Four nurses walk along a hall)

Overseas Aptitude Test – General Nurse

Faculty of Nursing & Midwifery

Practical test

A methodology known as objective structured clinical examination (OSCE) is used. OSCE is acknowledged internationally as an assessment methodology that enables the applicant to demonstrate competence in a simulated practice setting, known as a station.

Assessment of competence for practice through a range of OSCEs includes a number of different simulated stations. A station is set up as a clinical setting and has all the necessary equipment.

You are required to complete 14 stations – each station assesses different competencies.

Each station has a descriptor sheet and this is displayed both outside and inside the station and is available for you to refer to as you need. You spend 10 minutes at each station carrying out the care as per the station descriptor. There are a number of aims and competencies that you are expected to achieve at each station. When the time is up then the assessment ends, regardless of whether or not you have finished. For some stations, further details on the scenario will be available inside at the station. The station descriptors/scenarios may change from one test to the next.

There are trained assessors at each station. The OSCE assessors are experienced nurses who hold a postgraduate qualification and have been trained by RCSI as OSCE assessors. Some stations may have a mannequin. Stations may have one of the assessors acting as a patient or a relative or a staff member. Assessors consider the applicant's performance and mark as competent (pass) or incompetent (fail). In order to pass the practical part, the applicant must be deemed competent in each competency at each station

Sample OSCEs 

Find some sample station descriptors for OSCEs below.

Sample OSCEs - General Nurse DOCX | 169.5 KB

Why an applicant might fail an OSCE

On average 70% of applicants are successful at the first attempt and 80% are successful at the second attempt.

The failure rate needs to be viewed against the backdrop that the OSCEs are based on the NMBI standards and requirements for Irish-trained general student nurses. Therefore the OSCEs reflect what an RGN working as first year staff nurse in a general hospital (or comparable) would be expected to know and do in a safe and competent manner.

As applicants are already trained as general nurses in their own country, an exploration as to why some are failing might be useful for prospective employers, recruitment agencies and future applicants.

Notwithstanding that a certain level of examination anxiety is normal, the following observations are offered as mere suggestions as to possible factors that may be contributing to some applicants failing.

  • Relevant experience: It would appear that some applicants, although qualified for a number of years, may not have had recent relevant experience in a general hospital. Obviously, this is not the business of RCSI, but might be something prospective employers/recruitment agencies may wish to explore.
  • Lack of preparation: Some applicants appear to be ill-prepared for the test. A test generally opens 3.5 months in advance. Each applicant should assess how much preparation is essential for them. This should be factored into account if applying for an earlier test date. As a starting point in preparing for the test, applicants are strongly advised to be fully familiar with the most recent information on this website including all links and to be aware that additional reference material is frequently added. It is recommended that applicants practise filling in the documentation that may be used at the OSCEs.
  • Rote learning: Preparation for any examination is vital. However, nursing is not just about knowledge but it is also about the application of that knowledge to ensure safe delivery of patient care. It would appear that some applicants are rote-learning different aspects but not able to apply the knowledge. Applicants must be prepared for changes in scenarios and for safe application of knowledge that may not be required in the linear fashion in which a topic was rote-learnt. Please remember that RCSI does not endorse or approve any training or preparation course for the test.
  • Differences between countries: There will always be some differences between countries in regard to equipment and documentation. Images of equipment and documentation are clearly shown on the website – it would appear some applicants do not take care when studying the images of the equipment or practise filling in the documentation, both of which are crucial.
  • Not heeding: In an effort to help the applicants, the possible scenario/s pertaining to an OSCE station are displayed outside the station. However, it would appear some applicants do not take sufficient care in reading these. On the day of the OSCEs we advise applicants to avoid getting distracted.
  • Expectation: Some applicants present for an OSCE anticipating/expecting a specific scenario and may experience difficulty when presented with a different patient scenario. Of late we have noticed a significant increase in applicants coming into a station expecting one scenario and if it has changed some find it difficult to adjust. Even though they have been reading the scenario outside the station some still answer what they were expecting, which may be different. Please remember that the OSCEs are based on what is expected of a newly-qualified RGN who will meet different patients on a daily basis. Therefore, OSCEs can change from one day to the next. If an applicant is advised/guided to expect specific patient scenarios at OSCE stations then they are being misguided.

In conclusion, the majority of applicants prepare well, are able to apply knowledge in a safe way and give full care and attention throughout the test. However, the above observations may assist others.