Test of competence 2021

Midwifery
OSCE information booklet

V1.5

ToC 2021 Midwifery OSCE information booklet V1.5 1

Page
Contents

SECTION 1: Before the objective structured clinical examination (OSCE) ...................................... 4

1. Introduction........................................................................................................................ 4
2. General information about the competence test centres ................................................... 5
3. What is the UK like? .......................................................................................................... 6
4. Becoming familiar with midwifery practice in the UK ......................................................... 6
5. Applying for OSCE Part 2 .................................................................................................. 6
6. How do I prepare for the OSCE?....................................................................................... 7
7. Overview of the OSCE ...................................................................................................... 7
8. Evidence base for midwifery practice ................................................................................ 8
9. What will I be tested on? ................................................................................................... 8
10. Communication skills ..................................................................................................... 9
SECTION 2: The OSCE day .......................................................................................................... 11
11. General information about the competence test centre................................................ 11
12. Fitness to undertake the OSCE.................................................................................... 11
13. Fire alarm ..................................................................................................................... 12
14. Identification ................................................................................................................. 12
15. What can I expect in the OSCE?.................................................................................. 13
16. How should I dress?..................................................................................................... 13
17. What conduct is expected during the OSCE? .............................................................. 14
18. Competence test centre rules and regulations ............................................................. 14
19. Confidentiality............................................................................................................... 15
20. Taking the OSCE ......................................................................................................... 15
21. Grounds for dismissal or cancellation of OSCE results ................................................ 15
22. How is the OSCE assessed? ....................................................................................... 15
23. The passing standard................................................................................................... 16
24. Can I have my OSCE remarked? ................................................................................. 16
25. Unsafe practice and cessation of assessment ............................................................. 16
26. How do I get the results of the OSCE? ........................................................................ 16
27. What will the feedback look like? ................................................................................. 17
28. What are the potential results?..................................................................................... 17
29. What happens if I pass? ............................................................................................... 17
30. Can I have more than one attempt at the OSCE? ........................................................ 17
SECTION 3: Candidate guidance .................................................................................................. 19
31. Can I appeal my result? ............................................................................................... 19
32. What is a complaint and how can I make one? ............................................................ 19
33. Fitness to practise during the OSCE ............................................................................ 19
34. What happens if I am unable to attend the OSCE because of sudden illness or
circumstances beyond my control? ....................................................................................... 19
35. When can you apply for mitigating circumstances to be considered? .......................... 20
36. How will the OSCE be affected if I am pregnant or breastfeeding a young baby? ....... 20
37. I have a disability. Can the competence test centre accommodate my needs? ........... 20
SECTION 4: Annexes .................................................................................................................... 22
Annexe 1: Mitigating circumstances guide and form ...................................................................... 23
Mitigating circumstances guide.............................................................................................. 23
Mitigating circumstances form ............................................................................................... 24

ToC 2021 Midwifery OSCE information booklet V1.5 2

Annexe 2: Appeal process guide and form .................................................................................... 26
Appeal form – Level 1............................................................................................................ 29
Annexe 3: Complaint process guide and form ............................................................................... 30
Candidate complaint guide .................................................................................................... 28
Complaint form – Level 1 ....................................................................................................... 30
Annexe 4: Pregnant candidate checklist, risk assessment and support plan and guidance .......... 32
New and expectant mothers .................................................................................................. 32
New and expectant mothers’ guidance.................................................................................. 37

ToC 2021 Midwifery OSCE information booklet V1.5 3

SECTION 1: Before the objective structured clinical examination
(OSCE)
1. Introduction

We use the Test of Competence (ToC) to assess the skills and knowledge of people wanting to join
our register from overseas or rejoin our register after a long period away from practice. A new
version of the test was introduced in 2021. The test of competence measures candidates against
the current UK pre-registration standards for midwifery 1. In the UK, midwifery is a separate and
distinct profession from nursing, requiring three years of pre-registration undergraduate
education.

This booklet provides information about Part 2 of the test of competence, which is an objective
structured clinical examination (an OSCE). The blueprints and the test specifications are available
on the NMC website 2. The university learning platforms at the test centres also contain links to
online resources, which will help candidates to prepare for the test of competence.

There are currently three NMC competence test centres in the UK: Oxford Brookes University,
Ulster University and the University of Northampton. To quality-assure OSCEs across all three and
for moderation purposes, it will be necessary for the centres to share OSCE data, including
paperwork and video data associated with a candidate's examination. Data will also be shared with
the test design partner for quality assurance purposes. All information is shared securely. By
submitting your application, you are confirming that you have read and understood this
information.

