to which one you will be reading but just focus on the APIE and the common nursing practice skills.
Things that could go wrong during OSCE and cause you to FAIL
There are a few things that could get you a FAIL mark for the OSCE exam for nurses. Knowing some of these things will keep you aware of the things you should avoid on doing.
1. Running out of time
This is the most common issue that OSCE exam takers face. They fail the test because they ran out of time to do what is supposed to be done to pass. That is why it is important to practice under time pressure to somehow be in control of the limited time that will be given to you during the OSCE.
2. Not correcting yourself
Nobody is perfect. Despite doing enormous amounts of practicing, things can still go wrong and that is fine. As long as you keep a mental note to yourself that you should correct yourself if you make a mistake. Pride and ego has no place in the OSCE so you should know how to admit your mistakes, apologize and do something about it. For example, you forgot to perform the hand washing technique before starting the ANTT. As soon as you figure it out, you can either say it right away to the examiner or say it after you have finished everything. The former is better since there is a lesser chance for you to forget what you have done wrong and you get to correct it before you ran out of time. You can just say “Before I proceed, I just want to say that I should have performed handwashing within the NHS guidelines before starting the ANTT. Would you like me to perform it or proceed to the next step?” then the examiner will either let your proceed or make you do the whole process.
3. Not writing fast enough
Another complain I have been hearing from those who failed the OSCE is that they did not finish either the Planning or Implementation stage. In these stations, they will sit you in a curtain closed room to write your answers. The problem? It is right beside the other stations where all the other exam takers will be making noise from their own stations and it can get quite distracting. So as soon as you sit down, start thinking, analyzing and writing. Do not dilly-dally.
4. Lack of focus
Alright this is a no-brainer yet it happens a lot. Our brains always tend to wander off at some point but it should never be during the OSCE. This is not the time to think about what is going on back home, how the other exam takers are doing, what dinner you would be eating that night or which part of Europe will you be traveling to next. There should be nothing else in your head during that time but the exam.
5. Home TV shopping act
When I took my OSCE, I could not help but hear the other nurses from the other stations since it was just all divided by curtains. The first thing I noticed was some of them talk like hosts from home TV shopping channels. Always remember that this is an exam, not a promotion. You are here to get your license not to sell something.
I was part of the first batch of the ONP who took the OSCE and it was a real challenge because no one else knew what to teach us. Even the senior nurses here in the UK does not know what to tell us about it because they took a different process to obtain their licenses. The OSCE for nurses was new to everyone. We were practically trying to find our way in the dark. That is why I am sharing my own experience about the test. Now it has been 2 years and there has already been a lot of changes since. Feel free to share updates and your own experience about the OSCE. Let us all help each other to reach a common goal.