Mock OSCE

In your objective structured clinical examination (OSCE), you will be assessed on 10

stations in total:

• Three of the stations are linked together around a scenario about the ‘provision and
monitoring of care’, with one station for each of Assessment, Implementation and
Evaluation (AIE), delivered in that sequence and with no stations in between.
• Five stations will take the form of either standalone or linked stations, testing practical
clinical skills. Each standalone station will last up to 8 minutes, with each pairing of skills
stations lasting up to 16 minutes in total (including reading time), with no break between
each paired skill.
• There are also two silent stations. In each OSCE, one station will specifically assess
professional issues associated with professional accountability and related skills around
communication (called the professional values and behaviours, or PV, station). One station
will also specifically assess critical appraisal of research and evidence and associated
decision-making (called the evidence-based practice station, or EBP). These stations will
each be 10 minutes long.

We have developed this mock OSCE to provide an outline of the performance we expect and the
criteria that the test of competence will assess. This mock OSCE contains an AIE, one pair of
linked clinical skills, one PV and one EBP station.

The Nursing and Midwifery Council’s ‘The Code’ (2018) outlines professional standards of practice
and behaviours, setting out the expected performance and standards that are assessed through the
test of competence.

‘The Code’ is structured around four themes: prioritise people, practise effectively, preserve safety,
and promote professionalism and trust. These statements are explained below as the expected
performance and criteria. The criteria must be used to promote the standards of proficiency in
respect of knowledge, skills and attitudes. They have been designed to be applied across all fields
of nursing practice, irrespective of the clinical setting, and they should be applied to the care
needs of all patients. It is critical that you familiarise yourself with this document.

Please note: this is a mock OSCE example for education and training purposes only.

The marking criteria and expected performance apply only to this mock OSCE. They provide a
guide to the level of performance we expect in relation to nursing care, knowledge and attitude.
Other scenarios will have different assessment criteria appropriate to the scenario.

Evidence for the expected performance criteria can be found in the reading list and related
publications, which are available on the learning platform.

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 Mock OSCE
Theme from Expected performance Criteria
‘The Code’
Treat people as individuals and Introduces self to the patient at every
uphold their dignity contact and upholds the patient’s dignity
and privacy.
Listen to people and respond Actively listens to patients and provides
to their preferences and clear information, behaving in a
concerns professional manner, respecting others
and adopting non-discriminatory
behaviour.
Prioritise people

Make sure that people’s Upholds respect by valuing the patient’s

physical, social and opinions and being sensitive to feelings
psychological needs are and/or appreciating any differences in
responded to culture.
Act in the best interest of Treats each patient as an individual,
people at all times showing compassion and care during all
interactions.
Respects and upholds people’s human
rights.
Respect people’s right to Ensures that people are informed about
privacy and confidentiality their care and that information about them
is shared appropriately, maintaining
confidentiality.
Always practise in line with the Provides skills, knowledge and attitude
best available evidence supported by an evidence base at all
times.
Communicate clearly Communicates clearly and effectively to
people in their care, colleagues and the
public.
Work co-operatively Maintains effective and safe
Practise effectively

communication with people in their care,

colleagues and the public.
Share your skills, knowledge Supports others by providing accurate,
and experience for the benefit honest and constructive verbal and
of people receiving care and written feedback.
your colleagues
Keep clear and accurate Provides clearly written feedback on all
records relevant to your care given and demonstrates accurate
practice evidence-based verbal handover of care
to others.
Be accountable for your Accountably delegates to competent
decisions to delegate tasks and others, ensuring patient safety at all
duties to other people times.

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 Mock OSCE
Recognise and work within the Accurately identifies, observes and
limits of their competence assesses signs of normal or worsening
physical and mental health in the person
receiving care, requesting timely and
appropriate assistance as required.
Be open and candid about Documents events formally and takes
potential mistakes, preventing further action (escalates) if appropriate,
harm so that they can be dealt with quickly.
Provide assistance in an Acts in an emergency within the limits of
emergency their knowledge and competence, seeking
appropriate support as required.
Act swiftly if there is a danger Delivers care according to national
to others, maintaining safety policies and procedures to prevent danger
Preserve safety

to others, and applies appropriate

personal protective equipment (PPE) as
indicated by the nursing procedure in
accordance with the guidelines to prevent
healthcare-associated infections.
Raise concerns for those who Shares information if someone is at risk of
are seen to be vulnerable or at harm, in line with the laws relating to the
risk of harm disclosure of information.
Advise on, prescribe, supply, Checks prescriptions, patient identification
dispense or administer and administers medicines safely,
medicines within the limits of highlighting appropriately any areas of
your training and competence, concern.
the law, our guidance and
other relevant policies,
guidance and regulations
Demonstrate awareness of any Takes all reasonable personal
potential harm associated to precautions necessary to avoid any
their practice potential health risks to colleagues,
people receiving care and the public.
Uphold the reputation of the Demonstrates and upholds the standards
Promote professionalism

profession at all times and values set out in ‘The Code’.

Fulfil the registration Demonstrates up-to-date knowledge,
requirements skills and competence to provide safe and
and trust

effective care at all times.

