OSCE Skills Stations: The 20 Possible Skills

The OSCE skills stations test specific clinical procedures. Two pairs of skills, each pair sharing 21 minutes. The 4 skills tested in your sitting are drawn from a fixed list of 20.

The list is published. Preparation is thorough when you can perform any of the 20 correctly.

The 20 skills

1. Subcutaneous injection. Insulin, low-molecular-weight heparin. Site selection, angle, technique.

2. Intramuscular injection. Vaccines, antibiotics. Site (Z-track technique for deltoid or vastus lateralis), needle selection.

3. Inhaled medication administration. Inhaler, spacer, nebuliser. Patient teaching as well as technique.

4. Suppository administration. Glycerin, paracetamol. Positioning, technique, dignity.

5. NG tube insertion. Measurement, technique, position confirmation (pH testing, x-ray confirmation if required).

6. Blood glucose monitoring. Glucometer use, sampling, interpretation.

7. Peak flow measurement (PEFR). Patient instruction, technique, recording.

8. Oxygen therapy. Choice of delivery device (nasal cannula, Venturi mask, non-rebreather), flow rate, safety.

9. IV flush and VIP score. Saline flush via cannula, Visual Infusion Phlebitis assessment.

10. ANTT (aseptic non-touch technique). Procedure-agnostic, applied to dressings, IV access, sterile field setup.

11. Catheter specimen collection. Sample from an existing catheter without breaching the system.

12. Catheter removal. Female or male urinary catheter removal, with appropriate communication and documentation.

13. Wound assessment. Visual inspection, measurement, exudate, signs of infection, documentation.

14. Pressure area assessment. Waterlow or similar scoring, skin inspection, documentation.

15. Pain assessment. Verbal numerical scale, faces scale (for children or non-verbal adults), full pain history.

16. Nutritional assessment. MUST score, BMI, dietary history, identifying malnutrition risk.

17. Bowel assessment. Bristol stool chart, history, identification of issues (constipation, incontinence).

18. Oral care. Mouth assessment, oral hygiene technique, patient with dysphagia considerations.

19. Fluid balance. Input/output recording, calculation, identification of imbalance.

20. MSSU collection. Midstream urine sample, sterile technique, labelling and dispatch.

How the skills pair

The OSCE pairs two skills per station. The pairings are often grouped by clinical theme:

• Medication-related pair: SC injection paired with inhaled medication, or IM injection paired with suppository.
• Sample-collection pair: catheter specimen with MSSU, or blood glucose with PEFR.
• Assessment pair: wound assessment with pressure area, or pain with nutritional.
• Care pair: oxygen with fluid balance, or oral care with bowel assessment.

The specific pairings aren’t published in advance.

The framework that applies to every skill

Whatever the skill, the same framework applies:

Before: introduce yourself, identify patient, explain, gain consent, hand hygiene, gather equipment, check equipment integrity.

During: correct technique, IPC throughout (hand hygiene at the right moments, PPE matched to the task), communication with the patient throughout, dignity maintained.

After: dispose of equipment safely, hand hygiene, document, communicate with patient about what happens next.

Examiners mark on a structured checklist that covers each component. Missing any element of the framework loses marks even if the technical skill itself is correct.

What examiners watch most carefully

Across all 20 skills, four things examiners mark hard:

1. Hand hygiene at the right moments. Skipping a moment or doing hand hygiene out of sequence is the most common single mark loss.

2. Sharps and waste disposal. Sharps in the sharps bin (not the clinical waste). Used sharps not recapped. Disposal at point of use.

3. Dignity and consent. Curtains drawn, body parts not exposed unnecessarily, consent for each step.

4. Documentation. Every skill ends with a documentation step. Missing or incomplete records lose marks.

Preparation strategy

For each of the 20 skills:

• Read the procedure in a UK nursing skills text (Royal Marsden Manual, Nursing Standard, RCN guidance).
• Watch demonstration videos. RCN has some; e-Learning for Healthcare has some; NHS-published videos exist.
• Practice hands-on if possible. The physical execution differs from the description.
• Verbalise the steps while practising. The OSCE rewards visible thought process, not silent execution.

Most commonly tested skills (anecdotal pattern)

The NMC doesn’t publish frequency data, but the skills that come up most commonly in candidates’ reports are:

• Subcutaneous or intramuscular injection.
• Blood glucose monitoring.
• Oxygen therapy.
• Wound assessment.
• Pressure area assessment.
• ANTT.

The less common skills (NG tube insertion, MSSU collection, peak flow) appear too but less frequently. Don’t skip preparation for them.

How to use the time

For each skill in a pair, typical 10-minute breakdown:

• Minutes 0-2: introduction, identification, consent, explanation.
• Minutes 2-3: hand hygiene, equipment preparation, PPE.
• Minutes 3-8: carry out the procedure with running commentary.
• Minutes 8-9: hand hygiene, disposal, communication with patient.
• Minutes 9-10: brief documentation.

The next chapter covers the two silent written stations: Professional Values and Evidence-Based Practice.