Nursing and Midwifery Test of Competence

Nursing and Midwifery Tests

The information on this page is for Adult Nursing, Child Nursing, Learning Disability Nursing, Mental Health Nursing, and Midwifery.

The Test of Competence is made up of 10 stations, with a total testing time of about 3 hours.

Four of the stations are scenario-based and relate to four stages of the care process:

• A – Patient / Client-centred assessment
• P – Planning care
• I – Implementation
• E – Evaluation

Four of the stations are skills stations, testing practical clinical skills, and last up to 25 minutes in total.

The remaining two stations are silent stations:

• Professional Values – This station will specifically assess the professional issues associated with professional accountability and related skills around communication.
• Evidence-based Practice – This station will specifically assess critical appraisal of research and evidence and associated decision-making.

At each station you will be provided with the case scenario and any equipment you may need. The stations could be based around an actor, a simulation manikin or a written set of guidelines. The stations will be timed, overseen by a qualified assessor of practice and recorded on video.

Below you will find out more information on each nursing and midwifery station, as well as other useful resources in relation to this OSCE.

Assessment

Your verbal communication and non-verbal communication, and the ability to establish a rapport with your patient / client based on the 6 Cs of nursing / midwifery will be assessed during the assessment station. The 6 Cs are:

• care
• compassion
• competence
• communication
• courage
• commitment

Within this station, you will have time to read any forms provided. This can provide you with a structure and a systematic approach, so use this to help you. Before completing the assessment station, you may need to take observations of the patient / client and record them on an observation chart such as the national early warning score, NEWS, PEWS, or MEOWS, or the Glasgow coma score. It is important to complete and record all observations, if necessary, before the time has run out in order to pass.

You will then need to consider activities of daily living within this station, as this information will help you with the ongoing stations. You will be asked to carry out a holistic assessment, including an airways, breathing, circulation, disability and exposure (A–E) assessment. You will be able to document any notes during your patient / client’s assessment. These notes will not be assessed or marked but will be for your future reference at the writing stations.

Planning Care

This is a silent written station, and you will be monitored by the invigilator or assessor. You must write one (Midwifery) or two (Nursing) relevant aspects of care related to the scenario from the assessment station, which should include associated/relevant self-care. You will be required to complete this form in a black pen, which will be provided.

Implementing Care

In this station, you will be implementing care, such as administering oral drugs. In the bay, your patient may either be represented by an actor or a manikin, and either the actor or assessor will respond to you from a script as though they are the patient. Please remember that your verbal and non-verbal communication will be assessed in this station. Communicate with the actor or manikin, NOT the assessor, as you would with a real patient.

Evaluating Care

This station is a verbal one and you will be monitored by the assessor. In this station, you will write notes about a transfer/discharge or other form of evaluation, such as a situation, background, assessment, recommendation (SBAR), and you will then be required to provide a verbal handover to the assessor. You will have access to all your previous written notes to help you in this station.

In this station, you should avoid using unfamiliar abbreviations that are not universally recognised.

You will be assessed only on the verbal handover (not on your notes).

Professional Values and Evidence-Based Practice

You will have one Professional Values station and one Evidence-Based Practice (EBP) station. These are generic issues that are relevant to all fields of nursing. Please check the relevant section whether you are nursing or midwifery.

Nursing only

Typical areas that you could be tested on include, but are not limited to:

Professional Values

• Bullying
• Concealment of Bed Status
• Confidentiality
• Drug Error
• False Representation
• Falsifying Observations
• Falsifying Timesheets
• Hospital Food
• Impaired Performance
• Laboratory Results
• Professional Confrontation
• Racism
• Signs of Possible Abuse
• Social Media
• Witnessed Abuse

Evidence-Based Practice

• Ankle Sprain
• Autism Spectrum Disorder
• Bedside Handover
• Cervical Screening
• Cessation of Smoking
• Dementia & Music
• Diabetes
• Female Myocardial Infarction (MI)
• Fever Management in Children
• Prevention of Pressure Ulcers
• Restraint
• Saline vs Tap Water
• Venous Leg Ulcers

Midwifery only

Typical areas that you could be tested on include, but are not limited to:

Professional Values

• Bereavement Care
• Safeguarding Women and Children

Evidence-Based Practice

• Place of Birth
• Induction of Labour at Term