Mock Osce Rn3 Toc 2021 v1.1
Mock Osce Rn3 Toc 2021 v1.1
Mock Osce Rn3 Toc 2021 v1.1
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 up to 20 minutes in total
(including reading time), with no break between each paired skill.
There are also two new 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).
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 APIE,
one pair of linked clinical skills, one PV and one EBP station.
The Nursing and Midwifery Council’s 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.
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 on the learning platform.
times.
The mock APIE below is made up of four stations: assessment, planning, implementation and
evaluation. Each station will last approximately 15 minutes and is scenario-based. The
instructions and available resources are provided for each station, along with the specific timing.
Scenario
Terry Thomas was referred by their GP to the primary care mental health team in the
community clinic earlier today, increasing panic attacks and not leaving their home. A mental
health nursing assessment has been carried out, and Terry has agreed to work with the
primary care mental health team to explore interventions to manage the panic disorder.
You will be asked to complete the following activities to provide high-quality, individualised nursing
care for the patient, providing an assessment of needs that is based on the recovery model of
care. All four of the stages in the nursing process will be continuous and will link with each other.
On the following pages, we have outlined the expected standard of clinical performance and
criteria. These marking matrices is there to guide you on the level of knowledge, skills and
attitude we expect you to demonstrate at each station.
Assessment criteria
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 World Health Organisation (WHO) guidelines.
Introduces self to person.
Checks identity (ID) with person or carer (person's name is essential and either their date of birth
or hospital number) verbally, against wristband (where appropriate) and documentation.
Gains consent and explains reason for the assessment.
Uses SOLER throughout the assessment:
• Sitting at a comfortable angle and distance
• Open posture, with arms and legs uncrossed
• Leaning forward from time to time, looking genuinely interested and listening attentively
• Effective eye contact without staring
• Remaining relatively relaxed.
Uses appropriate questioning skills (open questions).
Builds trust and rapport by demonstrating compassion, taking time, active listening, and taking
an interest.
Uses brief verbal and non-verbal affirmations.
Uses reflection/paraphrasing to demonstrate concern.
Conducts a holistic mental health assessment relevant to the patient's scenario, using the
recovery model of care areas, including patient self-care and non-adherence to prescribed
medications.
Identifies and discusses any current risk factors, if present.
Accurately completes any assessment tools included, and accurately calculates and records
score, where appropriate.
Discusses the assessment findings with the person and closes the assessment appropriately.
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’.
Planning criteria
Clearly and legibly handwrites answers.
Identifies two relevant nursing problems/needs.
Identifies aims for both problems.
Sets appropriate evaluation date for both problems.
Ensures nursing interventions are current/evidence based/best practice.
Uses professional terminology in care planning.
Does not use abbreviations or acronyms.
Ensures strike-through errors retain legibility.
Accurately prints, signs and dates.
Acts professionally throughout the procedure in accordance with NMC (2018) ‘The Code:
Professional standards of practice and behaviour for nurses, midwives and nursing associates’.
Implementation criteria
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, and 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 (check 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)
• any allergies.
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
Evaluation criteria
Situation
Introduces self and the clinical setting.
States the patient's name, hospital number and/or date of birth, and location.
States the reason for the handover (where relevant).
Background
States date of admission/visit/reason for initial admission/referral to specialist team and
diagnosis.
Notes previous medical history and relevant medication/social history.
Gives details of current events and details findings from assessment.
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.
Recommendation
States what is required of the person taking the handover and proposes a realistic plan of
action.
Overall
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’.
Candidate briefing
You are a mental health nurse, working in the primary care mental health team in the
community clinic. Terry Thomas has been referred to you by the GP because of regular panic
attacks.
Please conduct an holistic mental health assessment using the recovery model of care areas
below and including patient self-care and adherence to prescribed medications.
A patient health questionnaire (PHQ-9) has already been completed by Terry. You will need to
calculate the score and refer to the scoring outcome table for the result.
Please discuss the outcome of your assessment and the PHQ-9 with your patient.
Consider the current risks for the patient using the information from the GP referral and the
information gathered in your assessment.
You have 20 minutes to complete this station, including all the required documentation.
Presenting complaint:
• Repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a
peak within minutes (panic attacks).
History of presenting complaint:
• Terry has feelings of impending doom and also feelings of being out of control.
• Terry experiences shortness of breath, chest pain, and rapid, fluttering or pounding heart
(heart palpitations).
• These attacks are leading to worrying about them happening again and avoiding situations in
which they've occurred.
• Terry also fears what they might do when they are experiencing an episode.
• Terry has visited A&E on two occasions because of the fast heartrate. Electrocardiograms
showed no abnormalities.
• Terry has recently completed a 6-week course of low-intensity cognitive behaviour
therapy.
• Terry has reported that this has not helped with the current episodes of panic attacks.
Social history:
• Never married.
• No children.
• Lives alone, near mother and next of kin (Katy Thomas).
• No pets or dependants.
• Terry has been the headteacher of a secondary school for 5 years and used to enjoy this
job, although has been on sick leave for 8 weeks.
• Lives alone in a two-storey house with bedroom and bathroom upstairs.
• Non-smoker.
• Does not drink alcohol.
Drug history:
• Oxytetracycline 500mg two times a day.
• Sertraline 100mg once a day.
• Ferrous sulfate 200mg two times a day.
