What are the APIE stations in the NMC OSCE?
The OSCE is Part 2 of the NMC Test of Competence, a practical exam taken at an approved test centre in the UK. The nursing OSCE has ten stations. Four are the APIE stations, linked around a single patient scenario and taken in order: Assessment, Planning, Implementation and Evaluation. Four more test clinical skills in two linked pairs, and two written stations cover professional values and evidence-based practice.
| Station | What you typically do | What it shows |
|---|---|---|
| Assessment | Identify the patient, gain consent, carry out an ABCDE assessment, record observations and calculate NEWS2 | Systematic, safe, person-centred assessment |
| Planning | Write a care plan from the assessment findings | Prioritising problems and planning specific, evidence-based care |
| Implementation | Give care, usually medicines from a prescription chart, with all checks | Safe medicines administration and communication |
| Evaluation | Review progress and hand over, usually in SBAR, verbally or in writing | Clear, accurate communication of progress and next steps |
How are the APIE stations marked?
Each station is marked against published criteria. The NMC has moved to more holistic marking based on key points rather than word-for-word scripts, and it discourages rote learning. If you resit, you may get a different scenario. You need to understand the principles well enough to apply them to any patient.
What examiners look for in every station
- Patient safety, including hand hygiene at the right moments.
- Correct patient identification and consent before any care.
- Clear, kind communication with jargon explained.
- Person-centred care: asking about preferences, worries and understanding.
- Professional values consistent with the NMC Code.
- Legible, accurate documentation with only approved abbreviations.
You must pass every station. If you fail, you receive feedback on the stations you did not pass and resit only those. NHS Employers guidance says you can sit the OSCE up to three times in one application, with at least 10 working days before a resit. Results usually arrive within about five working days. Check current rules with the NMC and your test centre.
How do I pass the assessment station?
- Prepare: Read the scenario. Clean your hands. Check the area is safe and private.
- Introduce and identify: Give your name and role. Ask the patient's full name and date of birth and check against the wristband and documents. Ask what they would like to be called.
- Consent: Explain what you will do and why, ask permission, and ask about pain before you start.
- A: Airway: Can they speak in full sentences? Any noisy breathing or obstruction?
- B: Breathing: Count respiratory rate for a full minute. Measure oxygen saturation and note air or oxygen. Look at effort and colour. Ask about breathlessness and cough.
- C: Circulation: Pulse for a full minute, blood pressure, capillary refill, skin colour and temperature. Ask about fluid intake and urine output.
- D and E: Disability and exposure: Use ACVPU, assess pain with a scale, consider blood glucose if relevant, take temperature, and with consent and dignity check skin, wounds, lines and pressure areas.
- Record, score and finish: Chart each observation accurately, calculate NEWS2, say what action it needs, make the patient comfortable with the call bell in reach, and clean your hands.
How do I write a care plan in the planning station?
A good OSCE care plan is specific to this patient, deals with the most important problems first and contains measurable, evidence-based actions. Use the same structure for each problem: the problem and its cause, a measurable goal with a time frame, nursing interventions, and how and when you will evaluate. Write legibly, sign and date where needed, and use approved abbreviations only.
Assessment found NEWS2 6, respiratory rate 23, saturation 94% on air, temperature 38.4 and pulse 104. He is breathless on moving, has a productive cough, has eaten and drunk little for two days, and is worried about his wife at home, who has dementia.
Problem: Breathing. Goal: Better breathing. Plan: Monitor obs. Give oxygen. Encourage fluids. Tell doctor.
Problem 1: Breathlessness and reduced saturation (94% on air) related to pneumonia. Goal: saturation maintained within his prescribed target range and he reports easier breathing within 24 hours. Interventions: escalate NEWS2 of 6 to the medical team now using SBAR; check his prescribed oxygen target and give oxygen as prescribed if he falls below it; repeat observations at the frequency NEWS2 and local policy require; sit him upright; give prescribed antibiotics on time; provide a sputum pot. Evaluation: with each set of observations and at the end of the shift. Problem 2: Risk of dehydration and poor nutrition. Goal: fluid intake meets the target set by the team, recorded every shift. Interventions: start a fluid balance chart, keep preferred drinks in reach, complete a MUST screen and refer if indicated. Problem 3: Anxiety about his wife. Goal: he says he feels reassured within a few hours. Interventions: ask who is caring for her and, with his consent, contact family or social services to check she is safe.
- It uses the actual findings, including the score and the patient's own words.
- It prioritises breathing, then hydration and nutrition, then psychological and social needs.
- Goals are measurable and time-limited, and escalation is explicit.
- It recognises his worry about his wife, a point many candidates miss.
How do I pass the implementation (medicines) station?
Implementation usually means giving medicines to the same patient from a prescription chart. The chart may contain deliberate errors, such as an unsigned prescription, a dose already given or a drug the patient is allergic to. Examiners can only mark what they see and hear, so say your checks aloud.
- Check the whole chart first: Patient details on every page, allergy status, weight if relevant, and each prescription for drug, dose, route, frequency, start date, signature and legibility.
- Check each medicine due now: Is it due? Already given? Is the dose appropriate? Any reason to withhold, such as an allergy, a low pulse or blood pressure for certain drugs, or an unclear or unsigned prescription?
- Identify and consent: Confirm name and date of birth against the wristband and chart, confirm allergies with the patient, explain each medicine and ask for consent.
- Prepare and give safely: Clean your hands, check expiry dates, prepare without touching tablets, and stay while the patient takes oral medicines.
- Document and act: Sign for what you gave. For anything not given, record the correct code and reason, and say who you will contact, such as the prescriber or pharmacist.
