Sit the four APIE stations in sequence

Four of the ten OSCE stations are one patient. You assess them, you plan their care, you carry the plan out and you evaluate it, in that order, and the NMC's candidate booklet is explicit that the four scenario stations relate to the four stages of the nursing care process. Practising one at a time teaches you that stage. What it does not teach you is the thing candidates find hardest, which is arriving at the planning station carrying what you found in the assessment and having to use it.

So you can now sit all four in sequence. A sitting opens at the assessment station and the next one unlocks when you have finished the one before it. You cannot jump ahead to whichever stage you feel strongest at, because on the day you will not be able to either.

Each station is passed or failed on its own, and a sitting is passed only when every station in it is passed. That is the NMC's rule rather than a threshold we chose, so three out of four is a fail with three stations banked, and you will not find it written as a percentage anywhere in the report. A percentage would be inventing a mark the exam does not give.

A sitting is paid for when it opens, one credit for each station, rather than a credit at a time as you reach them. That sounds less generous than it is. Charging as you went would let somebody begin a rehearsal that only means anything whole and then be stopped two stations into it, so if there are not enough credits on the account you are told at the door instead.

There are forty-eight stations to draw on now. Adult nursing has seven different patients to work through, and mental health, learning disabilities and children's nursing have one each, with both written station types in every field.

The other change is about time, and it came from a message somebody sent us saying they had quit, come back an hour later and found the station had ended. That was our fault. The clock now counts time spent in front of the station rather than time passing on the wall, so closing the tab, losing your connection or being called away pauses it, and the station is waiting where you left it with the time you had left. The exit button offers two things on purpose, saving and coming back, and leaving for good, because those are genuinely different and an attempt has to be closeable. Handing in asks you to confirm too, and tells you how many cells of the observation chart are still blank, since a blank cell is marked wrong and it is an easy thing to miss on a phone.

The limits are the same as they have always been and worth repeating. This covers six of the ten station types, the four scenario stations and the two written ones. The four skills stations are performed on manikins and equipment and are not simulated here at all. The verdict is a simulated one, marked against our own criteria, and it is not a prediction of how an NMC assessor would mark you. What it is good for is the rehearsal itself, the four stages in order, with a patient who will not tell you what to ask.