Patient details:
Name: Terry Thomas
Hospital No: 0004321
Address: 1 Sweet Street, Westshire, WW6 5PQ
Date of birth: 01/01/1984
Capacity/Consent
Relationships
Living situation
Patient self-care
Non-adherence to medication
Current risks
Date TODAY
Over the past 2 weeks, how often have you been Not at Several More Nearly
bothered by any of the following problems? all days than every
half the day
days
1. Little interest or pleasure in doing things
0 1 2 3
Column totals
Scenario
Terry Thomas was referred by their GP to the primary care mental health team in the
community clinic earlier today, for increasing panic attacks and not leaving their home. A
mental health nursing assessment has been carried out, and Terry has agreed to work with
the primary care mental health team to explore interventions to manage the panic disorder.
This is a silent written station. Please ensure that you write legibly and clearly.
You have 14 minutes to complete this station, including all the required documentation.
Aim(s) of care:
Re-evaluation date:
Aim(s) of care:
Re-evaluation date:
Nursing interventions
NAME (Print):
Nurse signature: Date:
Nursing problem/need
Aim(s) of care:
Re-evaluation date:
Nursing interventions
Scenario
Terry Thomas was referred by their GP to the primary care mental health team in the
community clinic earlier today for increasing panic attacks and not leaving their home. A
mental health nursing assessment has been carried out and Terry has agreed to work with
the primary care mental health team to explore interventions to manage increasing panic
attacks and not leaving their home. Terry has been prescribed additional medication to
help with their panic attacks, the GP asks you to administer the first dose while in the
community clinic and adds this to the community prescription chart.
Please administer and document Terry’s 10:00 medications in a safe and professional
manner.
You have 15 minutes to complete this station, including all the required documentation.
Write in BLOCK CAPITALS using black or blue If a dose is omitted for any reason, the nurse should enter
ink. the relevant code on the administration record and sign and
Sign and date and include bleep number. date the entry.
Record detail(s) of any allergies. 1. Medicine unavailable – 2.Patient not present at time of
INFORM DOCTOR OR administration
PHARMACIST
Sign and date allergies box. Tick box if no allergies 3.Self-administration 4.Unable to administer – INFORM
know. 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 prescription 7.Patient refused 8. Nil by mouth (on doctor’s
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
• At this station, you should have access to your assessment notes (but not the
assessment overview), and the planning and implementation documentation. If not,
please alert the examiner.
Scenario
Terry Thomas was referred by their GP to the primary care mental health team in the
community clinic earlier today, for increasing panic attacks and not leaving their home.
A mental health nursing assessment has been carried out, and Terry has agreed to work
with the primary care mental health team to explore interventions to manage their
increased anxiety and low mood. Terry has been prescribed additional medication to
help with the increased anxiety.
Using the situation, background, assessment and recommendation (SBAR) tool, please
make notes regarding your patient and use them to hand information over verbally to the
community nurse who will take over Terry’s care after discharge (the examiner).
This is a verbally assessed station. You will have the opportunity to make notes to
support your answer.
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.
Situation:
Background:
Assessment:
Recommendation:
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.
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.
Overview
Female urinary catheter insertion
Scenario
You are not required to document anything during this skills station.
Overview
Stoma bag change
Scenario
Please change the patient’s stoma bag and speak to your patient throughout the
procedure.
You are not required to document anything during this skill station, but if necessary,
verbalise to the examiner what would be documented or reported.
You will also be required to undertake two new 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.
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.
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 30 milligram codeine phosphate tablet from the
drug cupboard. She puts it in her mouth and swallows it in front of you.
You ask if she is okay, and she tells you that she needs the tablet for a
headache.
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 you would take in a number of bullet points.
Candidate documentation
Candidate name:__________________________
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Overview
Read the scenario and the summary of the research below.
Please identify the main points from the summary and apply the findings to the scenario
below.
This is a silent written station. Please write clearly and legibly.
You have 10 minutes to complete this task.
Scenario
You have been working on an Intensive Care Unit (ICU) for the past 6 months. Most of
your patients are given medication to induce a coma while they receive care and
treatment. As patients improve and are weaned off the sedation, you notice that it is
common for patients to report that they have not slept for the whole time they have
been on the unit. The patient you are looking after today, Mrs Green, reports this same
lack of sleep. She asks if is this common and, if so, why it might be.
Article summary
A systematic review in a well-regarded peer-reviewed journal investigated the sleep
disturbances in patients in intensive care units. The review found that:
• Study A, a large-scale study, showed that 60% of patients discharged from ICU
reported sleep disorders and deprivations.
• Study B, a smaller study, found similar results, with 51% of patients experiencing
dreams and nightmares, and 14% reporting nightmares negatively impacting their
quality of life 6 months after discharge from ICU. The study recommended that
patients return for a follow-up support appointment 2 to 3 months after leaving
ICU.
• Study C, a quantitative study, concluded that the inability to obtain physiological
sleep depends on the patient’s illness, previous sleep experience and the varying
severity of their illness.
• Patients in Study C reported a number of sleep-disturbing factors impacting their
sleep, including: noise, light, pain, anxiety, nursing interventions, diagnostic tests,
medications and non-invasive ventilation.
The review concluded that sleep disorders in ICU were common and that there were
multiple influencing factors causing sleep deprivation.
Candidate documentation
Candidate name:
What is the relevance of the findings of this research for Mrs Green, and what advice
would you give her?
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