HLT54121 Diploma of Nursing – Objective Structured Clinical Examination (OSCE)

Assessment 2A: Adult Vital Signs and Focused Neurological Assessment Station (2026)

1. Course and Assessment Metadata

Qualification: HLT54121 Diploma of Nursing (Australian TAFE / RTO)

Assessment label: Assessment 2A – Objective Structured Clinical Examination (OSCE) Station

Assessment type: Practical skills OSCE – simulated clinical station with structured checklist and global rating

Focus: Adult vital signs, focused neurological assessment, communication, infection prevention, documentation, and escalation

Study period and timing: Study Period 1, Week 6–7; OSCE duration 10–12 minutes per student, plus 3 minutes reading time

Weighting: 20% of unit grade; hurdle requirement (must achieve Satisfactory)

Mode: Individual, conducted in a simulation or skills laboratory using a standardised patient or manikin

2. Assessment Overview and Rationale

Objective Structured Clinical Examinations are standard in HLT54121 and university pre-registration nursing programs to assess whether students can demonstrate safe, coordinated performance of core clinical skills under time pressure. This OSCE station reflects common Australian and UK OSCE formats by using a detailed checklist that evaluates preparation, patient identification, consent, infection prevention, systematic assessment, interpretation of findings, documentation accuracy, and structured verbal handover.

You are required to perform a full set of adult vital signs and a focused neurological assessment for a patient with possible deterioration. You must interpret key findings, document accurately on an observation chart, and deliver a concise verbal report to the Registered Nurse while maintaining professional, person-centred communication throughout.

3. Station Scenario (OSCE 2A)

Clinical context:
You are an Enrolled Nurse student on a medical ward caring for Mr Samir Khan, a 67-year-old man admitted with a suspected transient ischaemic attack. He has a history of hypertension and atrial fibrillation and was stable earlier in the shift.

Task prompt (as displayed on the station card):

• Perform hand hygiene and introduce yourself.

• Correctly identify the patient using three identifiers and obtain consent for assessment.

• Perform a full set of vital signs: respiratory rate, heart rate, blood pressure, oxygen saturation, temperature, and blood glucose level if indicated.

• Conduct a focused neurological assessment appropriate to a ward setting, including level of consciousness, orientation, pupils, limb strength, and speech.

• Interpret whether findings are within normal range for this patient and identify any signs of deterioration.

• Document results on the observation chart and provide a brief ISBAR verbal handover to the Registered Nurse, including concerns and recommended actions.

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4. Student-Facing Instructions

4.1 Preparation Before OSCE Day

• Review all vital signs and neurological assessment skills checklists provided in the LMS.

• Practise the complete sequence until you can perform it safely without prompts, including equipment preparation, communication, documentation, and handover.

• Revise normal and abnormal vital sign ranges for older adults and common neurological red flags such as sudden confusion, unilateral weakness, facial droop, or slurred speech.

• Review your organisation’s escalation protocol, including criteria for clinical review or rapid response activation.

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4.2 What You Must Do at the Station

You will have 3 minutes reading time and 10–12 minutes performance time. The assessor will use a structured OSCE checklist aligned with skills practised in class.

1. Preparation and Safety

• Perform hand hygiene.

• Assess environmental safety.

• Gather and check required equipment, including stethoscope, blood pressure device, thermometer, pulse oximeter, watch, BGL meter if required, observation chart, and pen.

2. Patient Identification and Consent

• Introduce yourself and clarify your student role.

• Use three identifiers such as full name, date of birth, and UR number.

• Check the ID band against the chart.

• Explain the procedure clearly and obtain verbal consent.

• Ensure privacy, comfort, and cultural sensitivity.

3. Infection Prevention

• Apply standard precautions including appropriate hand hygiene and personal protective equipment.

• Clean equipment before and after use as required.

4. Vital Signs Assessment

• Measure respiratory rate, heart rate, blood pressure, oxygen saturation, and temperature using correct technique and logical sequence.

• Identify abnormal readings based on clinical context and age-related norms.

• Recognise trends or concerning values rather than recording numbers without interpretation.

5. Focused Neurological Assessment

• Assess level of consciousness and orientation to person, place, time, and situation.

• Check pupil size and reactivity using a penlight.

• Assess upper and lower limb strength and equality.

• Listen for speech abnormalities and observe for facial asymmetry.

• Identify and verbalise any findings consistent with neurological deterioration.

6. Interpretation and Immediate Response

• State whether findings are within normal range or suggest deterioration.

• Identify at least one appropriate immediate nursing action within EN scope, such as ensuring safe positioning, rechecking abnormal observations, or escalating concerns promptly.

7. Documentation

• Accurately document all observations on the observation chart, including date, time, and initials.

• Ensure entries are legible, complete, and professionally formatted.

8. Verbal Handover to Registered Nurse

• Provide a concise ISBAR-structured handover including patient identification, situation, assessment findings, level of concern, and recommended actions.

• Respond professionally to clarification questions from the assessor.

9. Closure

• Reassure the patient.

• Ensure safety measures such as bed positioning and call bell access.

• Perform final hand hygiene.

5. OSCE Marking Rubric / Checklist

Satisfactory / Unsatisfactory

You must achieve Satisfactory on all essential criteria and at least 80 percent of total checklist items to pass this station.

Global rating: Clear Pass / Borderline Pass / Borderline Fail / Clear Fail

6. Academic Integrity and Resit Policy

• OSCE performance must be your own work; coaching during the station is not permitted.

• Failure to achieve Satisfactory in any essential criterion results in an overall Unsatisfactory grade for the station.

• A resit may be offered after remediation in accordance with institutional policy.

• Repeated Unsatisfactory performance may affect progression in the program.

7.

A high-performing student enters the station with all required equipment prepared, performs hand hygiene without prompting, and introduces themselves clearly while checking three patient identifiers against the chart. Vital signs are obtained in a logical sequence using correct technique. The student recognises elevated blood pressure, increased respiratory rate, and slightly slurred speech, linking these findings to potential neurological deterioration rather than documenting values in isolation. Observations are recorded accurately and legibly, and the student provides a structured ISBAR handover to the Registered Nurse, clearly communicating concern and recommending urgent review.

8.

Clinical skill performance in OSCE environments requires the integration of psychomotor competence, situational awareness, and structured clinical reasoning. Students must not only perform technical tasks accurately but also interpret findings within the broader context of patient safety and risk recognition. Research on recognition of patient deterioration demonstrates that early identification of abnormal physiological cues and timely escalation significantly influence clinical outcomes (Massey, Chaboyer and Anderson, 2017). Embedding structured assessment and communication frameworks such as ISBAR into OSCE preparation supports the development of safe clinical habits that transfer to real-world practice settings.

9.  References

• Levett-Jones T, Hoffman K, Dempsey J et al. (2019) The five rights of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically at-risk patients. Nurse Education Today, 79, 35–40.

• Bickley L S (2021) Bates’ Guide to Physical Examination and History Taking. 13th edn. Philadelphia: Wolters Kluwer.

• Massey D, Chaboyer W, Anderson V (2017) What factors influence ward nurses’ recognition of and response to patient deterioration? An integrative review of the literature. Journal of Advanced Nursing, 73(1), 100–118.

• Nursing and Midwifery Council (2018) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates. London: NMC.

• Australian Commission on Safety and Quality in Health Care (2021) National Safety and Quality Health Service Standards (2nd edn). Sydney: ACSQHC.

• Considine J, Jones D and Pilcher D (2021) Patient deterioration and rapid response systems: A review of outcomes and safety implications. Australian Critical Care, 34(1), 90–97.