How do I pass the evaluation station?
Evaluation shows you can review progress and communicate it clearly, as a verbal handover, a written evaluation or both. SBAR (Situation, Background, Assessment, Recommendation) fits most tasks. A good evaluation states whether each care plan goal was met, partly met or not met, uses the real findings from the scenario and says what should happen next.
This is Mr Adeyemi, he has a chest infection. He's better now. Obs are OK. He's had his antibiotics. He was worried about his wife but it's sorted.
Situation: Mr Adeyemi, 74, bed 6, admitted with pneumonia, improving since this morning. Background: NEWS2 was 6 on assessment and was escalated; he started prescribed antibiotics; no known allergies; lives with his wife, who has dementia. Assessment: respiratory rate 19, saturation 96% on air, pulse 92, blood pressure 118 over 72, temperature 37.6, alert; NEWS2 now lower. He has drunk 900 mL since 8 am and is passing urine. One antibiotic was withheld as unsigned; the doctor has re-prescribed it. His daughter is staying with his wife, so goal 3 is met. Recommendation: continue observations and escalate if the score rises, give the antibiotic when next due, continue the fluid chart, follow up the dietitian referral.
Do not invent improvements the scenario did not give you, and make sure every problem in your care plan is addressed.
How should I prepare for the APIE stations?
Divya, an adult nurse with six years' ward experience abroad, passed assessment and evaluation at her first attempt but failed planning and implementation. Her feedback said her care plan goals were not measurable and did not include escalation of the early warning score, and she had given a medicine with an unsigned prescription, assuming it was an oversight. She studied the marking criteria and mock OSCE for her field, wrote care plans for five scenarios and had a UK-registered colleague review them, and practised with deliberately flawed charts, reading every line aloud. She passed both at her resit.
- Download the official materials: Current marking criteria, mock OSCE, timings, supporting documents and equipment list for your field.
- Learn principles, not scripts: ABCDE, NEWS2, care planning, the medicines checks and SBAR.
- Practise aloud with a partner: Take turns as nurse and patient and speak every check.
- Write by hand under time pressure: Care plans and observation charts on paper, legibly.
- Run full APIE sequences: Use the NMC's current timings, then compare your performance with the marking criteria.
No course can promise a pass. Safe, systematic, person-centred care is what the OSCE rewards, and practising it carefully is the best preparation.
Further support
Our course NMC OSCE Preparation: APIE Stations takes you through each station with worked examples of what to say, do and write. NMC Registration for Internationally Educated Nurses explains the full route to the register, and NMC CBT Preparation (Test of Competence Part 1) covers the computer-based test.
Frequently asked questions
What does APIE stand for in the NMC OSCE?
APIE stands for Assessment, Planning, Implementation and Evaluation, the four stages of the nursing process. In the OSCE they are four linked stations built around one patient scenario and taken in that order. Together they test whether you can care for a patient safely from first assessment through to handover.
How many stations are in the NMC OSCE?
The nursing OSCE has ten stations: four linked APIE stations, four clinical skills stations delivered as two linked pairs, and two written stations on professional values and evidence-based practice. You must pass every station. Check the NMC's current information for your field, as materials and scenarios are updated.
Should I memorise OSCE scripts?
No. The NMC's marking criteria focus on key points rather than exact wording, and it discourages rote learning. Resit candidates may get a different scenario. Learn the principles behind ABCDE assessment, care planning, medicines checks and SBAR so you can adapt to any patient, and practise speaking naturally.
Which care plan format should I use in the planning station?
Use the documentation provided at the test centre. Within it, a reliable structure for each problem is: the problem and cause, a measurable goal with a time frame, specific nursing interventions including any escalation, and how and when you will evaluate. Prioritise life-threatening problems first and include psychological and social needs the patient mentions.
What happens if I spot an error on the prescription chart?
Do not give that medicine. Explain to the patient why it is being withheld, record it using the correct code and reason, and tell the examiner who you would contact, such as the prescriber or pharmacist. Spotting deliberate errors, like unsigned prescriptions or allergies, is part of what the station tests.
If I fail one APIE station, do I resit all four?
Generally you resit only the stations you failed, and you get feedback on which ones they were. Test centres explain how passed APIE paperwork is used if you resit some APIE stations. Rules on attempts, waiting times and fees can change, so check the NMC and your test centre before booking.
How long do I have to pass the OSCE after arriving in the UK?
If you are sponsored by an employer, NHS Employers guidance says the first attempt is expected within 12 weeks of the employment start date on your certificate of sponsorship, and you should pass within eight months of the start of your visa. Your employer will confirm what applies to you.
Related courses
NMC OSCE Preparation: APIE Stations
This course prepares internationally educated nurses for the four linked APIE stations of the NMC OSCE: assessment, planning, implementation and…
NMC Registration for Internationally Educated Nurses
This course walks internationally educated nurses and midwives through each stage of joining the NMC register, from checking you are ready to…
NMC CBT Preparation (Test of Competence Part 1)
This course prepares internationally educated nurses for Part 1 of the NMC Test of Competence, the computer-based test. It explains the structure of…
Sources and further reading
- Test of Competence 2021: OSCE marking criteria and mock OSCEs. Nursing and Midwifery Council.
- Recruitment of overseas nurses and midwives: OSCE information. NHS Employers.
- National Early Warning Score (NEWS) 2. Royal College of Physicians.
- Professional guidance on the administration of medicines in healthcare settings. Royal Pharmaceutical Society and Royal College of Nursing.
- The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council.
- The OSCE process. Leeds Teaching Hospitals NHS Trust Competence Test Centre.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.
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