Provide leadership to make Identifies priorities, manages time and
sure that people’s wellbeing is resources effectively, and deals with risk
protected and to improve their to make sure that the quality of care or
experiences of the health and service is maintained and improved,
care system putting the needs of those receiving care
or services first.

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 Mock AIE
Post-operative return to the ward
The mock AIE below is made up of three stations: assessment, implementation, and evaluation.
Each station will last up to 20 minutes and is scenario-based. The instructions and available
resources are provided for each station, along with the specific timing, which is strictly kept.

Scenario

Following an abdominal hysterectomy, Anne has returned from theatre to the surgical ward
under your care.

You will be asked to complete the following activities to provide high-quality, individualised
care for the patient, as would be expected of a registered nursing associate, providing an
assessment of needs, using a model of nursing that is based on the activities of living. All
three of the stages in the nursing process will be continuous and will link with each other.

Station You will be given the following resources

Assessment – 20 minutes • Assessment overview and documentation (pages
You will collect, organise and 10–12)
document information about the • National early warning score (NEWS2) (page
patient. 13–14)
• Universal pain assessment tool (page 15)
• A fluid-balance chart (page 16)
Implementation – 15 minutes • An overview and medicines administration record
You will administer medications (MAR) to be completed (pages 17–23).
while continuously assessing the
individual’s current health status.

Evaluation – 8 minutes • Documents from the previous three stations

• An overview and a blank situation, background,
You will document the care that
has been provided so that you assessment and recommendation (SBAR) tool to
can do a verbal handover to your be completed (pages 24–25)
colleague (the examiner).

On the following pages, we have outlined the expected standard of clinical performance
and criteria. These marking matrices are there to guide you on the level of knowledge,
skills and attitude we expect you to demonstrate at each station.

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 Mock AIE
Post-operative return to the ward
Marking criteria for Post-operative return to the ward – Assessment station

Assesses the safety of the scene and privacy and dignity of the patient.
Cleans hands with alcohol hand rub, or washes with soap and water and dries with paper towels,
following WHO guidelines.
Introduces self to person.
Checks ID with person (person’s name is essential and either their date of birth or hospital
number) verbally, against wristband (where appropriate) and documentation.
Checks for allergies verbally and on wristband (where appropriate).
Gains consent and explains reason for the assessment.
Uses a calm voice, speech is clear, body language is open, and personal space is appropriate.
Conducts an A to E assessment (please refer to the examiner guidance for specific
scenarios) – verbalisation accepted:
Airway:
• clear
• no visual obstructions.
Breathing:
• respiratory rate
• rhythm
• depth
• oxygen saturation level
• respiratory noises (rattle, wheeze, stridor, coughing)
• unequal air entry
• visual signs of respiratory distress (use of accessory respiratory muscles, sweating,
cyanosis, ‘see-saw’ breathing).
Circulation:
• heart rate
• rhythm
• strength
• blood pressure
• capillary refill
• pallor and perfusion.
Disability:
• conscious level using ACVPU
• presence of pain
• urine output
• blood glucose.
Exposure:
• takes and records temperature
• asks for the presence of bleeds, rashes, injuries and/or bruises
• obtains a medical history.
Accurately measures and documents the patient’s vital signs.

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 Mock AIE
Post-operative return to the ward
Accurately uses specific assessment tools: pain chart, fluid balance.
Calculates national early warning score accurately.
Repeats vital signs observations.
Accurately completes document: signs, dates and adds time to assessment charts.
Disposes of equipment appropriately – verbalisation accepted.
Cleans hands with alcohol hand rub, or washes with soap and water and dries with paper towels,
following WHO guidelines – verbalisation accepted.
Acts professionally throughout the procedure in accordance with NMC (2018) ‘The Code:
Professional standards of practice and behaviour for nurses, midwives, and nursing associates’.

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 Mock AIE
Post-operative return to the ward
Marking criteria for Post-operative return to the ward – Implementation station

Cleans hands with alcohol hand rub, or washes with soap and water and dries with paper towels,
following WHO guidelines.
Introduces self to person.
Seeks consent from person or carer prior to administering medication.
Checks allergies on chart and confirms with the person in their care, also notes red ID wristband
(where appropriate).
Before administering any prescribed drug, looks at the person’s prescription chart and correctly
checks ALL of the following:
Correct:
• person (checks ID with person: verbally, against wristband (where appropriate) and
documentation)
• drug
• dose
• date and time of administration
• route and method of administration
• diluent (as appropriate).
Correctly checks ALL of the following:
• validity of prescription
• signature of prescriber
• prescription is legible.
If any of these pieces of information is missing, unclear or illegible, the nurse should not proceed
with administration and should consult the prescriber.
Considers contraindication where relevant and medical information prior to administration
(prompt permitted). (This may not be relevant in all scenarios.)
Provides a correct explanation of what each drug being administered is for to the person in their
care – prompt permitted.
Administers drugs due for administration correctly and safely.
Omits drugs not to be administered and provides verbal rationale (ask candidate reason for non-
administration if not verbalised).
Accurately documents drug administration and non-administration.
Acts professionally throughout the procedure in accordance with NMC (2018) ‘The Code:
Professional standards of practice and behaviour for nurses, midwives, and nursing associates’.

