Registered Nurse Objective Structured Clinical Examination (NMC OSCE) Communication, Values and Professional Practice Syllabus

What does SBAR stand for and what is it used for?

Situation, Background, Assessment, Recommendation — a structured communication tool for clear, concise handover and escalation of concerns between healthcare professionals.

In SBAR, what information goes in the 'Situation' section?

Your name and role, the patient's name/location, and a concise statement of the immediate problem or reason for the communication.

In SBAR, what does the 'Background' section contain?

Relevant clinical history and context: admission reason, diagnosis, current treatments, allergies, recent observations and relevant results.

In SBAR, what does the 'Assessment' section contain?

Your professional assessment of the problem — current vital signs/observations (e.g. NEWS2 score), what you think is going on, and the severity.

In SBAR, what does the 'Recommendation' section contain?

What you want to happen and by when — a clear request or action (e.g. 'I need you to review the patient within 30 minutes'), and clarifying expectations.

What is NEWS2 and how does it relate to escalation?

The National Early Warning Score 2 aggregates six physiological parameters (respiratory rate, oxygen saturation, any supplemental oxygen, temperature, systolic blood pressure, pulse, consciousness/AVPU) into a score that triggers graded clinical escalation; a score of $\geq 7$ indicates a high risk requiring urgent response.

What is a clinical 'handover' and why is structured handover important?

Handover is the transfer of professional responsibility and accountability for some or all aspects of care of a patient to another person or team. Structure (e.g. SBAR) reduces omissions and communication errors, a leading cause of patient harm.

What are the '6 Cs' of nursing introduced in Compassion in Practice (2012)?

Care, Compassion, Competence, Communication, Courage, and Commitment.

In the 6 Cs, what is meant by 'Compassion'?

Delivering care through relationships based on empathy, respect and dignity — sometimes described as 'intelligent kindness' — central to how care is perceived by patients.

In the 6 Cs, what is meant by 'Competence'?

Having the knowledge, clinical and technical skills, and ability to understand an individual's health and social needs and to deliver evidence-based care effectively.

In the 6 Cs, what is meant by 'Courage'?

Doing the right thing for the people we care for, speaking up when there are concerns, and having the personal strength and vision to innovate and embrace new ways of working.

What is meant by 'dignity' in patient care?

Treating people as valued individuals, respecting their privacy, autonomy and worth, maintaining modesty, listening to their wishes, and never demeaning or humiliating them.

Give practical examples of preserving a patient's privacy and dignity during care.

Closing curtains/doors, keeping the patient covered, gaining consent before procedures, knocking before entering, using gowns/blankets, lowering your voice for confidential information, and offering same-sex care where appropriate.

Define person-centred care.

Care that is responsive to the individual's preferences, needs and values, treating people as partners, sharing decisions, respecting autonomy, and seeing the whole person rather than just a condition.

What are the four principles of person-centred care (Health Foundation)?

Care is: (1) personalised, (2) coordinated, (3) enabling, and (4) treats people with dignity, compassion and respect.

What is culturally sensitive (culturally competent) care?

Care that recognises and respects patients' cultural, religious and spiritual beliefs and practices — e.g. dietary needs, modesty, gender preferences, religious observances — without stereotyping, and adapts care accordingly.

What are the nine protected characteristics under the Equality Act 2010?

Age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation.

Define a 'health inequality'.

An unfair and avoidable difference in health status or access to/quality of healthcare between groups of people, often linked to social, economic, geographic or demographic factors (social determinants of health).

What is the difference between equality and equity in healthcare?

Equality means treating everyone the same (giving the same resources); equity means giving each person what they need to achieve the same outcome, accounting for differing starting points and needs.

What are the four sections/themes of the NMC Code (2015, updated 2018)?

Prioritise people, Practise effectively, Preserve safety, and Promote professionalism and trust.

Under 'Prioritise people' in the NMC Code, what core duties apply?

Treat people as individuals and uphold dignity, listen and respond to their needs and preferences, make sure their physical/social/psychological needs are met, act in their best interests, and respect their right to privacy and confidentiality.

Under 'Practise effectively' in the NMC Code, what core duties apply?

Always practise in line with the best available evidence, communicate clearly, work cooperatively, share skills and experience, keep accurate clear records, and be accountable for your decisions and delegation.

Under 'Preserve safety' in the NMC Code, what core duties apply?

Recognise and work within the limits of your competence, raise concerns immediately if safety is at risk, act without delay if there is risk of harm, be open and candid (duty of candour), and have appropriate indemnity arrangements.

Under 'Promote professionalism and trust' in the NMC Code, what core duties apply?

Uphold the reputation of the profession, act with honesty and integrity, uphold professional boundaries, refuse gifts/favours that could be seen as an inducement, and be a model of integrity and leadership.

What is meant by a nurse's 'scope of practice'?

The range of activities a nurse is educated, competent and authorised to perform. Nurses must recognise and work within the limits of their competence and only undertake tasks for which they have the necessary knowledge and skills.

Define delegation in nursing and state who remains accountable.

Delegation is the transfer of a task (but not overall accountability) to a competent person. The registered nurse who delegates remains accountable for the appropriateness of the delegation and for ensuring the person is competent and adequately supervised.

What are 'The Five Rights of Delegation'?

The right task, the right circumstance, the right person, the right direction/communication, and the right supervision/feedback.

What is the professional Duty of Candour?

The professional and statutory duty to be open and honest with patients (and, where appropriate, families) when something goes wrong that causes, or could cause, harm or distress — including telling them, apologising, putting things right where possible, and explaining the effects.

What is the difference between professional and statutory duty of candour?

The professional duty (NMC/GMC) applies to all individual registrants for any harm or near-miss; the statutory duty (Health and Social Care Act 2008, Regulation 20, CQC-enforced) applies to organisations and is triggered by defined 'notifiable safety incidents' causing moderate/severe harm or death.

What is reflective practice and name a common model used in nursing.

Reflective practice is the structured review of an experience to learn and improve future practice. Common models include Gibbs' Reflective Cycle, Kolb's learning cycle, Schon (reflection-in/on-action), and Driscoll's 'What? So what? Now what?'.

What are the requirements for NMC revalidation, and how often must it be done?

Every three years nurses must demonstrate: 450 practice hours (or 900 if dual-registered), 35 hours CPD (20 participatory), five pieces of practice-related feedback, five written reflective accounts, a reflective discussion, health and character declaration, professional indemnity, and confirmation from a confirmer.