1 [Link]
2 [Link]

ToC 2021 Midwifery OSCE information booklet V1.5 4

 2. General information about the competence test centres
Please allow plenty of time to travel to the competence test centre. Bear in mind that rush-hour traffic
often causes delays. If you arrive late, you might not be able to take the OSCE.

University Contact details Location details

Oxford Brookes Oxford Brookes comprises two sites:

University
ctc@[Link] • Oxford
01865 488 418 • Swindon

You can find out more about how to

get to both sites on the travel
webpage 3.

Ulster University – Magee You can find out more about how to get
ctc@[Link] to Ulster University – Magee campus on
02871 675 150 the location webpage 4.

University of You can find out more about how to

Northampton get to the innovation centre at the
ctc@[Link] University of Northampton on the
01604 892 066 website 5.

3
[Link]
centre/locations/
4
[Link]
5 [Link]

5
ToC 2021 Midwifery OSCE information booklet V1.5 5
 3. What is the UK like?
The UK is a multicultural, multi-faith society where all people must have their culture, faith and
human rights respected by all healthcare professionals. Furthermore, all people must be treated
equally and not be subject to discrimination based on disability, ethnicity, religion, gender or sexual
orientation, in accordance with the Equality Act 2010 6.

The UK may be very different from the last country you practised in, and you should spend time
finding out about the population, health and social care, and other aspects of life. Your test will be
related to current practice in the UK.

4. Becoming familiar with midwifery practice in the UK

You must familiarise yourself with the ethical and professional standards expected of registered
midwives, as outlined in NMC (2018) ‘The Code’ 7. These are the required standards, which underpin
professional midwifery practice.

All healthcare professionals must work in partnership with women, obtaining their consent and
respecting their dignity and privacy. It is unacceptable for your words or actions to imply or express
disapproval of any woman’s lifestyle. You must not discriminate in any way against those in your
care. The public expects high standards of professional practice from midwives.

Midwives work in partnership with other healthcare professionals. Midwives are expected both to
contribute and to lead in areas of care where they have expertise. Many organisations are recruiting
midwives, using ‘the 6 Cs’ – care, compassion, competence, communication, courage and
commitment – and you should be familiar with these and be able to demonstrate them throughout
Part 2 of the test of competence (the OSCE).

5. Applying for OSCE Part 2

Part 2 is a midwifery objective structured clinical examination (OSCE). The Part 1 computer-based
test (CBT) and the Part 2 OSCE can be taken in either order, but the majority of candidates take the
CBT in their home country before travelling to the UK and taking the OSCE.

Please note: Only the NMC can authorise you to undertake Part 2 the OSCE.

Once your qualification has been confirmed to meet the requirements for registration and you have
reached the application preparation stage on your application, you will receive a Test of Competence
invitation email from NMC confirming your eligibility to sit the CBT and the OSCE. You will be able to
contact one of the OSCE test centres to book your OSCE – part 2.

If you have a disability requiring any reasonable adjustments, please notify the competence test centre
separately, after booking your OSCE. You may be entitled to extra time at the stations if you have
learning support needs. Evidence from professional reports must be provided at the time of booking,
to verify the learning support needs adjustments prior to undertaking the OSCE. The academic
lead/manager and the appropriate wellbeing and occupational health team at the university will review
the report and provide advice on an individual basis. Further information can be found in Annexe 1.

6 [Link]
7 [Link]

ToC 2021 Midwifery OSCE information booklet V1.5 6

 6. How do I prepare for the OSCE?
The OSCE is designed to assess your ability to competently apply your professional midwifery skills
and knowledge in the UK. It is set at the level expected of midwives as they enter the profession at
the point of registration. This means that you must demonstrate that you are capable of applying
knowledge to the care of women at the level expected of a newly registered midwife.

The examination is testing your ability to apply knowledge and skills to the care of women, rather
than testing how well you can remember and recite facts. All scenarios and associated questions
relate to current best practice, and you should answer them in relation to published evidence. Please
refer to the reading lists, which contain references for each OSCE station.

Support materials are available on the competence test centre learning platforms, and you will be
given access prior to taking the OSCE. Here are the learning platforms used at each centre:

• Oxford Brookes – Moodle

• Ulster University – Blackboard Learn
• University of Northampton – NILE

On the online learning platforms, there is a set of preparation materials available for midwifery
practice. These include:

• mock OSCE
• reading lists
• marking criteria
• ‘Preparing for your OSCE’ handbook.

There are examples of the documentation, including observation charts, relating to the field of
practice for which you are being examined included in the mock OSCEs, as well as background
reading, useful information and links.