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 Mock AIE
Post-operative return to the ward
Marking criteria for Post-operative return to the ward – Evaluation station
Introduces self and the clinical setting.
States the patient’s name, hospital number and/or date of birth, and location.
State the reason for the handover (where relevant).
States date of admission/visit/reasons for initial admission/referral to specialist team and
diagnosis.
Notes previous medical history and relevant medication/social history.
Gives details of current events, detailing findings from assessment.
States most recent observations, any results from assessments undertaken, and what changes
have occurred.
Identifies main nursing needs.
States nursing and medical interventions completed.
States areas of concerns.
States what is required of the person taking the handover.
Verbal communication is clear and appropriate.
Systematic and structured approach taken to handover.
Acts professionally throughout the procedure in accordance with NMC (2018) ‘The Code:
Professional standards of practice and behaviour for nurses, midwives, and nursing associates’.

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Assessment
Post-operative return to the ward
Candidate briefing
You are a registered nursing associate working on a surgical ward at Brunel Hospital. A patient
has been returned to the ward post-operatively.

Please conduct an assessment of the patient. As part of this, please complete an A to E

assessment (airway, breathing, circulation, disability, exposure), record the patient’s vital signs
(blood pressure, temperature, pulse rate, oxygen saturations, respiratory rate), and maintain a
fluid-balance chart and a national early warning score (NEWS).

Repeat the physiological observations as per the post-operative notes, undertake a pain
assessment and respond to this appropriately, and respond to the drop in oxygen saturation
levels as per the post-operative notes and the prescription chart.

Depending on the patient’s circumstances and condition, you may wish to focus on some areas of
assessment in more depth than others.

Please note that there is no need to remove the patient’s clothing to assess exposure. Please ask
the examiner for any additional clinical information you require.

All equipment has been checked, calibrated and is clean.

An observation chart is provided and must be completed within the station.

This document must be completed using a GREEN PEN.

You have 20 minutes to complete this station, including the completion of the following
documentation: physiological measurements x 2, fluid-balance chart, national early
warning score, and pain assessment.

Assume that it is TODAY and that it is 10:00 hours.

Assessment
Post-operative return to the ward
Overview of recent history
Patient information

Name: Anne Thomas

Date of birth: 01/01/1956
Address: 1 Sweet Street, Westshire, WW6 5PQ (own home)
GP: Dr Biswaz, The Plains Surgery, Westshire.
Consultant: Mr Beckett

Presenting complaint
• Post-operative – abdominal hysterectomy
• Nausea
• Patient-controlled analgesia (PCA) (will run out during shift)
• Urinary catheter
• Intravenous infusion
• Oxygen saturation levels – 90% on air.

Past medical history

• Uterine fibroids – diagnosed 2020.

Social history
• Has lived in a detached house for more than 30 years (own home)
• Lives with husband and two dogs
• Generally fit and active, a keen walker, attends a local gym, and enjoys swimming three
times a week
• Smoking – never
• Alcohol – wine most days with evening meal.

Drug history
• Takes paracetamol for uterine pain – 1 gram four times a day (QDS) as required (PRN).

Allergies
• Shellfish (anaphylaxis).

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Assessment
Post-operative return to the ward
Candidate notes
This documentation is for your use and is not marked by the examiners.

Name: Anne Thomas

NHS number: 000654321
Date of birth: 01/01/1956
Address: 1 Sweet Street, Westshire, WW6 5PQ
Airway

Breathing

Circulation

Disability

Exposure – full clinical history

Nursing Associate Mock OSCE ToC 2021 final_V1.0_Updated 18.10.21

Page 12 of 40
Assessment
Post-operative return to the ward

Chart 1: National early warning score (NEWS)

NEWS scoring system

National early warning score (NEWS2) ©Royal College of Physicians 2017

NEWS thresholds and triggers

NEW score Clinical risk Response

Aggregate score 0–4 Low Ward-based response

Red score Low– Urgent ward-based response*
Score of 3 in any individual
medium
parameter
Aggregate score 5–6 Medium Key threshold for urgent
response*
Aggregate score 7 or more High Urgent or emergency response**

* Response by a clinician or team with competence in the assessment and treatment of

acutely ill patients and in recognising when the escalation of care to a critical care
team is appropriate.
**The response team must also include staff with critical care skills, including
airway management.

Nursing Associate Mock OSCE ToC 2021 final_V1.0_Updated 18.10.21

Page 13 of 40
NEWS key FULL NAME: Anne Thomas
0 1 2 3 DATE OF BIRTH: 01/01/1956 DATE OF ADMISSION Today
Assessment
Post-operative return to the ward
Chart 2: Universal pain assessment tool

Page 15 of 40
Assessment
Post-operative return to the ward
Chart 3: Fluid-balance chart

NAME: Anne Thomas HOSPITAL NUMBER: 000654321

DATE: TODAY

TIME INPUT OUTPUT

HOUR TOTAL GASTRIC HOUR TOTAL

ORAL ENTERAL PARENTERAL URINE BOWELS DRAINS
TOTAL INPUT LOSSES TOTAL OUTPUT

0800 0 0 1000 0 0 1000 1000 200 0 0 0 200 200

0900 0 0 500 0 0 500 1500 50 0 0 0 0 250

1000

1100

1200

1300

1400

1500

1600

1700

1800

1900

2000

2100

2200

2300

0000

0100

0200

0300

0400

0500

0600

0700
PRINT NAME OF NURSE COMPLETING THE FLUID BALANCE CHART: TOTAL BALANCE:

SIGNATURE OF NURSE COMPLETING THE FLUID BALANCE CHART: (NEGATIVE/POSITIVE):

Implementation
Post-operative return to the ward
Candidate paperwork and briefing
Candidate name: _______________________________________
This document must be completed using a BLACK PEN.

