Objective Structured Clinical Examination (OSCE) in Nursing

1. Objective Structured Clinical
Examination (OSCE) in Nursing

2. Objectives
• Be psychologically prepared;
• Be familiar with how equipment works;
• Know which procedures/guidelines are to be used in the OSCE;
• Be familiar with checklist/marking criteria;
• Rehearse skills;
• Know the timing of the OSCE;
• Develop skills on clinical placement;
• Revise the underpinning theory of skills;
• Use feedback from mock/formative OSCEs;
• Use available resources such as guided study, quizzes and videos;
• Check whether they should wear uniforms;
• Confirm the date, time, venue and allow enough time to get there;
• Practice answering questions verbally.

3. Definition
• In OSCE a multi-station, clinical skills
assessment method that is based on
objective testing and direct observation of
student performance. Standardized content
and scoring procedures are used.

4. Purposes
• It is designed to test clinical skill performance and competence
in a range of skills.
• It is a practical, real-world approach to learning and assessment.
• It assesses competency, based on objective testing through
direct observation.
• It is comprised of several "stations" in which examinees are
expected to perform a variety of clinical tasks within a specified
time period against criteria formulated to the clinical skill.
• It has been used to evaluate those areas most critical to
performance of health care professionals
– ability to obtain/interpret data
– ability of problem-solving
– ability to teach, communicate, and handle unpredictable patient
behavior

5. Arrangement of Stations:
• A minimum of five stations are to be prepared
based on the competencies expected as per
objectives for each course. It should include
– Cognitive Station-1
– Procedural Station -2
– Interpretive Station-1
– Communication Skill Station -1
– Viva
• Total duration of all stations including viva
should not exceed 2 hours for UG programme

6. Cognitive skill station:
• A case scenario can be given and students
are asked to prepare a nursing care plan.
• Care plan may be restricted to three priority
nursing diagnoses and its interventions
based on the scenario
– 5 minutes for reading the scenario
– 25 minutes for writing a care plan

7. STATION – 1:- COGNITIVE SKILL
STATION - EXAMPLE
Instructions to the students
• Read the below given scenario and answer the questions.
• Time minutes for reading the scenario and 25 minutes for writing a care
plan
• Maximum marks : 10
Scenario
• Mr. X 70 year Old man admitted in the medical ward with complaints of
loss of consciousness. History revealed that he is a known CVA patient, and
was on treatment for last one year. On examination the patient is
unconscious. Nasogastric tube inserted for feeding. Indwelling urinary
catheter was inserted for incontinence of urine. Temperature - 98.60 F,
pulse 86/minutes, BP 160/100 mm of Hg. Lung auscultation shows air
entry equal on both sides, crepitus present bilaterally.
Question
1. Based on this scenario identify and list down six priority nursing
diagnoses.
2. Prepare a nursing care plan (Three priority nursing diagnoses) for the
patient.

8. Procedural Skill station:
• Procedures based on
competencies expected in the
course.
• All articles for procedures are
to be arranged in advance as
per the list of procedures
being identified for the lot
– 15 minutes for performing
procedure and recording

9. STATION: 2 - PROCEDURAL SKILL
STATION 1 - EXAMPLE
Instructions to the students:-
• Read the scenario and respond appropriately
• You will be given 15 minutes to exhibit your skill
• You may use the available resources
• Maximum mark: 10
Scenario
• Mr. X70 year Old man admitted in the medical ward with complaints of loss
of consciousness. History revealed that he is a known CVA patient, and was
on treatment for last one year. On examination the patient is unconscious.
Nasogastric tube inserted for feeding. Indwelling urinary catheter was
inserted for incontinence of urine. Temperature- 98.60 F, pulse 86/minutes,
BP 160/100 mm of Hg. Lung auscultation shows air entry equal on both
sides, crepitus present bilaterally. Bed bath is given a few minutes before.
Question
1. You are assigned to check the Blood Pressure of Mr.X.

10. STATION: 2 - PROCEDURAL SKILL
STATION – 2 - EXAMPLE
Instructions to the students:
• Read the scenario and respond appropriately
• You will be given 15 minutes to exhibit your skill
• You may use the available resources
• Maximum mark 10
Scenario
• Roy 57 yr old admitted in the medical ward with complaints of
fever, body pain, generalized weakness. He is a known case of
diabetics and is on treatment with insulin injection for the last
2 years. On examination the patient is conscious. oriented.
Blood was withdrawn and sent for investigations. Now Vitals
are temperature 1000F, pulse -90/mt, BP -130/ 80 mm of hg.
The doctor prescribed Tab. Paracetamol 500mg TDS.
Question
1. You are assigned to check the vital signs of Mr X.

11. Interpretive Skill Station:
• The student has to write an
interpretative note as per
scenario given in the station
– 1 minute for reading questions
– 4 minutes for writing the
responses

12. STATION – 3: INTERPRETIVE SKILL
STATION – EXAMPLE
Instructions to the students:
• Identify the instruments exhibited and respond to
the questions given below.
• You will be given 15 minutes.
• Maximum mark: 10
Senario
(Exhibiting the following ARTICLES)
• A, B , C, D, E
Questions
• Identify and write the name of the instrument.
• Write one use of each Article.

