What is APIE in OSCE exam?

In nursing, APIE stands for Assessment, Planning, Implementation, and Evaluation. It is the core clinical framework used in the Nursing and Midwifery Council OSCE for internationally educated nurses applying to register in the UK.

The APIE stations follow one continuous patient journey, meaning you will care for the same patient case across all four stations. Each stage builds on the one before it, so the information you gather in Assessment will support your Planning, Implementation, and Evaluation.

You will complete four separate stations:

• Assessment – 20 minutes
• Planning – 14 minutes
• Implementation – 15 minutes
• Evaluation – 8 minutes

Throughout APIE, you are assessed on your ability to deliver safe, patient-centred nursing care, communicate clearly, recognise concerns, prioritise care, and complete accurate documentation in line with UK nursing practice.

For the Nursing and Midwifery Council Adult OSCE, the current APIE timings are:

• Assessment – 20 minutes
• Planning – 14 minutes
• Implementation – 15 minutes
• Evaluation – 8 minutes

You will be given one patient to deal with throughout with a certain set of problems, patients you may encounter in the APIE station can include:

Alzheimer’s Disease, Chronic Heart Failure, Community Assessment (Diabetes), Ectopic Pregnancy, End of Life Care, Suspected Deep Venous Thrombosis, Hernia (Abdominal), Homelessness, Pneumonia, and Subdural Haematoma.

You will use different coloured pens in each station, as all the paperwork is returned for each station, this stops people changing the documentation in other stations.

1. Assessment – 20 minutes

This station focuses on assessing your patient, gathering information, identifying concerns, and documenting your findings safely and accurately.

Within the 20 minutes you are expected to:

• Read the scenario and patient information carefully
• Introduce yourself and confirm patient identity
• Gain consent
• Complete an A–E assessment (Airway, Breathing, Circulation, Disability, Exposure)
• Take and interpret observations
• Recognise normal and abnormal findings
• Identify concerns, deterioration, or risks
• Escalate concerns appropriately where needed
• Complete all required documentation
• Calculate and record NEWS2 if required

Depending on the patient scenario, you may also need to complete additional assessment tools, such as:

• Glasgow Coma Scale (GCS) – for a patient presenting with a head injury or reduced consciousness
• MUST (Malnutrition Universal Screening Tool) – for nutritional screening, including patients with diabetes or weight loss concerns
• 6CIT – cognitive assessment for a patient with Alzheimer’s disease or confusion
• Wells Score – for a patient with suspected Deep Vein Thrombosis (DVT)

The examiner is assessing your ability to complete a structured assessment, recognise deterioration, use the correct assessment tools, communicate clearly, prioritise care, and document findings accurately within the time available.

2. Planning – 14 minutes

This station focuses on planning care based on your assessment findings.

You will be given a scenario linked to the patient from Assessment. The scenario may explain that the patient’s condition has now changed—for example, they may be post-operative, their symptoms may have progressed, or they may have been transferred to another healthcare setting. Read the scenario carefully and pay close attention to the timeframe you are being asked to plan care for, such as the next 24 hours or the next week.

Within the 14 minutes you are expected to:

• Review the information gathered during Assessment
• Read and interpret the new scenario carefully
• Identify the patient’s main nursing problems
• Prioritise what needs addressing first
• Set realistic goals or expected outcomes
• Plan safe nursing interventions
• Use patient-centred care, promoting comfort, dignity, and independence wherever possible
• Complete the planning documentation clearly

You are required to complete 2 care plans, with a minimum of 7 relevant nursing interventions for each care plan.

Each care plan should be:

• Relevant to the patient’s condition and current needs
• Individualised and patient-centred
• Focused on promoting safety and independence
• Clearly written and linked to your assessment findings
• Printed, signed, and dated

Your care plans should relate directly to what you identified in Assessment and reflect the patient’s current condition and changing care needs.

3. Implementation – 15 minutes

In the Nursing and Midwifery Council Adult OSCE, the Implementation station is a 15-minute medication administration station. You will be required to administer medications in tablet/oral form and complete the medication chart accurately.

Within the 15 minutes you are expected to:

• Read the patient scenario and medication chart carefully
• Check patient identity and gain consent
• Complete the 7 rights of medication administration:
  • Right patient
  • Right drug
  • Right dose
  • Right route
  • Right time
  • Right date
  • Right documentation

Before administering, ensure:

• the medication chart has the prescriber’s signature
• allergies are checked on the chart and confirmed with the patient
• the medication is due at the correct time
• the dose is correct
• the route is correct
• it is safe to administer

You should explain each medication clearly to the patient, including:

• what the medication is for
• its action
• common side effects

After administration, you must check that the patient has taken the medication safely before signing the chart.

Be aware that the medication chart may contain intentional traps. Always check carefully for issues such as:

• a medication having been given recently and prescribed again
• incorrect dose prescribed
• documented allergies
• duplicate medications
• medication prescribed at the wrong time
• medication not due yet
• contraindications based on the patient scenario

If a medication is withheld, you must clearly explain why. Common reasons may include:

• allergy
• incorrect prescription
• unsafe dose
• duplication/recent administration
• patient refusal
• clinical reason or contraindication

Withheld medications should be coded correctly on the medication chart according to the instructions given.

If a medication is not due, there is no need to code it as withheld.

You must also ensure the final page of the medication chart is fully completed, including:

• signatures
• documentation of withheld medications
• correct withholding codes where required

Examiners are assessing safe medication administration, attention to detail, patient communication, accurate documentation, and your ability to recognise unsafe prescriptions and act appropriately.

4. Evaluation – 8 minutes

This is the handover station. In the Nursing and Midwifery Council Adult OSCE, you will hand over the patient to a colleague, another nurse, or a doctor using a clear SBAR (Situation, Background, Assessment, Recommendation) structure.

You will be given all of your paperwork back from the previous APIE stations (Assessment, Planning, and Implementation) to refer to during this station. Use this information to help prepare your handover.

You will also be given a handover sheet to write notes on before speaking. You are not marked on the written notes you make on this sheet—it is there simply to help organise your thoughts. The marks are awarded for your verbal handover to the examiner.

Within the 8 minutes you are expected to:

• Read the scenario carefully, as the patient’s condition or circumstances may have changed
• Review all paperwork returned to you from the previous stations
• Review any new observations, results, treatments, or updates provided
• Use the handover sheet to structure your thoughts
• Deliver a clear verbal handover to the examiner using SBAR
• Leave yourself enough time to complete the verbal handover fully

Your handover should include:

• Your name and role
• Patient name, age, and relevant identifiers
• The patient’s current location
• Who you are handing over to
• Reason for the original admission, assessment, or presentation
• Date of admission if relevant
• Current condition and what has changed
• Comparison of current observations with previous observations
• Treatments, medications, and procedures completed
• Allergies
• Test results or investigations
• Past medical history
• Social history and lifestyle factors
• Concerns or risks identified
• Deficits in activities of daily living
• Referrals made or required
• Recommendations for ongoing care
• Escalation plan and frequency of monitoring

The examiner is assessing your ability to give a clear, structured, safe verbal handover, prioritise key information, recognise changes in the patient’s condition, and communicate effectively to support continuity of care.

Ulster ToC