Scenario
Following an abdominal hysterectomy, Anne has returned from theatre to the surgical ward under
your care. On handover, you are advised that Anne has:
• nausea
• a patient-controlled analgesia (PCA) pump (which will run out during the shift)
• a urinary catheter
• an intravenous infusion (IVI)
• oxygen saturation levels at 90% on air.

Please proceed to administer and complete the documentation for the 14:00 hours medications
in a safe and professional manner.

• Talk to the person.

• Please verbalise what you are doing and why to the examiner.
• Read out the chart and explain what you are checking/giving/not giving and why.
• Complete all the required drug administration checks.
• Complete the documentation and use the correct codes.
• The correct codes for non-administration are on the chart.
• Check and complete the last page of the chart.

You have 15 minutes to complete this station, including all the required documentation.

Complete all sections of the document.

Assume that it is TODAY and that it is 13:50 hours

Page 17 of 40
 HOSPITAL MEDICATION PRESCRIPTION AND ADMINISTRATION RECORD
Surname: Thomas Height (m): 160 cm

Forename(s): Anne Weight (kg): 55 kg

Date of birth: 01/01/1956 Body mass index (BMI): 21.4

Hospital/NHS number: 000654321

Ward: Surgical ward Consultant: Mr Beckett
Date of admission: Today Time of admission: 08:30

Number of prescription records Chart 1  2  3  of 1  2  3 

All prescribers MUST complete the signature record

NAME GMC/NMC Signature Bleep NAME GMC/NMC Signature Bleep
Number Number
Dr LINDA 258852 Dr L Walker 654
WALKER

Details of person administering medication: must be completed by ALL administering medication

NAME Initials Signature Base

ALERTS: Allergies/sensitivities/adverse reaction

Medicine(s)/Substances Effect(s)

SHELLFISH ANAPHYLAXIS

IF NO KNOWN ALLERGIES TICK BOX

Signature: Dr L Walker Bleep number: 654 Date: Today
Allergy status MUST be completed and SIGNED by a prescriber/pharmacist/nurse BEFORE any
medicines are administered.

Medication risk factors

Pregnancy  Renal impairment  Impaired oral access Diabetes 

Other high-risk conditions  – specify
Patient self-medicating 
 HOSPITAL MEDICATION PRESCRIPTION AND ADMINISTRATION RECORD
Surname: Thomas Height (m): 160 cm

Forename(s): Anne Weight (kg): 55 kg

Date of birth: 01/01/1956 Body mass index (BMI): 21.4

Hospital/NHS number: 654321

Ward: Surgical ward Consultant: Mr Beckett
Date of admission: Today Time of admission: 08:30
Information for prescribers: Medicine non-administration/self-administration:

Write in BLOCK CAPITALS using black or If a dose is omitted for any reason, the nurse should enter
blue ink. the relevant code on the administration record and sign
Sign and date and include bleep number. and date the entry.

Record detail(s) of any allergies. 1.Medicine unavailable – 2.Patient off ward

INFORM DOCTOR OR
PHARMACIST

Sign and date allergies box. Tick box if no 3.Self-administration 4.Unable to administer –
allergies know. INFORM DOCTOR (alternative
route required?)
Different doses of the same medication must 5.Stat dose given 6.Prescription incorrect/unclear
be prescribed on different lines.

Cancel by putting a line across the 7.Patient refused 8.Nil by mouth (on doctor’s
prescription and sign and date. instruction only)

Indicate the start and finish date. 9.Low pulse and/or low 10.Other – state in nursing
blood pressure notes including action taken

ONCE-ONLY MEDICINES, PREMEDICATION, ANTIBIOTIC PROPHYLAXIS AND PATIENT GROUP

DIRECTIONS
Check allergies/sensitivities and patient identity
Date Time Drug Dose Route Instructions Prescriber’s Time Signature Pharmacy
signature, given given check
print name
& bleep
number
Today 08:00 Patient- 1mg IV PCA set up DR L 10:19 P. Anne
controlled in recovery WALKER Corfield Jones
analgesia (PCA) (separate Dr L
Morphine PCA chart – Walker
sulphate 50 mg not
654
in 50 ml sodium available to
chloride 0.9% candidates).