You are advised to access the following required materials to begin your preparation:
• NMC (2018) ‘The Code’: [Link]

• The NMC blueprints and test specifications: [Link]

register/toc/toc-2021/resources/

Please note: We have become aware that some organisations and consultancies are offering OSCE
preparation training sessions for candidates for Part 2 of the test of competence. Please be aware
that by attending these courses offered by third parties, you do so at your own risk. These training
sessions are not endorsed or approved by either the competence test centres or the NMC, and they
could prepare you inaccurately for the examination.

7. Overview of the OSCE

Your ability to apply your knowledge is tested in Part 1 of the NMC test of competence. In Part 2, you
will be tested on your clinical and communication skills. In other words, you will demonstrate how you
apply holistic woman-centred midwifery care and how you apply key clinical skills.
ToC 2021 Midwifery OSCE information booklet V1.5 7
 Everything you see in the OSCE is as set out in the blueprints and the test specification on the NMC
webpage 8. These set out the scope and content of the examination in terms of the topics, skills and
procedures that a newly registered midwife would need to know and be able to do.

For example, if a scenario involves a vulnerable woman or child with a non-accidental injury,
candidates would be expected to know that the person or child may need to be removed from those
suspected of causing the injury. Candidates would be expected to know how to raise concerns, know
that they should alert the relevant safeguarding team, and be able to share information appropriately
within and across care teams. We do not expect candidates to have detailed information about
procedures or policies that are specific to certain NHS trusts. We cannot test everything, but we will
test typical midwifery scenarios and clinical skills that UK midwives will encounter.

8. Evidence base for midwifery practice

You can find evidence-based guidelines in midwifery journals and texts and from professional
organisations’ webpages, such as the Royal College of Midwives 9. The National Institute for Health
and Care Excellence 10 and Scottish Intercollegiate Guidelines Network 11 are also useful sources. A
reading list is provided giving links to the evidence base for each skills station.

9. What will I be tested on?

The OSCE comprises 10 stations, with a total testing time of about 3 hours. Four stations will be
scenario-based and will relate to four stages of the midwifery care process:

• Assessment
• Planning
• Implementation
• Evaluation.

Four of the six remaining stations will take the form of two sets of two linked stations, testing
practical clinical skills. Each pairing of skills stations will last for up to 30 minutes in total, with 4
minutes in between the pairings.

Please remember that you will have done many of these midwifery skills several times before. Make
sure that you read the station instructions and scenarios carefully. Do not be afraid to take the
opportunity to look at them again if you are unsure. You will not be penalised for this.

Typical skills that may be tested either on their own or within a midwifery scenario include:

• auscultation of foetal heart

• newborn examination
• palpation
• calculating drug dosages
• hand hygiene

8 [Link]
9 [Link]
10 [Link]
11 [Link]

ToC 2021 Midwifery OSCE information booklet V1.5 8

 • medication administration
• physiological observations
• safe disposal of sharps.

In each OSCE, one station will specifically assess professional issues associated with professional
accountability and the related skills around communication. One station will also specifically assess
critical appraisal of research and evidence and associated decision-making. These two stations are
both written stations.

10. Communication skills

Communication is central to midwifery practice and will be assessed continually during the OSCE.

We assess the full range of communication skills (verbal, non-verbal and written) by observing the
interaction between the candidate and a simulated pregnant woman (this may be an actor or a
manikin) and also by assessing your midwifery documentation in each station.

The assessor will assess your approach to the woman throughout the examination, and will assess
your communication skills such as:

• clearly explaining care, diagnosis, investigations and/or treatments

• involving the woman in decision-making
• communicating with relatives and healthcare professionals
• seeking and obtaining informed consent
• active listening
• dealing appropriately with an anxious woman or anxious relatives
• providing clear instructions on discharge
• providing advice on lifestyle, health promotion or risk factors
• demonstrating compassion and care during communication
• clear documentation that meets the requirements of NMC (2018) ‘The Code’
• professional behaviour
• professional attitude.

You should speak to the woman as you would any person you are meeting for the first time. If you
are being assessed using a manikin, please remember to verbalise your actions, and reasons for
actions, in the same way as you would with a real woman in your care. If you ask the manikin a
question, the assessor will answer accordingly.

A. Approaching the woman/manikin

• Introduce yourself and explain or clarify the purpose of the midwifery encounter.
• Check what the woman wants you to call them.
• Be polite, respectful and non-judgemental, and maintain the woman’s dignity.
• Be empathic, acknowledge the woman’s emotions or concerns, and show sensitivity to any
discomfort.
• Ensure that you gain consent from the woman (or carer/guardian for children or certain
people with disabilities) prior to undertaking any procedures.

ToC 2021 Midwifery OSCE information booklet V1.5 9

 • Be sensitive to personal space, stand or sit at an appropriate distance from the
actor/manikin, and be aware of their body language. You are too close if the actor moves
back or recoils.
• Treat a manikin as you would a real woman.

