Reasons Why Nurses Fail the OSCE: Understand the Challenges

The OSCE (Objective Structured Clinical Examination) is a crucial evaluation method used to assess the clinical competence of nursing students. While many students excel in their OSCE, some may face challenges and fail to meet the required standards. In this blog post, we will explore the most common reasons why nurses fail the OSCE, shedding light on the areas where students often struggle and providing insights for improvement.

Insufficient Preparation:

One of the primary reasons for failure in the OSCE is inadequate preparation. The examination requires a comprehensive understanding of nursing theories, clinical skills, and patient care. Students who fail to dedicate enough time and effort to practise and revise are more likely to struggle during the examination.

Tips for Improvement:

  1. Develop a study plan and allocate sufficient time for focused preparation.
  2. Review key nursing concepts, clinical procedures, and patient assessment techniques.
  3. Practice OSCE scenarios using mock exams, role-playing, and simulation exercises.
  4. Seek guidance from instructors or mentors to identify areas for improvement.
Communication Breakdown:

Effective communication is an essential skill for nurses, and poor communication can lead to failure in the OSCE. Students who struggle to communicate clearly and confidently with patients, healthcare professionals, or examiners may lose crucial points in the assessment.

Tips for Improvement:

  1. Practise active listening and empathy to better understand patients’ needs and concerns.
  2. Enhance verbal and non-verbal communication skills, including maintaining eye contact, using appropriate body language, and speaking clearly.
  3. Develop skills in conveying information effectively, such as providing clear instructions and explanations to patients.
Inadequate Clinical Decision-Making:

The OSCE evaluates students’ ability to make appropriate clinical decisions based on patient assessments and available information. Nurses who fail to demonstrate sound judgement and critical thinking during the examination may receive a lower score.

Tips for Improvement:

  1. Strengthen your knowledge of nursing protocols, guidelines, and evidence-based practices.
  2. Practise clinical reasoning and decision-making through case studies and critical thinking exercises.
  3. Develop the ability to prprioritizeatient care based on the urgency and severity of the situation.
  4. Familiarise yourself with common patient scenarios and the recommended interventions.
Time Management Challenges:

Nursing is a time-sensitive profession, and efficient time management is crucial. In the OSCE, students are evaluated on their ability to prioritise tasks and manage their time effectively within the given timeframe. Poor time management skills can lead to incomplete assessments or rushed procedures, resulting in lower scores.

Tips for Improvement:

  1. Practice time management techniques such as creating to-do lists, setting priorities, and allocating appropriate time for each task.
  2. Familiarise yourself with common time-consuming procedures and develop strategies to perform them efficiently.
  3. During practice sessions, simulate time constraints to enhance your ability to work under pressure.


The OSCE can be a challenging assessment for nursing students, but understanding the common reasons for failure can help individuals prepare more effectively. By addressing the areas of inadequate preparation, communication breakdowns, clinical decision-making challenges, and time management issues, nurses can increase their chances of success in the OSCE. Remember, consistent practice, seeking guidance, and embracing opportunities for improvement are key to overcoming these challenges and becoming a competent and confident nurse.