Page 19 of 40
 HOSPITAL MEDICATION PRESCRIPTION AND ADMINISTRATION RECORD
Surname: Thomas Height (m): 160 cm

Forename(s): Anne Weight (kg): 55 kg

Date of birth: 01/01/1956 Body mass index (BMI): 21.4

Hospital/NHS number: 000654321

Ward: Surgical ward Consultant: Mr Beckett
Date of admission: Today Time of admission: 08:30

PRESCRIBED OXYGEN
For most chronic conditions, oxygen should be prescribed to achieve a target saturation of 94–98%)
or 88–92% for those at risk of hypercapnic respiratory failure i.e. CO2 retainers).
Is the patient a known CO2 retainer? Yes  No 
Continuous oxygen therapy  Check and record O2 saturation levels as directed by
Surgical team
‘When required’ oxygen therapy 
Target O2 saturation 88-92% 
Target O2 saturation 94-98% 
Other saturation range: ________________
Saturation not indicated e.g. end-of-life care (state
reason) ________________________ 
Starting device and flow rate: Start date: Date Time FR/D
N (nasal cannulae) Today Today 10.00 4L/min/N

Prescriber’s signature: Stop date:

Dr L Walker Today

Print name: Pharmacy

Dr Linda Walker check: A Jones
Codes for starting device and modes of delivery
Air not requiring oxygen or A Humidified oxygen at 28% (add% H28
weaning or PRN oxygen for other flow rate)
Nasal cannulae N Reservoir mask RM
Simple mask M Tracheostomy mask TM
Venturi 24 V24 Venturi 35 V35
Venturi 28 V28 Venturi 40 V40
Venturi 60 V60 Patient on CPAP system CP
Patient on NIV system NIV Other device (specify)
 HOSPITAL MEDICATION PRESCRIPTION AND ADMINISTRATION RECORD
Surname: Thomas Height (m): 160 cm

Forename(s): Anne Weight (kg): 55 kg

Date of birth: 01/01/1956 Body mass index (BMI): 21.4

Hospital/NHS number: 000654321

Ward: Surgical ward Consultant: Mr Beckett
Date of admission: Today Time of admission: 08:30

ANTIMICROBIALS
Check allergies/sensitivities and patient identity
Review IV after 24-48 hours – Review oral after 5-7 days
1.Drug Date and signature of nurse administering medications
and code if not administered.
Date Dose Frequency Route Duration Time Today Tomorrow Pharmacy
check
Today

Start Indication/
date Organism

Finish Cultures sent? Yes No

date
Prescriber’s Print
signature and bleep name

Check allergies/sensitivities and patient identity

2.Drug Date and signature of nurse administering medications
and code if not administered.
Date Dose Frequency Route Duration Time Today Tomorrow Pharmacy
check
Today

Start Indication/
date Organism

Finish Cultures sent? Yes No

date
Prescriber’s Print
signature and bleep name

Check allergies/sensitivities and patient identity

3.Drug Date and signature of nurse administering medications
and code if not administered.
Date Dose Frequency Route Duration Time Today Tomorrow Pharmacy
check
Today

Start Indication/
date Organism

Finish Cultures sent? Yes No

date
Prescriber’s Print
signature and bleep name
 HOSPITAL MEDICATION PRESCRIPTION AND ADMINISTRATION RECORD
Surname: Thomas Height (m): 160 cm

Forename(s): Anne Weight (kg): 55 kg

Date of birth: 01/01/1956 Body mass index (BMI): 21.4

Hospital/NHS number: 000654321

Ward: Surgical ward Consultant: Mr Beckett
Date of admission: Today Time of admission: 08:30

REGULAR MEDICINES
Check allergies/sensitivities and patient identity
1.Drug Enoxaparin Date and signature of nurse administering medications and
code if not administered.
Date Dose Frequency Route Duration Time Today Tomorrow Pharmacy Notes
check
Today 40mg OD S/C Throughout 18:00 Anne New
hospital
admission
Jones 
Start Today Instructions VTE risk factors Amended
date /indication 
Finish Unchanged
date 
Prescriber’s DR L WALKER Print Dr L WALKER Supply at home
signature and bleep name

Check allergies/sensitivities and patient identity
2.Drug Paracetamol Date and signature of nurse administering medications and
code if not administered.
Date Dose Frequency Route Duration Time Today Tomorrow Pharmacy Notes
check
Today 1g QDS Oral Throughout 08:00 Anne New
hospital
admission
14:00
18:00
Jones
Anne

22:00 Jones
Start Today Instructions Post-operative pain Amended
date / indication control 
Finish Unchanged
date 
Prescriber’s DR L WALKER Print Dr L WALKER Supply at home
signature and bleep name

Check allergies/sensitivities and patient identity
3.Drug Date and signature of nurse administering medications and
code if not administered.
Date Dose Frequency Route Duration Time Today Tomorrow Pharmacy Notes
check
Today New


Start Instructions Amended
date / indication 
Finish Unchanged
date 
Prescriber’s Print Supply at home
signature and bleep name 
 HOSPITAL MEDICATION PRESCRIPTION AND ADMINISTRATION RECORD
Surname: Thomas Height (m): 160 cm

Forename(s): Anne Weight (kg): 55 kg

Date of birth: 01/01/1956 Body mass index (BMI): 21.4

Hospital/NHS number: 000654321

Ward: Surgical ward Consultant: Mr Beckett
Date of admission: Today Time of admission: 08:30

AS-REQUIRED MEDICINES
Check allergies/sensitivities and patient identity
1.Drug METOCLOPRAMIDE HYDROCHLORIDE Date and signature of nurse administering medications and
code if not administered.
Date Dose Frequency Route Duration Time Today Tomorrow Pharmacy Notes
check
Today 10 mg TDS PO Anne New
Jones 
Start Today Instructions/ Post-operative Amended
date indication nausea 
Finish Unchanged
date 
Prescriber’s DR L WALKER Print name Dr L WALKER Supply at
home
signature and
bleep 
Check allergies/sensitivities and patient identity
2.Drug Date and signature of nurse administering medications and
code if not administered.
Date Dose Frequency Route Duration Time Today Tomorrow Pharmacy Notes
check
Today New


