About OSCE with BIMEL

What will be tested in OSCE Stations

The OSCE comprises 10 stations, with a total testing time of about 3 hours. Four stations will be scenario-based and will relate to four stages of the nursing care process:

1.  Assessment
2.  Planning
3.  Implementation
4. Evaluation.

Four of the six remaining stations will take the form of two sets of two linked stations, testing practical clinical skills. Each pairing of skills stations will last for up to 21 minutes in total, with 4 minutes in between the pairings.

Please remember that you will have done many of these nursing skills several times before. Make sure that you read the station instructions and scenarios carefully. Do not be afraid to take the opportunity to look at them again if you are unsure. You will not be penalised for this.

Typical skills that may be tested either on their own or within a nursing scenario include:

Stations 

•  administration of inhaled medication (AIM)
• aseptic non-touch technique (ANTT)
•  catheter specimen of urine collection (CSU)
•  fluid balance chart (FBC)
•  in-hospital resuscitation (without defibrillation) (IHR)
•  intramuscular injection (IM)
•  mid-stream sample of urine (MSSU) and urinalysis
•  peak expiration flow rate (PEFR)
•  removal of urinary catheter (RUC)
•  subcutaneous injection (SC)
•  paediatric basic life support (BLS) – infant and child (children’s nursing)
•  calculating drug dosages
• hand hygiene   
•  medication administration
•  physiological observations
•  safe disposal of sharps
•  wound care
•  oxygen therapy.
•  nasopharyngeal suctioning
•  nutritional assessment
•  oral care plan
•  bowel assessment
•  administration of suppository.

In each OSCE, one station will specifically assess professional issues associated with professional accountability and the related skills around communication. One station will also specifically assess critical appraisal of research and evidence and associated decision-making. These two stations are both written stations.

Communication skills

Communication is central to nursing practice and will be assessed continually during the OSCE.

We 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 assessor will assess your approach to the patient throughout the examination, and will assess your communication skills such as:

• clearly explaining care, diagnosis, investigations and/or treatments
•  involving the patient in decision-making
•  communicating with relatives and healthcare 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 that meets the requirements of NMC (2018) ‘The Code’
•  professional behaviour
•  professional attitude.

You should speak to the patient as you would any person you are meeting for the first time. If you are being assessed using a manikin, please remember to verbalise your actions, and reasons for actions, in the same way as you would with a real patient. If you ask the manikin a question, the assessor will answer accordingly.

Approaching the patient/manikin

•  Introduce yourself and explain or clarify the purpose of the nursing encounter.
•  Check what the patient wants you to call them.
•  Be polite, respectful and non-judgemental, and maintain the patient’s dignity. 
• Be empathic, acknowledge the patient’s emotions or concerns, and show sensitivity to any discomfort.
•  Ensure that you gain consent from the patient (or carer/guardian for children or certain people with disabilities) 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.

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 canunderstand.
•  Remember always to check whether the patient understands or 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.
•  Do not routinely oversimplify 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 the available evidence-based 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 interventions. They may not always agree with your proposed plan of care.
•  Treat the manikin as you would a real person.
• Nursing assessment
•  You should be able to undertake an accurate nursing assessment and develop a plan of care.
•  Identify the patient’s nursing care needs accurately.
•  Listen attentively to the patient’s problems and concerns.
•  Use clear language, and question 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.

In stations that involve demonstrating a practical skill, you will find a manikin, an actor or other piece of equipment. Where a manikin plays the role of a patient, you must treat the simulated patient as you would a real patient. An assessor will be in each station observing you, except for written stations.

You must carry out effective hand hygiene before starting the stations. Soap, water and hand gel will be available at all stations.

You may be asked to take a nursing assessment or carry out a practical clinical skill. Each station will have a scenario overview, which will give relevant information about the patient, such as name, age and what is expected of you in the station.

Each station (or pair of linked stations) lasts between 8 and 21 minutes, and staff will be there to help you to make the transition from station to station as needed.

A lead assessor will be overseeing the test day, with assessors based at each station, observing. Each station has a camera and sound system installed. The built-in cameras will record the examination and will be used to review the examination afterwards for quality-assurance purposes. This is not optional but is part of the process, so you will be asked, at the point of booking, to consent and that you understand that videoing will take place throughout the OSCE. The videos are used for examination and reviewing purposes only, by the university and the NMC.

Please note: Filmed assessments are treated as examination scripts. Once the scripts have been marked and moderated, the pass or fail decision is final, and candidates or any sponsoring authority cannot request access to the film. An appeal or complaint may involve the investigator reviewing the filmed assessments, but films will not be released to you or any sponsor.

We require that you dress for the OSCE in a manner that is appropriate for a clinical environment. All nurses must be dressed professionally, must maintain a high standard of infection control, and must ensure their own health and safety and that of their patients. The guidelines below are based on the expected standards for pre-registration healthcare students at any UK university. They mirror the professional standards required of all healthcare professionals in the UK.

· Clothing: Please dress as you would in clinical practice. In the UK, this is normally a clinical dress, tunic or polo shirt with smart trousers or scrubs. You must not wear jeans or shorts. Nurses in the UK frequently wear dark plain trousers and plain polo shirts/tunics. Where possible, candidates should be dressed in a similar manner. Candidates who wish to wear alternatives, for example because of cultural or maternity requirements, should discuss this with the competence test centre before arriving for the OSCE.

· Shoes: Must be plain, flat, black and rubber-soled, enclosing the whole foot and not made of porous or absorbent material.

· Fingernails: Must be kept short, unvarnished with no extensions or decoration.

· Hair: Must be tied up off the face and secured with simple hair ties/bobbles above the collar of your tunic or polo shirt. Hair should be of a natural shade and style. Facial hair should be kept clean, trimmed and tidy.

· Head scarf/turban: If you wear a head veil/turban, please ensure that it is appropriate in colour (plain black or navy), and it must be tucked into the collar of your tunic or polo shirt.

· Jewellery: Plain ‘ball’ ear studs are allowed to be worn (maximum of one per ear). No tongue piercings should be worn. A single plain band wedding/commitment ring is allowed. You must be bare beneath the elbow: no bracelets or wristwatches are to be worn.

· Make-up: Must be kept to a minimum and must be discreet and natural.

· Socks/tights: Dark blue or black socks with trousers, and flesh-coloured or black tights.

The OSCE is a formal examination and candidates are required to behave appropriately and in accordance with university regulations and policies.

Candidates are already professional nurses, and they are expected to behave in a professional manner at all times while at the competence test centre.

You will be provided with all the materials you need during the examination.