Clinical Skills updates in the NMC OSCE September 2024

By MNL’s Lead OSCE Trainer Helen Romnes

Great news for nurses taking the NMC OSCE – two skills have been removed from the Adult Criteria, effective from the end of September.

In-hospital Resuscitation and Nasopharyngeal Suctioning will no longer be tested at any of the test of competence centres, running OSCEs in the UK.

This will certainly take some pressure off the nurses, who often struggled with these skills. They felt they were particularly challenging, as they are skills that many hardly have any real-life experience of.

My Nurse’s Life fully support this move by the NMC, as we believe that nurses joining the register should not be examined on In-Hospital Resuscitation (IHR) in the OSCE.

In fact, cardiopulmonary resuscitation is tested in all healthcare workplaces on a yearly basis, and therefore was unnecessarily included in the exam. Nurses do indeed need to be competent in resuscitation, in all medical workplaces. However, when working as a nurse in the UK, training and assessment will happen as part of their annual mandatory training.

The truth is many nurses found this skill very stressful and dreaded getting it in test. It had higher fail rates than many of the other skills, as it seems as if every step was counted as critical by the examiners. Achieving the right depth and rhythm (5-6cm depth of the chest and 100-120 beats a minute), is something that may take some candidates some time to achieve in training. A day or half a day training at their workplace provides the perfect environment for this.

Further, we found the leading body The UK Resuscitation Council videos further confuse the matter, as they do not appear to be performing a 30:2 ratio of compressions to rescue breaths, on their informational video. They give continuous breaths, and this adds further to the confusion, as candidates may use this resource in further study.

We believe all these factors placed unfair pressure on the candidate during the test. Each skill station in the test is weighted, but it seems that the participants needed to show a much greater level of competence in this skill than the others.

We also believe that the removal of nasopharyngeal suctioning skill station from the adult OSCE, was a wise decision by the NMC. The reality is that most nurses never use this skill in their clinical practice – except for emergency, critical care and complex care nurses. It is in fact a skill generally reserved for children’s nurses, who often use it on babies who are struggling to breath. It has in fact remained in the paediatric OSCE criteria where it belongs.

Another positive move by the NMC, is to remove suppository insertion from the mental health criteria. This skill again, is a skill rarely used by them. They have now reintroduced Intramuscular Injection skill for the mental health OSCE. This makes a lot of sense, as this is a procedure regularly carried out by the mental health nurses.

So many nurses will be relieved by these decisions of the NMC and are happy to be able to concentrate on the more relevant skills left. We at MNL applaud these decisions.