Start Instructions/ Amended
date indication 
Finish Unchanged
date 
Prescriber’s Print name Supply at
home
signature and
bleep 
OMITTED DOSES OF MEDICINE CODED 10 (OTHER) AND DELAYED DOSES
Check allergies/sensitivities and patient identity
Date Time Drug Dose Route Instructions Reason for Signature Pharmacy
omission given check
10/delay >2hrs

Page 23 of 40
Evaluating care
Post-operative return to the ward
Candidate paperwork and briefing
Candidate name: _______________________________________
• This document must be completed using a BLUE PEN.
• At this station, you should have access to your assessment notes and the
implementation documentation. If not, please alert the examiner.

Scenario

You are a registered nursing associate working on a surgical ward at Brunel Hospital.
You have been caring for Anne Thomas following her abdominal hysterectomy. The
surgical team has returned to review the patient, and you need to give an update on the
current position and any required interventions.

The most recent observations were:

• Temperature: 36.9ºC
• Pulse: 72 beats per minute
• Respirations: 16 breaths per minute
• Oxygen saturations: 98% on oxygen
• Blood pressure: 142/72 mmHg.

The patient is comfortable in all aspects of care.

Using the situation, background, assessment and recommendation (SBAR) tool, please
make notes regarding your patient and use them to hand information over verbally to
your colleague (the examiner).

You have 8 minutes in total to make notes on the SBAR form (this is not assessed) and to
complete the verbal handover to the examiner. You will be informed when there are 2
minutes remaining.

Assume that it is TODAY and that it is 13:30 hours.

Page 24 of 40
Evaluating care
Post-operative return to the ward
Candidate notes
These are for your use and are not marked by the examiners.

Patient details:
Name: Anne Thomas
NHS number: 000654321
Address: 1 Sweet Street, Westshire, WW6 5PQ
Date of birth: 01/01/1956
Situation:

Background:

Assessment:

Recommendation:

Page 25 of 40
Mock clinical skills
The mock clinical skills assessment below is made up of two paired stations. The instructions
and available resources are provided for each station, along with the specific timing.

Station You will be given the following resources

Blood glucose monitoring – • Overview and documentation (pages 30–31)

8 minutes
You will perform a capillary blood
glucose test on a patient who has
lower-limb cellulitis.

• Overview and documentation (page 32–34)

Physiological observations –
8 minutes
You will take and record vital signs
and calculate a national early
warning score for a patient admitted
for a breast biopsy.

On the following pages, we have outlined the expected standard of clinical performance
and criteria. These marking matrices are there to guide you on the level of knowledge,
skills and attitude we expect you to demonstrate at each station.

Page 26 of 40
Mock clinical skills

Marking criteria – Blood glucose monitoring station

Assembles the equipment required and checks that the strips are in date and have not been
exposed to air.
Explains the procedure to the person. Gains consent.
Cleans own hands with alcohol hand rub, or washes with soap and water and dries with
paper towels, following WHO guidelines.
Dons a disposable plastic apron and non-sterile gloves.
Checks that the patient’s hands are visibly clean.
Takes a single-use lancet and takes a blood sample from the side of the finger, ensuring that
the site of the piercing is rotated. Avoids use of index finger and thumb.
Gives the patient a piece of gauze to stop the bleeding.
Ensures that all sharps and non-sharp waste are disposed of safely (including scooping
method of re-sheathing, if used, and transportation of sharps) and in accordance with locally
approved procedures.
Cleans hands with alcohol hand rub, or washes with soap and water and dries with paper
towels, following WHO guidelines – verbalisation accepted.
Verbalises whether the result is within normal limits and indicates whether any action is
required.
Documents the result accurately, clearly and legibly.
Acts professionally throughout the procedure in accordance with NMC (2018) ‘The Code:
Professional standards of practice and behaviour for nurses, midwives and nursing
associates’.

Page 27 of 40
Mock clinical skills

Marking criteria – Physiological observations station

Introduces self, explains procedure to the person, and gains consent.
Cleans hands with alcohol hand rub, or washes with soap and water and dries with paper
towels, following WHO guidelines.
Blood pressure:
• assesses whether the patient has any contraindications to using a particular arm, such as
lymphoedema, trauma or surgery, intravenous infusion
• provides a relaxed and comfortable environment
• ensures that the cuff is the correct size for the arm
• ensures that the patient’s arm is free from clothing and is supported on a pillow, placed
mid-sternal level, legs are uncrossed, feet are flat on the floor, artery marking centred
over the brachial artery and superior to the elbow
• places the lower edge of the cuff 2cm to 3cm above the brachial artery pulsation
• asks the patient to stop talking during the procedure
• inflates cuff on the Dinamap.
Pulse:
• places the first and second finger along the appropriate artery
• applies light pressure until pulse is felt
• counts pulse for 60 seconds
• assesses rhythm – verbalisation accepted
• assesses strength – verbalisation accepted.
Respirations and pulse oximetry:
• counts respiratory rate for 60 seconds
• assesses rhythm – verbalisation accepted
• assesses depth – verbalisation accepted
• observes for respiratory noises (rattle, wheeze, stridor, coughing)
• observes for unequal air entry
• observes for visual signs of respiratory distress (use of accessory respiratory muscles,
sweating, cyanosis, ‘see-saw’ breathing)
• determines the site to be used to perform the pulse oximetry (warmth and capillary refill)
• ensures that the area is clean and that all nail polish and artificial nails have been
removed.
Temperature:
• inspects the ear canal
• checks the thermometer for damage
• verifies mode setting (ear)
• places disposable probe covering on probe tip
• aligns the probe tip with the ear canal and gently advances into the ear canal, ensuring a
snug fit
Page 28 of 40
Mock clinical skills

