We publish our Test of Competence pass rates four times per year. If you want to know more about the Test of Competence, click here.

Understanding the OSCE and the factors that influence pass rates

Part two of the Test of Competence is a practical exam called the OSCE. This test has undergone significant changes in recent years to reflect our updated Standards of proficiency for registered nurses. The previous OSCE only had six stations, but we have increased this to ten stations to ensure the OSCE is reflective of clinical practice and gives us the confidence that internationally educated professionals have the right skills to provide safe, kind, and effective nursing.  

It is important for us to understand OSCE pass rates and the factors that affect the success of applicants. This is because we want to ensure that applicants have the best chance of passing the OSCE, while also making sure that professionals joining the register have the necessary skills, knowledge, and expertise to provide good care for the public.

We have been working with our five OSCE test centres, test development partner, and employers who support applicants through the OSCE process, to learn more about what makes an applicant successful, and what factors may have a negative impact on passing the OSCE.

Successfully passing the OSCE

Successful applicants are those that are prepared to meet our Standards of proficiency. We have also found that two of the most important factors are test preparation and having access to good quality support.

We recommend that staff and practice educators involved in applicant preparation attend a ‘Preparing candidates for Practice in the UK’ session (formerly Train the Trainer). This is offered by all OSCE test centres. By engaging with this course, colleagues ensure they can support their applicants and give them the best opportunity to pass first time. In addition, all test centres and the NMC website have support materials available, including OSCE mock exams, marking criteria and top tips.

Factors which affect OSCE pass rates

Support from employers: Most applicants are supported by an employer or recruitment agency to go through the OSCE. However, the level of support and quality of test preparation can vary greatly. This means some applicants are at a disadvantage as they have not had the time to prepare and develop their clinical skills to pass the OSCE.

Sector: We often see applicants from social care and the independent sector have lower pass rates. This is because they receive less support to practise the range of clinical skills covered in our Standards and the OSCE, compared to applicants who are supported by an NHS Trust or Health Board.

Pastoral care: Pastoral care is important for applicants as they prepare to take the OSCE, as well as on the day of the test itself. The five OSCE test centres have worked together to maximise the level of pastoral support for each candidate and ensure that the test centre environment is conducive to a positive outcome.

However, we continue to see candidates that are very anxious which increases the likelihood of errors and in turn, increases OSCE failures. Applicants need support and time to prepare for the test, and we recommend that pastoral care is an integral part of the preparation process for any OSCE applicant.

Equally important for applicants who are new to the UK is the amount of time they have to adjust and acclimatise to their new home ahead of the examination. The impact of pastoral care given to applicants whilst adjusting, during the preparation period, and on the day of the OSCE, should not be underestimated. This period can often be emotional and stressful due to the high levels of pressure and responsibility that many applicants face.

Test consistency

From February 2022 we have increased the number of test sites where candidates can access the OSCE assessment. All five of our test centres are committed to ensuring there is consistency in marking and moderation. This involves regular communication between test centres and the NMC to explore pass rates, station performance and moderation to ensure parity of results. This includes cross site moderation.

The NMC also undertakes quality assurance checks across all centres to help maintain test consistency.

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