A Must-Read Guide for Internationally Qualified Nurses and Midwives Going to Australia 

The OSCE (Objective Structured Clinical Examination) can feel like walking a tightrope — one wrong step and you could lose crucial marks. For internationally qualified nurses and midwives (IQNMs) pursuing registration in Australia, knowing what not to do can be just as important as knowing what to do.

This exam is designed to test your real-world clinical skills, communication, critical thinking, and cultural safety. Many brilliant candidates fall short, not because they don’t have the knowledge — but because they make avoidable mistakes under pressure.

Here are the top 10 common OSCE mistakes — and how you can steer clear of them for a confident, competent performance.

1.  Skipping or Improper Hand Hygiene

The mistake: Forgetting to perform hand hygiene at the correct moments, or doing it too quickly and superficially.

Why it matters: Hand hygiene is a non-negotiable part of Australian clinical practice and a critical safety measure.

How to avoid it:

• Perform hand hygiene at the beginning, before and after procedures, after contact with a patient or environment, and when exiting the station.

• Use visible technique: show hand rub steps if using a sanitiser.

• Say it aloud if it’s not practical to physically demonstrate.

 Tip: Start each station by saying, “I’m performing hand hygiene” and mimic the action properly.

2.  Forgetting to Introduce Yourself and Gain Consent

The mistake: Jumping straight into the task without a proper greeting, role identification, or consent.

Why it matters: It violates patient autonomy, which is a fundamental aspect of person-centred care in Australia.

How to avoid it:

• Start every station with:
  “Hello, my name is ____. I’m your nurse today. May I confirm your name and date of birth? Is it alright if I assist you today?”

  Tip: Treat the simulated patient as real. Your respect and communication will count for more than perfection.

3.  Not Maintaining Patient Privacy and Dignity

The mistake: Leaving the patient exposed, not closing the curtain, or speaking about sensitive matters loudly.

Why it matters: Australia strongly values dignity, respect, and confidentiality.

How to avoid it:

• Close imaginary curtains and say it out loud: “I’m closing the curtain for privacy.”

• Offer a blanket or gown where appropriate.

• Speak softly and respectfully, even if you’re being timed.

  Tip: If unsure, always ask: “Would you like some privacy before we continue?”

4.  Incomplete Aseptic or Infection Control Technique

The mistake: Touching sterile items with bare hands, failing to dispose of sharps correctly, or missing PPE.

Why it matters: It signals a lack of clinical safety, which is a major fail point.

How to avoid it:

• Know your aseptic non-touch technique (ANTT).

• Verbalise what you’re doing: “I’m using a non-touch technique to maintain sterility.”

• Follow the 5 Moments of Hand Hygiene and donning/doffing PPE steps correctly.

  Tip: Practice procedures like wound care and injections with full PPE and waste disposal every time.

5.  Rushing and Missing Safety Checks

The mistake: Skipping ID checks, allergy checks, or giving medications without cross-checking orders.

Why it matters: These are life-saving safety measures — missing them is a major red flag.

How to avoid it:

• Always check 3 patient identifiers: name, DOB, ID band.

• Ask about allergies out loud — even if it seems obvious.

• Read medication charts carefully and verbalise your checks.

  Tip: Use the 6 Rights of Medication Administration as your mantra: right patient, medication, dose, route, time, and documentation.

6.  Poor Time Management

The mistake: Spending too long on one part of the task, then rushing or missing key steps.

Why it matters: OSCE stations are time-bound, and every second counts. Not managing your time can lead to incomplete assessments, missed safety steps, or unfinished documentation.

OSCE Station Timing:

•  Registered Nurses (RN): 8 minutes of performance time + 2 minutes reading time

•  Registered Midwives (RM): 10 minutes of performance time + 2 minutes reading time

How to avoid it:

• Practice scenarios using a timer — simulate real exam conditions.

• Break down your task:

  • First minute: Introduction, identity check, consent

  • Next 5–7 minutes (RN) or 7–9 minutes (RM): Focused assessment or procedure

  • Final minute: Summarise care, document or explain next steps

  Tip: If you realise you’re running out of time, verbalise your clinical intent (e.g., “I would now reassess vital signs and report to the nurse-in-charge”) to show safe thinking, even if you don’t finish every step.

7.  Lack of Verbalisation

The mistake: Doing tasks silently or not explaining your rationale when needed.

Why it matters: Assessors can’t give you credit for skills they don’t see or hear.

How to avoid it:

• Say what you’re doing and why, especially if it’s a mental or safety step.

• Talk to the patient — not just the assessor.

  Example: “I’m checking for signs of inflammation — redness, warmth, swelling — around the wound.”

8.  Missing Documentation

The mistake: Forgetting to chart medications, observations, or care provided.

Why it matters: Incomplete documentation equals incomplete patient care.

How to avoid it:

• Practice common charting formats (e.g., medication charts, fluid balance, vital signs).

• Use clear, legible writing if it’s a paper station.

• If no chart is provided, verbalise what you would document and where.

  Tip: End each station with: “I would document this in the patient’s record as per hospital protocol.”

9.  Failing to Escalate or Handover Appropriately

The mistake: Handling a critical situation alone without informing a senior or handing over care safely.

Why it matters: Australia promotes team-based care and early escalation of deterioration.

How to avoid it:

• Use the ISBAR format (Introduction, Situation, Background, Assessment, Recommendation) for handover.

• Say clearly: “I would escalate this to the nurse-in-charge or the medical team.”

  Example: “The patient’s blood pressure is 80/40. I will escalate to the doctor immediately and continue monitoring.”

10.  Letting Anxiety Take Over

The mistake: Freezing, forgetting your sequence, or apologising too much.

Why it matters: OSCE is about safe practice, not perfection.

How to avoid it:

• Practice deep breathing before each station.

• Use mental scripts and mnemonics to stay on track.

• If you forget something, recover gracefully and continue.

  Tip: Instead of panicking, say, “Let me pause to ensure I’m following the safest procedure” — then move on.

 Final Thoughts

Mistakes happen. What matters most is how you prepare for them — and how you recover when they do.

The Australian OSCE doesn’t expect perfection. It expects safe, compassionate, and competent care delivered with integrity and respect. If you can keep these values front and centre, you’re already on the right track.

Want extra help avoiding these mistakes?

 Join our OSCE Prep Program for mock exams, live coaching, and real-time feedback from Australian Nurse Educators.

Let us help you pass your OSCE the first time — and start your nursing journey in Australia with confidence.