By the Clinical Educator Team at Global Nurse Guide
1. Introduction: Don’t Panic!
The OSCE just got more realistic, not harder.
If you are reading this, you likely just passed your CBT and are now facing the daunting prospect of the practical exam. We know hearing about “Exam Changes” can send your heart rate up faster than a frantic shift on the ward. But take a deep breath.
As of January 2026, the Nursing and Midwifery Council (NMC) updated the Test of Competence (ToC). The goal wasn’t to trick you; it was to align the exam with “real-world” practice. The new stations reflect what you will actually see in UK hospitals: blood clots, surgical prep, and privacy concerns.
This guide breaks down exactly what has changed, how to pass the new stations, and the “Red Flags” you must avoid.
2. Deep Dive: The 6 New Stations
Here is the breakdown of the major changes across the APIE, Clinical Skills, Professional Values, and Evidence-Based Practice stations.
A. The New APIE Scenario: Suspected Deep Vein Thrombosis (DVT)
This is a new scenario added to the Assessment, Planning, Implementation, and Evaluation (APIE) cycle. You will be presented with a patient complaining of calf pain or swelling, often post-surgery or after long immobility.
What You Do: Perform a holistic assessment. You must specifically inspect the limb for redness, warmth, tenderness, and swelling. You will likely need to use a measuring tape to compare calf circumference.
Top Tip to Pass: Verbalize everything. Say, “I am checking for unilateral swelling and warmth.”
⚠️ CRITICAL FAIL WARNING: DVT
Do NOT massage the leg.
If you rub or massage the painful area, you risk dislodging the clot (embolization), which can cause a Pulmonary Embolism. This is an immediate fail. Treat the limb gently.
B. New Clinical Skills Stations
1. Anti-Embolism Stockings (TEDs)
This is a technical station. It is not just about putting the stocking on; it is about safety and sizing.
What You Do: You must assess the patient’s skin integrity, measure the leg accurately to choose the correct size, and apply the stocking without creating a tourniquet effect.
Equipment Needed:
| Item | Purpose |
| Tape Measure | Essential for sizing (Thigh/Calf). |
| Sizing Chart | Use this to select the correct stocking code. |
| Stockings | The actual garment to apply. |
| Talc (Optional) | Sometimes available to ease application (check local guidelines). |
Top Tip to Pass: Smooth out all wrinkles. A wrinkled stocking can cause skin damage, which the examiner looks for closely.
⚠️ CRITICAL FAIL WARNING: STOCKINGS
You will fail if you do not measure the leg.
Guessing the size is dangerous. You must demonstrate measuring the calf and thigh circumference and checking the length against the sizing chart before opening the stocking packet.
2. Pre-Operative Checklist
What You Do: You will go through a formal checklist for a patient heading to theater.
Top Tip to Pass: This is a safety gate. You must verify:
Consent (Is it signed? Is it the right procedure?).
Allergies (Is the red band on?).
Fasting status (When did they last eat/drink?).
Removal of jewelry/dentures.
C. Professional Values
1. The Deteriorating Patient
What You Do: You will encounter a scenario where a patient’s observations are worsening. You need to calculate the NEWS2 (National Early Warning Score) and decide on the escalation path.
Top Tip to Pass: Don’t just record the vitals. Act on them. If the score is high, verbalize: “I am escalating this to the doctor/outreach team immediately.”
2. Patient Private Details (GDPR)
What You Do: You may face a situation where a relative asks for information, or notes are left open.
Top Tip to Pass: Be the guardian of confidentiality. Politely refuse to give info to unauthorized people and ensure screens/files are secured.
D. Evidence-Based Practice (EBP)
The NMC has introduced two quirky but relevant new research topics for you to summarize:
Cholesterol & Coffee: Analyzing research regarding the impact of coffee consumption on lipid profiles.
Honey for Herpes: summarizing evidence regarding the efficacy of medical-grade honey for viral sores.
Top Tip to Pass: Read the abstract and conclusion of the provided article carefully. Your summary must reflect only what the article says, not your personal opinion on coffee or honey!
- Focus: You must explain that honey/propolis has fewer side effects than Acyclovir and is a viable alternative for patients with adverse reactions.
3. The “Silent Killer”: Documentation
In the 2026 update, examiners are placing a heavier emphasis on timeliness.
The Change: 2026 standards require “writing accurate notes within minutes.”
The Trap: Many nurses write beautiful notes but run out of time.
The Fix: Keep it concise. Use standard terminology. If you didn’t write it, you didn’t do it. But if you write a novel, you won’t finish the exam.
4. Frequently Asked Questions (FAQ)
Q: Is the marking criteria different in 2026?
A: Yes. There is a significant shift in focus. While you still need to know how to do a task, the examiner is now grading you on why you are doing it. You must understand the rationale (e.g., “I am measuring the leg to prevent pressure damage,” not just measuring because the checklist says so).
Q: Do I need to check the ID in every station?
A: YES. This has not changed. In every single station—whether it is giving meds, putting on stockings, or discussing coffee studies—check the ID and check for allergies. It is the first step of safe practice.
🌟 What can I do for you next?
To help you practice the new “Clinical Skills” section, would you like me to generate a step-by-step script for the “Pre-Operative Checklist” station, including the specific questions you should ask the patient?