13. Communication Skill Station:
• Health education and
Counselling on topics
relevant as per the Case
scenario given.
– 10 minutes for preparing the
plan for Health Education
including AV Aids
– 5 minutes for Health
education / Health
Counselling.

14. STATION –4 – COMMUNICATION
SKILL STATION - EXAMPLE
Instructions to the students:
• A case scenario is given. Prepare for health education relevant to the
scenario
• Time: 10 minutes for preparing the plan for Health Education including AV
Aids and 5 minutes exclusively for presentation of the planned health
education / Health counselling
• Maximum mark: 10.
SCENARIO:
• Mr. X70 year Old man admitted in the medical ward with complaints of loss
of consciousness. History revealed that he is a known CVA patient, and was
on treatment for last one year. On examination the patient is unconscious.
Nasogastric tube inserted for feeding. Indwelling urinary catheter was
inserted for incontinence of urine. Temperature- 98.60 F, pulse 86/minutes,
BP 160/100 mm of Hg. Lung auscultation shows air entry equal on both
sides, crepitus present bilaterally. Bed bath is given a few minutes before.
QUESTION
1. Now you educate the family members about prevention of pressure sore.

15. Viva
• Viva can be done at the
end of the circuit.
• Student has to respond
to one set of quiz
questions / one face to
face viva

16. VIVA STATION
QUIZ QUESTIONS - EXAMPLE
Total = 10 marks (5x1=5 marks)
1. Nurse obtained a client’s pulse and found the rate to be above normal. The nurse
document this finding as -------------------------
2. A client who is unconscious needs frequent mouth care. When performing a
mouth care, the best position of a client is--------------------------
3. The Urine output less than 100ml is called ------------------------
4. Which area considered being the accurate one to take the client’s temperature?
5. When recording blood pressure, the sounds which can be heard with a
stethoscope placed over the artery is termed as-------------------------------
Give Reasons: (5x1=5 marks)
6. What are the preparation of choice for a patient who has been admitted in
Emergency department with an open contaminated injury and no recent history
of tetanus immunization. Why?
7. What type of water is using for tepid sponge and what is the reason behind it?
8. What is cleansing enema and its indication?
9. Which is the ideal comfort device given to a patient with respiratory difficulty and
give the reason behind it?
10. Convert 40 degree Celsius to Fahrenheit temperature.

17. Give Reasons: (5x1=5
marks)
6. What are the preparation of choice for a patient who
has been admitted in Emergency department with an
open contaminated injury and no recent history of
tetanus immunization. Why?
7. What type of water is using for tepid sponge and what
is the reason behind it?
8. What is cleansing enema and its indication?
9. Which is the ideal comfort device given to a patient
with respiratory difficulty and give the reason behind
it?
10. Convert 40 degree Celsius to Fahrenheit temperature.

18. SCORE SHEET – OSCE
Sl. No. Criteria
Max.
marks
Marks out of 50 Total
Marks
out of
100
Internal
examiner
External
examiner
1
Cognitive / writing
skills: Nursing care
plan
10
2 Procedural skill 20
3 Interpretive skill 5
4
Communicative
skill
5
5 Viva 10
Total 50

19. Conclusion
Sl
no
Skill stations
Time
duration
Internal
marks
External
Marks
Needed
Materials
Work effect
1 Orientation - - -
Answer
booklets
-Provide declaration form to the
students and get it signed
-Orientation other than training
should be provided
-provide the answer booklets
-Separate class room need to be
arranged
2
Cognitive
skill station
-1
5’+25’
=30’
10 10
Prepared
scenario
-Provide prepared scenario by
maintaining the social distancing.
3
Procedural
skill station
2
15’+15
’
=30’
20 20
Station with
single
separate
procedure
for internal
and external
examiner
-Station should be prepared with
separate area for internal and
external Examiner
-check list should be prepared for
both procedure for number of
students

20. Sl
no
Skill stations
Time
duration
Internal
marks
External
Marks
Needed
Materials
Work effect
4
Interpretive
skill
1’+ 4’=5 5 5
File should
be ready
-Questions for
interpretations include
reasoning (5 nos)
5
Communica
tive skill
10’+5=
15
5 5
Scenario
based
Health
education
10 Minutes
preparation in the
zero station
5 minutes health
counseling /Education
6 Viva - skill 10‘ 10 10
Quiz
questions
should be
provided
Questions should be
filed and kept
1 hr
45”
50 50

21. References
• Godson, N. (2012). Nursing and health survival
guide : objective structured clinical examination.
Pearson Education.
• Mubashar Hussain Sherazi, & Dixon, E.
(2019). The objective structured clinical
examination review. Springer.
• Amar Agarwal, Prakash, D. P., & Athiya Agarwal.
(2009). Objectively structured clinical
examination (OSCE) in ophthalmology. Jaypee
Brothers.

22. THANK YOU