OSCE Station 2: Planning (APIE) Walkthrough

The Planning station takes the assessment from Station 1 and converts it into a care plan. The patient remains the same; the task changes from gathering information to designing a structured response.

What the station tests

Prioritisation. Did you identify the most important issues from the assessment, and justify the priority order?

Goal setting. Are the goals you’ve set specific, measurable, time-bound, and clinically appropriate?

Intervention selection. Are the interventions you’ve chosen evidence-based and matched to the goals?

Documentation. Is the plan clearly written, with the format an incoming nurse could pick up and act on?

Patient-centred approach. Did you consider the patient’s preferences, capacity to engage, and individual circumstances?

The structure that works

A care plan in the OSCE Planning station typically follows this structure:

1. Identify priorities. Two to four issues from the assessment, in priority order with brief justification for the order.

2. Set goals. One goal per priority, in SMART format where possible.

3. List interventions. Three to five interventions per goal, clinically appropriate.

4. Note evaluation criteria. How will you know if the plan is working. What measurements or observations will tell you.

SMART goals

SMART is the UK standard for nursing goal setting:

• S, Specific: clear, not vague.
• M, Measurable: has a value or observable change you can track.
• A, Achievable: realistic given the patient’s situation.
• R, Relevant (or Realistic): connects to the priority issue.
• T, Time-bound: has a timeframe.

Weak goal: “Patient will be more comfortable.”

SMART goal: “Patient’s pain score will reduce from 7/10 to 3/10 or less within 2 hours of analgesic administration, evaluated using the verbal numerical pain scale.”

The SMART version is testable. The weak version isn’t.

A worked example structure

Sample plan structure for a hypothetical patient with breathlessness and anxiety:

Priorities:

1. Acute breathlessness (most urgent; affecting oxygenation).
2. Anxiety (contributing to breathlessness; needs addressing in parallel).
3. Dehydration (less urgent but contributing to overall picture).

Goals:

1. SpO2 will be maintained at or above 94% on appropriate oxygen therapy within 30 minutes.
2. Patient will report anxiety reduced to manageable level within 1 hour using verbal scale.
3. Hydration status improved within 4 hours, evidenced by urine output and skin turgor.

Interventions for Priority 1:

• Position upright or forward-leaning.
• Apply oxygen as prescribed.
• Monitor SpO2 and respiratory rate at 15-minute intervals initially.
• Reassess NEWS2 score.

Interventions for Priority 2:

• Calm verbal reassurance.
• Explain what’s happening at each step.
• Reduce environmental stimuli where possible.
• Involve family or carer if present and helpful.

Interventions for Priority 3:

• Encourage oral fluids if appropriate.
• IV fluids as prescribed.
• Monitor fluid balance hourly.

Evaluation:

• Reassess SpO2 and NEWS2 within 30 minutes.
• Reassess anxiety verbally within 1 hour.
• Review fluid balance and urine output at 4 hours.

This structure takes roughly 10-12 minutes to write out properly. The examiner reads what you’ve written and marks against the criteria.

Common failure patterns

No prioritisation. Listing everything from the assessment without ordering. Examiners want to see clinical reasoning, not transcription.

Vague goals. “Patient will feel better.” Not measurable, not time-bound, fails on multiple SMART criteria.

Interventions disconnected from goals. A patient with breathlessness whose interventions include extensive psychological assessment but not oxygen therapy. The link between goal and action is missing.

Generic interventions. Listing standard nursing actions without tailoring to the specific patient. “Monitor vital signs” appears in every care plan; what makes this care plan for this patient is the specificity.

No evaluation criteria. Skipping the evaluation section means the plan can’t be tested. Always include how you’ll know the plan is working.

What the examiner is reading for

A planning station passes when:

• Priorities are clinically reasonable and explained.
• Goals are SMART (or close to it).
• Interventions are evidence-based and matched to goals.
• The plan is clearly written.
• Patient-centred considerations are visible.

A planning station fails when:

• No clear priorities.
• Goals not measurable.
• Interventions that don’t address the goals.
• Documentation that an incoming nurse couldn’t use.

How to use the time

Typical 12-15 minute breakdown:

• Minutes 0-2: read the handover or assessment summary, identify priorities.
• Minutes 2-5: write priorities and brief justification.
• Minutes 5-10: write SMART goals and interventions.
• Minutes 10-13: add evaluation criteria.
• Minutes 13-15: review the plan, check it reads coherently.

The next chapter covers Station 3, Implementation, where the plan moves into action.