The Objective Structured Clinical Examination (OSCE) is designed to test your ability to apply mental health nursing knowledge safely and effectively in real-life scenarios.
During the exam, you will rotate through a series of stations that simulate psychiatric clinical situations. You will be observed and assessed on your clinical skills, knowledge, communication, risk management, decision-making, and professional behaviour.
The NMC OSCE focusses on certain areas of mental health, including assessing clinical knowledge, communication, and professional values skills. The exam has 10 stations:
- 4 APIE (Assessment, Planning, Implementation, Evaluation)
- 4 skills stations
- 2 written stations (values & behaviours, evidence-based practice).
What We Cover at Training
We teach what is covered in the exams and how it is presented to you. We give you guidance through teaching, demonstrations and testing your knowledge in a series of prepared stations, that mirror the real exam. We go over exactly what the examiners are looking for.
Common Station Types
While the OSCE format may vary across exam centres, mental health OSCEs include 10 main stations:
We teach you how to build your knowledge, work on existing communication skills and perfect them.
- Prepare for scenarios such as bipolar disorder, suicidal ideation in APIE and panic disorder, depression and psychosis in other areas.
- Practice APIE and skills stations until you can demonstrate effectively and meet the standards required by the NMC.
- Look at a situation from a holistic perspective and draw on resources the patient already has available to them.
Practice core mental health skills
- Risk assessment: PHQ9, Suicide, self-harm, aggression.
- Medication safety: Including mood stabilizers, antipsychotics, antidepressants.
- De-escalation: Managing agitation or distress.
- Physical health monitoring: OBS, MUST assessment, medication side effects.
Mock OSCEs & timed practice
- Rehearse under exam conditions.
- Review performance against marking criteria.
Manage exam-day strategies
- Introduce, consent, identity check.
- Verbalise everything.
- Maintain dignity, respect, and professionalism.
Communication Skills in Mental Health Nursing
- Verbal: Open questions, empathy, reflecting, clarifying.
- Non-verbal: Calm tone, appropriate eye contact, open body posture.
- Professional: Boundaries, cultural sensitivity, therapeutic focus.
- Recovery-oriented: Highlight strengths, coping strategies, and hope.
These are common practical/skills stations in the mental health OSCE.
Talking Therapies
In OSCE stations, you are not expected to deliver full therapy sessions, but you must demonstrate awareness of different therapies, explain them clearly to a patient, and use therapeutic communication skills.
Cognitive Behavioural Therapy (CBT)
- Focuses on the relationship between thoughts, feelings, and behaviours.
- Helps patients challenge negative thinking and develop healthier coping strategies.
Mindfulness-Based Therapy
- Teaches patients to stay present, accept thoughts without judgment, and reduce rumination.
- Often used in depression, anxiety, and relapse prevention.
Interpersonal Therapy (IPT)
- Focuses on how relationships and social roles affect mood.
- Common in depression and grief-related difficulties.
Psychodynamic Therapy
- Explores unconscious thoughts, past experiences, and how they influence current behaviours.
Supportive Counselling
- Uses active listening, empathy, validation, and reassurance.
- Suitable across all mental health settings.
Reminiscence Therapy
- Encourages patients (often older adults or those with dementia) to recall positive life events using photos, music, or familiar objects, using the senses.
- Benefits: boosts self-esteem, reduces anxiety, enhances orientation.
De-escalation
- Calm, non-threatening body language.
- Open posture, safe distance, avoid sudden movements.
- Clear, slow communication and empathy.
- Offer simple choices to return control.
Nutritional Assessment
- Use MUST tool: BMI, weight loss, intake, illness effect.
- Ask about appetite, eating patterns, medication side effects (e.g. antipsychotics → weight gain).
- Refer to dietitian or GP as needed.
Physiological Observations
- Measure and record temperature, pulse, respiration rate, BP, O2 saturation.
- State normal ranges and interpret deviations.
- Link to mental health
Intramuscular (IM) Injection
- Used for depot antipsychotics or rapid tranquillisation.
- Follow the 7 rights of medication administration.
- Use ANTT, correct site selection, and safe disposal of sharps.
- Monitor patient post-injection for adverse effects.
Evidence-Based Practice in the NMC OSCE
What it is
- A written station lasting around 10 minutes.
- You will be given a short clinical scenario
- The task: demonstrate knowledge of current guidelines, research, and best practice when caring for that patient.
We teach how to meet the criteria through;
1. Use of evidence
- Reference UK national guidelines such as NICE (National Institute for Health and Care Excellence) or RCN (Royal College of Nursing) standards.
- Show awareness of policies like Mental Health Act, Mental Capacity Act, safeguarding, and NHS frameworks.
2. Safe, person-centred care
- Care must be evidence-based, recovery-oriented, and respect dignity, safety, and cultural needs.
3. Clear structure
- Introduce the condition/scenario.
- Summarise relevant evidence or guidance.
- Apply it directly to the scenario (how it guides assessment, planning, intervention, and evaluation).
- Conclude with patient outcomes and MDT involvement.
- A written station (about 10 minutes).
- You’re given a short scenario (e.g. a safeguarding concern, a medication error, a confidentiality breach).
- You must write a response showing how you would apply professional standards.
Your answer should reflect:
1. The NMC Code (2018) — its 4 themes:
- Prioritise people
- Practise effectively
- Preserve safety
- Promote professionalism and trust
2. Ethical principles
- Autonomy (respecting choices, consent)
- Beneficence (doing good)
- Non-maleficence (avoiding harm)
- Justice (fairness, equality, non-discrimination)
3. Key professional behaviours
- Honesty and integrity
- Accountability (take responsibility for actions, escalate errors)
- Confidentiality (except when safety is at risk)
- Compassion and respect
- Collaboration with colleagues