• presses and releases the scan button.

Accurately measures and documents the patient’s vital signs, completes documentation –
signs, dates and adds time.
Calculates national early warning score accurately.
Disposes of equipment appropriately – verbalisation accepted.
Cleans hands with alcohol hand rub, or washes with soap and water and dries with paper
towels, following WHO guidelines – verbalisation accepted.
Acts professionally throughout the procedure in accordance with NMC (2018) ‘The Code:
Professional standards of practice and behaviour for nurses, midwives and nursing
associates’.

Page 29 of 40
Mock clinical skills
Blood glucose monitoring
Overview
Scenario

You are a registered nursing associate working on a medical ward.

Ally King was admitted 4 days ago with lower-limb cellulitis to the left leg. Ally has a
history of uncontrolled type 2 diabetes with episodes of hyperglycaemia, although it is
now stable. Ally requires pre-meal blood glucose monitoring.

Ally usually manages the diabetes and performs their own blood glucose monitoring at
home, but they are currently unable to do this.

All identification checks have been completed. Your patient has just washed their hands.

Please perform a capillary blood glucose test on your patient, adhering to infection-prevention
procedures throughout.

Please verbalise your choice of testing site and speak to your patient throughout. Please
document the result on the page provided and explain the result and any further action to the
patient.

All the equipment you need is provided and has already been calibrated.

You have 8 minutes to complete this station.

Assume that it is TODAY and that it is 12:00 hours.

Page 30 of 40
Mock clinical skills
Blood glucose monitoring
Candidate name:

Patient Pre-meal Post meal

details:

Date & Blood Name & Date & Blood Name &
time glucose signature time glucose signature
level level
mmol/L mmol/L

Ally King
1 Sweet Street
Westshire
WW6 5PQ

Date of birth:
01/01/1969

Hospital
number:
000654321

Allergies:
None

GP: Dr Biswaz

Page 31 of 40
Mock clinical skills
Physiological observations
Overview

Scenario

You are working in the breast clinic.

Sunita Lee has been admitted for a breast biopsy. As part of the admission process, you will
need to take and record the patient’s vital signs and calculate a national early warning score.

All identification checks have been completed.

Please take and record the patient’s vital signs (blood pressure, temperature, pulse rate,
oxygen saturations, respiratory rate) and calculate a national early warning score (NEWS).

Please speak to your patient throughout. Please document your results on the NEWS
observation form, calculate the score and complete the form in full.

All the equipment you need is provided and has already been cleaned and calibrated.

An observation chart has been provided.

You have 8 minutes to complete this station.

Assume that it is TODAY and that it is 07:45 hours.

Page 32 of 40
Mock clinical skills
Physiological observations
Chart 1: National early warning score (NEWS)

NEWS scoring system

National early warning score (NEWS2) ©Royal College of Physicians 2017

NEWS thresholds and triggers

NEW score Clinical risk Response

Aggregate score 0–4 Low Ward-based response

Red score Low– Urgent ward-based response*
Score of 3 in any individual
medium
parameter
Aggregate score 5–6 Medium Key threshold for urgent
response*
Aggregate score 7 or more High Urgent or emergency response**

* Response by a clinician or team with competence in the assessment and treatment of

acutely ill patients and in recognising when the escalation of care to a critical care
team is appropriate.
**The response team must also include staff with critical care skills, including
airway management.

Page 33 of 40
NEWS key FULL NAME:
0 1 2 3 DATE OF BIRTH: DATE OF ADMISSION
Mock silent stations
You will also be required to undertake two silent stations. In each OSCE, one station will
specifically assess professional issues associated with professional accountability and related
skills around communication (called the professional values and behaviours station, or the PV
station). One station will also specifically assess your critical appraisal of research and
evidence and associated decision-making (called the evidence-based practice station, or EBP
station).

The instructions and available resources are provided for each station, along with the specific
timing.

Station You will be given the following resources

Professional values and • Overview and documentation (pages 37–38)

behaviours
Drug misuse – 10 minutes
You will read the scenario and
summarise the actions that you would
take, considering the professional,
ethical and legal implications of this
situation.

Evidence-based practice • Overview and documentation (pages 39–40)

Cranberry juice and UTIs – 10

minutes
You will read the scenario and
summary of the research, then write
up how you would apply the findings
to the scenario.

On the following pages, we have outlined the expected standards of clinical performance and
criteria. These marking matrices are there to guide you on the level of knowledge, skills and
attitude we expect you to demonstrate at each station.

