Essential Clinical Skills Every NMC OSCE Candidate Must Perfect

One of the most common concerns among internationally educated nurses preparing for the NMC OSCE is uncertainty about what will actually appear in the clinical skills station. The good news is that the NMC operates from a defined, fixed list of skills. There are no surprises.

There are 22 clinical skills that can be assessed in the OSCE skills station. Every one of them reflects real NHS nursing practice, and every one of them is fully preparable. This guide walks you through each skill, what examiners expect to see, and the most common errors to avoid.

The Complete List of NMC OSCE Clinical Skills

The following 22 skills form the definitive list for the NMC OSCE skills station. Your preparation should cover all of them, as you will not know in advance which skill you will be asked to perform.

1. Administration of Inhaled Medication (AIM)

Candidates must demonstrate the safe administration of inhaled medication, typically via a metered-dose inhaler (MDI) or nebuliser. This includes checking the prescription, confirming patient identity and allergy status, explaining the procedure, and verifying technique.

Key focus: Correct inhaler technique, patient education on device use, and post-administration assessment of response.

2. Administration of Suppository

This station assesses your ability to safely administer a rectal suppository, including patient dignity, correct positioning, glove use, and documentation. Consent and clear explanation to the patient are essential.

Common error: Insufficient attention to patient dignity and privacy during the procedure.

3. Aseptic Non-Touch Technique (ANTT)

ANTT is a foundational infection prevention framework used across multiple clinical procedures. Candidates must demonstrate the correct principles: identifying key parts and key sites, maintaining a sterile field, and avoiding contamination throughout. ANTT principles underpin wound care, IV procedures, and catheter care.

Common error: Breaking the sterile field without acknowledging it or taking corrective action.

Examiner insight: ANTT is assessed not just in dedicated stations but as an underpinning standard across many other skills. A lapse in aseptic technique in any station will affect your mark.

4. Blood Glucose Monitoring

Candidates must demonstrate the safe and accurate measurement of blood glucose using a point-of-care glucometer. This includes performing a capillary blood glucose test, interpreting the result, and identifying the appropriate clinical response based on the reading.

Key focus: Correct lancet use, accurate reading, safe disposal of sharps, and clear documentation.

5. Bowel Assessment

Bowel assessment requires candidates to conduct a structured, holistic review of a patient's bowel function, using the Bristol Stool Chart as a reference tool. Candidates must demonstrate sensitivity, effective communication, and the ability to identify and escalate concerns.

Common error: Failing to use the Bristol Stool Chart correctly or omitting dietary and medication history from the assessment.

6. Catheter Specimen of Urine (CSU)

This station assesses the ability to obtain a urine specimen from an indwelling urinary catheter using ANTT principles. Candidates must identify the correct sampling port, clean it appropriately, and transfer the specimen to the correct container for laboratory analysis.

Common error: Aspirating from the drainage bag rather than the sampling port, which compromises sample validity.

7. Fine-Bore Nasogastric Tube Insertion

Nasogastric tube insertion is one of the higher-acuity skills on the list. Candidates must demonstrate the safe insertion technique, explain the procedure clearly to the patient, and crucially, confirm correct gastric placement using pH testing of aspirate (pH 1 to 5.5). X-ray confirmation is required if aspirate cannot be obtained.

Common error: Relying on auscultation alone to confirm placement; this is not an acceptable method under current NMC and NHS guidance.

8. Fluid Balance (FB)

Accurate fluid balance monitoring is a patient safety-critical skill. Candidates must demonstrate the ability to record all fluid intake (oral, IV, enteral) and output (urine, drain, vomit), calculate the cumulative balance, and recognise when escalation is required.

Common error: Omitting a category of fluid intake or output, or failing to recognise an abnormal balance and escalate accordingly.

9. Intramuscular Injection (IM)

IM injection requires candidates to demonstrate safe site selection (typically the vastus lateralis or deltoid), correct needle length and angle (90 degrees), aspiration technique where applicable, and safe disposal. Patient explanation and post-injection observation are also assessed.

Key focus: Correct site identification, angle of insertion, and Z-track technique where indicated.

10. Intravenous Flush and Visual Infusion Phlebitis (VIP) Assessment

Candidates must demonstrate how to flush a peripheral IV cannula safely using a pulsatile flush technique, and conduct a VIP assessment of the cannula site. The VIP score (0 to 5) should be recorded accurately and action taken based on the finding.

Common error: Flushing against resistance without escalating, or failing to document the VIP score.

Examiner insight: IV flush and VIP assessment are closely linked to patient safety. Candidates who demonstrate awareness of signs of phlebitis and act on them appropriately stand out.

11. Mid-Stream Specimen of Urine (MSU) and Urinalysis

This station assesses patient education; specifically the ability to explain the MSU collection technique clearly and accurately, as well as the correct performance of urinalysis using a reagent strip, and interpretation of results.

Common error: Inadequate patient explanation of the mid-stream technique, leading to an invalid specimen.

