Common Reasons Candidates Fail the APIE Stations in the NMC OSCE in 2025

The NMC OSCE (Objective Structured Clinical Examination) is a critical step for international nurses and midwives looking to join the UK register. Among its most essential components are the APIE stations in the NMC OSCE—Assessment, Planning, Implementation, and Evaluation. Unfortunately, these are also where many candidates struggle. After reviewing multiple candidate feedback, we have identified the most common reasons for failure in the APIE stations.

Despite being foundational to nursing care, many candidates find these stations difficult to pass. In this blog, we will explore these common pitfalls and help you avoid them, ensuring your success.

1. Incomplete or Inaccurate Assessment – A Key APIE Stations Failure

One of the top reasons candidates fail the Assessment Station is that they miss key components of A-E elements. Whether it is a failure to complete the A-E (Airway, Breathing, Circulation, Disability, Exposure) assessment, not accurately recording vital signs, or miscalculating the NEWS2 score, any miss can be considered an error.

Common Mistakes:

• Miss to document any vital value correctly (e.g., temperature or respiratory rate)
• Failed to document Total score, monitoring frequency, and escalation appropriately
• Partially completed A-E assessment
• Forgetting to consider the ID and allergy check
• Failed to wait full one minute each while observing Heart Rate and Respiration rate.
• Failed to address the holistic assessment for the patient
• Time management is crucial; miss completing the station and documentation accurately within 20 minutes.

Tips:

• Always follow the structured A-E approach.
• Double-check the NEWS2 score and know when to escalate.
• Record findings clearly and legibly on the assessment chart.
  

2. Poor Care Planning

In the Planning Station, candidates are required to create two nursing care plans based on identified problems. Unfortunately, many candidates choose an irrelevant nursing problem.

Common Mistakes:

• Failed to document monitoring frequency as per the requirement, Ex. In the immediate post-op scenario, ensure to document the immediate post-op monitoring frequency.
• Failed to identify the appropriate nursing problem as per the patient’s requirement
• Failed to document appropriate intervention for patient care.

Tips:

• Select nursing problems as per the patient’s requirement, such as pain, risk of infection, or shortness of breath etc.
• Ensure the aim is realistic, measurable, and achievable in the given time frame.
• Document relevant interventions to achieve the aim.
• Practice with a timer to achieve time management

3. Unsafe or Incorrect Implementation

The Implementation station focuses mainly on the safe administration of medication, a skill that demands accuracy, safe administration, and accurate documentation. This is often considered a “high-risk” station—errors here can result in immediate failure.

Common Mistakes:

• Not checking for patient ID and allergies twice
• Skipping validating part of the prescription, such as the prescriber’s details, pharmacy check, etc.
• Incorrect drug preparation or incorrect dose
• Failing to verbalize indications and side effects
• Fail to document accurately

Tips:

• Always confirm: right patient, right medication, right dose, right route, right time, and right documentation.
• Identify the correct due medications as per the due time.
• Check allergy, overdose, and safe administration of the medications.
• Communicate indications and side effects of all medications before administering.
• Ensure to follow accurate documentation
• Ensure to complete the administration with documentation within 15 minutes.

4. Partial handover during Evaluation

Evaluation is your opportunity to demonstrate critical thinking by summarizing the care delivered and planning for ongoing needs. Here, follow the SBAR handover format while handing over patient details.

Common Mistakes:

• Missed to mention important details such as allergy status, regular medications, pain status, etc.
• Failed to provide an appropriate recommendation as per the patient’s requirement

Tips:

• Use SBAR (Situation, Background, Assessment, Recommendation) while handing over.
• Clearly state what was done, how the patient responded, and what recommendations are suggested next.
• Complete handover within 8minutes using SBAR format

5. Lack of Confidence and Poor Communication Skills

Although clinical knowledge is critical, poor communication can also be a reason for failure, especially when it impacts patient safety.

Common Mistakes:

• Not introducing yourself or gaining consent
• Using medical equipment inappropriately
• Fail to provide patient-centric care

Tips:

• Start station by introducing yourself, confirming the patient’s identity (where required), and gaining consent.
• Speak clearly and verbalise each action you are performing.
• Remain calm and professional throughout the procedure.

The APIE stations are a core component of the NMC OSCE. Understanding why candidates fail—whether it’s due to incomplete assessments, weak planning, unsafe administration or documentation, or Incomplete handover—can help you prepare more effectively.

If you are preparing for the NMC OSCE and feel unsure about the APIE stations, consider enrolling in the Mentor Merlin focused training program. Mock exams, on-site practice, and online preparation support can make a significant difference.

Passing the OSCE isn’t just about knowledge; it’s about applying that knowledge safely and confidently. With structured preparation, regular practice, and a focus on patient-centred care, success is well within reach.

Want to avoid APIE stations failures in NMC OSCE? Join our intensive Mentor Merlin prep class today.

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