Page 35 of 40
Mock silent stations

Marking criteria for Professional values and behaviours – Drug misuse station
Recognises that taking NHS/hospital property for personal use or gain, including medication,
is prohibited.
Recognises the professional duty to report any concerns that may result in compromising the
safety of patients in their care or the public, and that failure to report concerns may bring their
own fitness to practise into question and place their own registration at risk.
Raises concern with manager at the earliest opportunity, verbally or in writing. Recognises
the need to be clear, honest and objective about the reasons for concern, reflecting duty of
candour.
Recognises that the manager may wish an incident report to be completed, recording the
events, steps taken to deal with the matter, including the date, and with whom the concern
was raised.
Takes into consideration their own responsibility for the safety of the colleague, and considers
the effects of codeine on their ability to work and drive home.
Considers that the colleague may need a medical review for their headache or may need
support in dealing with a substance misuse problem.
Acknowledges the need to keep to and uphold the standards and values set out in ‘The
Code’: prioritise people, practise effectively, preserve safety, and promote professionalism
and trust.
Handwriting is clear and legible.

Marking criteria for Evidence-based practice – Cranberry juice and UTIs station
Summarises the main findings of the article summary and draws conclusion, making
recommendations for practice.
Writes clearly and legibly.
Explains to Freda that there is some research that shows that cranberry juice may prevent a
urinary-tract infection (UTI) occurring if drunk regularly in healthy individuals.
Considers that cranberry juice may be less likely to induce nausea than other sugary drinks
when taken regularly.
Informs Freda that there is no available evidence that cranberry juice may prevent UTIs in
individuals who have high-risk conditions or those who have indwelling catheters as people in
these groups were not included in the study.
Explains to Freda that there is no available evidence to suggest that cranberry juice can be
used to treat a UTI in place of antibiotics.
Informs Freda that it is necessary to note that the research was funded by a leading cranberry
juice manufacturer, indicating a potential conflict of interest.

Page 36 of 40
Mock silent stations
Professional values and behaviours
Drug misuse
Overview

Scenario

You are just about to commence the lunchtime drug round. You enter the clinical room and
one of your nursing colleagues is in the room already.

You witness the nurse take a 30mg tablet of codeine phosphate from the drug cupboard.
She puts it in her mouth and swallows it in front of you. You ask whether she is okay, and
she tells you that she needs the tablet for a headache.

As far as you are aware, this is an isolated incident.

Using your knowledge of NMC (2018) ‘The Code: Professional standards of practice and
behaviour for nurses, midwives and nursing associates’, consider the professional, ethical and
legal implications of this situation.

Please summarise the actions that you would take in a number of bullet points.

This is a silent written station. Please write clearly and legibly.

You have 10 minutes to complete this station.

Page 37 of 40
Mock silent stations
Professional values and behaviours
Drug misuse
Candidate documentation
Candidate name:__________________________

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Page 38 of 40
Mock silent stations
Evidence-based practice
Cranberry juice and UTIs
Overview
Scenario

You are working on a urology ward, looking after Freda Garcia, who has developed a urinary tract
infection (UTI) following surgery 2 days ago. She has a temperature of 37.8°C and a heart rate of 92
beats per minute. She has been reviewed by the medical team, and a course of oral antibiotics has been
prescribed and commenced.
During your comfort round, Freda asks whether you would recommend drinking cranberry juice to help
with the UTI. Please prepare a response.

Article summary

A randomised, double-blind, placebo-controlled, multi-centre clinical trial in a well-regarded, peer-

reviewed journal compared the preventative effects of cranberry juice and antibiotics on UTIs.
• A total of 373 healthy women were recruited into the trial who had previously been diagnosed with
two or more UTIs within the past year.
• Participants were randomly assigned. The participant group (n = 185) was asked to consume one
serving (240 ml) of cranberry juice daily, and the placebo group (n = 188) was asked to consume
the same volume of a flavoured sugary drink daily over a period of 24 weeks. Any participant with
a current UTI or actively taking antibiotics was excluded from the study.
• UTI episodes were reported by 39 participants in the cranberry group and 67 in the placebo group.
• Women who developed a UTI during the study were still given an antibiotic.
• At 2 months, nausea was the only significant adverse effect commonly reported in the placebo
group compared with those in the participant group (5.9% of participants in the placebo group
versus 1.6% of participants in the cranberry group).
• Overall, the results estimated that cranberry juice would prevent one symptomatic UTI per three
women per year.
• The study excluded those who needed to take a preventative antibiotic, had an indwelling catheter
and/or had other high-risk conditions, such as diabetes, cancer, polycystic disease, interstitial
cystitis, previous urologic surgery, stones, anatomical abnormalities, spinal cord injury, were
immunocompromised, had severe renal impairment, multiple sclerosis or were pregnant.
• This large-scale study was funded by a leading cranberry juice manufacturer.

Please identify the main points from the summary and apply the findings to the scenario.

This is a silent written station. Please write clearly and legibly.

You have 10 minutes to complete this station.

Page 39 of 40
Mock silent stations
Evidence-based practice
Cranberry juice and UTIs
Candidate documentation
Candidate name:

What is the relevance of the findings of this article for Freda, and what advice would you give?
Give your responses here as bullet points:
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