12. Nutritional Assessment

Candidates must conduct a nutritional screening using the Malnutrition Universal Screening Tool (MUST) or an equivalent validated tool. This includes calculating BMI, assessing recent weight loss, and identifying the impact of acute illness on nutritional risk.

Key focus: Accurate scoring, identifying patients at risk, and demonstrating awareness of appropriate referral pathways, including the dietitian.

13. Oral Care Plan

Oral care is a fundamental aspect of patient hygiene and comfort, particularly for patients who are nil by mouth, ventilated, or cognitively impaired. Candidates must assess the oral cavity, identify any concerns, and document and implement an appropriate oral care plan.

Common error: Treating oral care as routine rather than clinically significant, and failing to document findings and actions.

14. Oxygen Therapy

Safe oxygen therapy requires candidates to understand the indications, target saturations (typically 94 to 98% for most patients; 88 to 92% for those at risk of hypercapnic respiratory failure), and the correct delivery devices. Candidates must titrate oxygen appropriately and reassess.

Common error: Applying high-flow oxygen to a COPD patient without awareness of the risk of hypercapnia, or failing to reassess saturations following commencement of therapy.

15. Pain Assessment

Candidates must demonstrate the use of a validated pain assessment tool (such as the numerical rating scale or the Abbey Pain Scale for non-verbal patients), explore the nature of the pain using a structured approach (such as SOCRATES), and formulate an appropriate response.

Key focus: Selecting the correct tool for the patient, demonstrating empathy, and taking appropriate action rather than only documenting the score.

16. Peak Expiratory Flow Rate (PEFR)

This station assesses the ability to explain and demonstrate peak flow measurement correctly, obtain three consecutive readings, select the highest valid reading, and interpret it in the context of the patient's predicted or personal best.

Common error: Failing to explain the technique clearly before the patient attempts the measurement, or using an incorrect mouthpiece technique.

17. Pressure Area Assessment

Candidates must use a validated risk assessment tool; most commonly the Waterlow Score, to assess a patient's risk of pressure ulcer development, and formulate an appropriate care plan. Knowledge of pressure ulcer grading (Grade 1 to 4) is also expected.

Key focus: Accurate Waterlow scoring, identifying appropriate preventative interventions, and patient positioning awareness.

18. Removal of Urinary Catheter (RUC)

Candidates must demonstrate the safe removal of a urinary catheter, including patient explanation, correct deflation of the balloon, safe disposal, and post-removal documentation. Candidates must also demonstrate awareness of expected post-removal monitoring, including first void.

Common error: Failing to confirm balloon deflation before removal, or omitting post-procedure documentation and monitoring plan.

19. Subcutaneous Injection

Subcutaneous injection requires candidates to demonstrate correct site selection (abdomen, outer thigh, or upper arm), the appropriate needle angle (45 to 90 degrees depending on the site and patient), and safe administration technique, including skin pinching where indicated.

Common error: Injecting at the incorrect angle for the chosen site, or failing to rotate injection sites for regular medications such as insulin.

20. Wound Assessment

Wound assessment requires a structured approach covering wound type, size, bed condition, exudate, periwound skin, pain, and signs of infection. Candidates must select an appropriate dressing using ANTT principles and document their findings accurately.

Key focus: Using a recognised wound assessment framework, maintaining aseptic technique throughout, and communicating findings clearly.

21. Anti-Embolism Stockings

Candidates must demonstrate correct measurement, selection, and application of anti-embolism (TED) stockings and assess for contraindications, including peripheral arterial disease. Patient education on the purpose and correct wear of stockings is also assessed.

Common error: Failing to assess for contraindications before application, or applying incorrectly sized stockings.

22. Pre-Operative Check

The pre-operative check station assesses the ability to complete a structured pre-operative assessment, verifying patient identity, consent, allergies, fasting status, site marking, and removal of prosthetics, jewellery, and nail varnish. This is a patient safety-critical station.

Key focus: Systematic, structured completion of the checklist with clear patient communication and documentation throughout.

What Every Skills Station Has in Common

Regardless of which skill you are assessed on, examiners will apply the same overarching criteria across every station:

• Introduce yourself and confirm patient identity using two identifiers

• Obtain valid consent before beginning any procedure

• Maintain patient dignity and privacy throughout

• Apply ANTT principles wherever infection risk exists

• Communicate clearly — explain what you are doing and why, in terms the patient can understand

• Document accurately — findings, actions, and any escalation

• Escalate appropriately when results or findings indicate a clinical concern

At Envertiz Academy, each of these 22 skills is taught and assessed in simulation environments that replicate NHS ward conditions. Our trainers provide structured, criterion-referenced feedback after every session, ensuring you are fully prepared before your OSCE date.

Final Thoughts

The NMC OSCE clinical skills station is not unpredictable. The list is fixed, the marking criteria are published, and every skill is teachable. What separates candidates who pass the first time from those who do not is the quality of their preparation, not just knowing the steps, but being able to perform them calmly, accurately, and with genuine patient-centred care.

Work through each skill methodically. Practise under timed conditions. Seek feedback. And remember that how you perform matters as much as what you perform.

Contact us today to find out how Envertiz Academy can support your OSCE preparation.