Objective Structured Clinical Exam: A successful approach to pre-registration mental health nurse assessment

Aug 31, 2026

Objective Structured Clinical Exam (OSCE) methodology is presented as a summative assessment for second-year undergraduate mental health nursing students on a new three-year programme aligned with Nursing and Midwifery Council (NMC) standards. The discussion explains the validation rationale for assessing communication, nursing practice, decision-making, leadership, and teamwork, while addressing validity and reliability concerns in a logistically demanding, multi-station format. It further examines OSCE design choices for mental health nursing, including constraints affecting assessment of interpersonal skills and the need to reduce student anxiety through careful planning.

LanguageEnglish

CategoryPresentations

FormatDOCX

Pages9

Reading Time3 min

AccessFree to download

Introduction

Nursing and Midwifery Council standards

Programme validation and assessment decision

The OSCE as an assessment tool

Development and evidence base

Mental Health Nursing Practice Three OSCE

Requirements for decision making and practice

Objective Structured Clinical Exam: A successful approach to pre-registration mental health nurse assessment Pre-registration mental health nursing courses are a mixture of clinical practice and university based education completed over 3 years, culminating in a successful student entering the professional nursing register. During a student’s time at university they will encounter many different types of assessment, whether formative or summative. These are typically academic written assignments, academic exams, presentations, viva, assessed clinical practice by an approved mentor, and objective structured clinical exam. An OSCE to assess second year mental health nursing students was determined to be a highly appropriate method of allowing students to demonstrate the skills associated with the nursing process, NMC standards and learning outcomes for the module. It was recognised that preparation was essential in supporting the reduction of the student’s anxieties over the process, careful design and planning was needed to ensure reliability and validity of a logistically challenging assessment method. Keywords: OSCE; Mental Health Nursing; Assessment; Undergraduate; Students Introduction The Nursing Midwifery Council sets the standards for pre-registration mental health nurses and the competencies that are required for registration (NMC, 2010). In 2010 standards were set by the NMC; across the domains of communication, interpersonal skills, nursing practice, decision making and leadership, management and team working. It is important to note that following the Shape of Caring Review (Willis, 2015) these standards and domains may well be replaced following further review. However, public and patient involvement has been prominent within the Shape of Caring Review and as such the OSCE process discussed here is not only currently relevant as will be demonstrated but will maintain its currency for future standards. During validation of an entirely new degree programme developed to meet the NMC standards set in 2010, the question arose as to how, as a higher education institute, we are to suitably assess these areas of learning for undergraduate mental health students and ensure they are meet the standards of clinical competence. The decision taken by the programme team for the summative assessment for the module ‘Mental Health Nursing Practice Three (MHNP3)’ was to utilise an Objective Structured Clinical Exam (OSCE). This paper will explore the underpinning design rationale and the subjective experience of staff and students regarding the MHNP3 OSCE. The OSCE was undertaken by students during their second year of undergraduate training on the new 3 year degree programme. This particular cohort were the first to participate in the new programme, and engage with new modules and assessment strategies The OSCE as an assessment tool OSCE have been used to assess students working in health care settings since their introduction by Harden et al. in the 1970s (1975). Traditionally the process is to rotate students across 15 to 20 different stations, assessing a variety of skills. Each station lasts between 3-10 minutes (Alinier, 2003). Over the past decade, the use of OSCEs within nursing has become a staple part of the process for assessing students (Rushforth, 2007). Along with this has been the strengthening of the evidence base for their use, now regarded as having high validity and reliability (Schuwirth and van der Vleuton, 2003; Bartfay et al., 2004). OSCE have become a major contributor towards the assessment of student nurses and are regarded by some as the gold standard for assessment, allowing the student to demonstrate the knowledge and understanding underpinning the activity as well as the clinical application (Bartfay et al., 2004). Mental Health Nursing Practice Three OSCE From the OSCE’s inception as an assessment for medical students, criticism has been levelled at its process due to perceived limitations. Nicol and Fre

FAQs

Why is OSCE considered appropriate for pre-registration mental health nursing students?

OSCE allows students to demonstrate skills linked to the nursing process, NMC standards, and module learning outcomes through structured, observable performance in multiple stations.

What challenges does the OSCE format create for assessing mental health nursing competencies?

Short time limits and the task-based structure can make communication and interpersonal skills harder to demonstrate, and there is limited literature specifically addressing OSCE in mental health nursing.

How was the MHNP3 OSCE designed to meet NMC expectations?

NMC requirements for mental health nursing practice and decision-making were used as a framework to guide the OSCE design, aligning assessment content with expected competencies.

Aug 31, 2026

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