B. Explaining and advising

• Establish what the woman already knows and/or wants to know.

• Explain clearly what you are going to do and why, so that the woman can understand.
• Remember always to check whether the woman understands or has any questions.
• Offer appropriate reassurance.
• Do not alarm the woman but you must be able to explain the need for urgent action if it is
required.
• Do not routinely oversimplify names for parts of the body. It is reasonable to expect that
most people will know common body names such as ‘bladder’, ‘ovary’, ‘womb’ and ‘vein’.
If you doubt a woman’s understanding, check and alter your communication to meet their
individual needs.
• Treat the manikin as you would a real person.

C. Involving the woman in management

• Respect the woman’s autonomy, and help them to make a decision based on the
available evidence-based information.
• Explain information and its implications so that the woman can make an informed choice
about their care.
• Check the woman’s understanding and feelings about the proposed midwifery
interventions. She may not always agree with your proposed plan of care.
• Treat the manikin as you would a real woman.

D. Midwifery assessment

• You should be able to undertake an accurate midwifery assessment and develop a plan
of care.
• Identify the woman’s midwifery care needs accurately.
• Listen attentively to the woman’s problems and concerns.
• Use clear language, and question at a comfortable pace.
• Clarify and check information, and summarise understanding.
• Be able to plan safe and effective person-centred care, based on your midwifery
assessment and evidence-based best practice.

ToC 2021 Midwifery OSCE information booklet V1.5 10

SECTION 2: The OSCE day
11. General information about the competence test centre
Please allow plenty of time to travel to the competence test centre. Bear in mind that rush-hour traffic
often causes delays. If you arrive late, you might not be able to take the OSCE.

A full refund will be given only if more than 3 weeks’ notice is given of the need to cancel or re-
schedule. The following refund rates apply:

• More than 3 weeks’ notice of cancellation: full refund.

• Fewer than 3 weeks’ notice of cancellation: no refund unless in exceptional circumstances, for
which a medical certificate may be requested.
• No refund will be given for non-attendance or if no prior notice of cancellation is given (within
the stated time above).

When you arrive, you will be asked to put all of the documents for your NMC ID check into a wallet
so that these can be verified whilst you are taking your OSCE. Reception will take your photograph
to accompany your documents so that we can confirm your identity. You will be asked to store all
other belongings in a small locker so please avoid bringing bulky items.

Unfortunately, we do not have room to allow friends or family, including children, to wait for you while
you take the OSCE. Do not bring large suitcases to the assessment centre, as we have no storage
space for anything other than small handbags/rucksacks.

Smoking is illegal in enclosed public spaces and workplaces in the UK. Therefore, smoking is not
permitted at the competence test centre. Once you have entered the competence test centre, you
will not be allowed to leave until the OSCE is finished.

Once your OSCE starts, you will then be under exam conditions until your OSCE is completed in full.
Prior to undertaking the OSCE, the invigilator will provide a briefing on its format.

12. Fitness to undertake the OSCE

You need to be fit and well to undertake the OSCE. You will be asked to complete a confidentiality
agreement and declaration.

It is acknowledged that a candidate with a declared disability may require reasonable adjustments to
complete the examination. The request for reasonable adjustments must be made before the date of
the examination, by contacting the competence test centre, either by email or phone.

A reasonable adjustment will allow for a candidate to undertake midwifery care that:

• remains effective and does not result in altered care

• is accepted within professional midwifery practices
• enables the candidate to demonstrate competence
• will not place the candidate, or woman giving birth, at risk of harm by injury or illness.

A reasonable adjustment will not allow for the required standard of competence to be reduced
because of a disability.

ToC 2021 Midwifery OSCE information booklet V1.5 11

Please note: Reasonable adjustments can be made to assess how you demonstrate that you have
met a competence or standard. The standard or competence itself is not subject to a reasonable
adjustment. If you have a health condition, we strongly advise you to disclose it, as the competence
test centre can then give you information about the support that may be available to you and, if
necessary, make any special arrangements. A disability or health condition cannot be considered if it
is disclosed after the OSCE.

13. Fire alarm

If there is a fire alarm, follow the directions of the competence test centre staff to the fire exit. If the
fire alarm sounds during the OSCE, you should remain with your assessor at all times. Staff will
direct you to an assembly point and will conduct a roll call to make sure that all assessors, actors and
candidates are gathered together. You must not speak to other candidates during an emergency
evacuation. Once the area is deemed safe, you will be directed back to the competence test centre
and given instructions about resuming the OSCE.

14. Identification
We will check your identity at the competence test centre, and we will only accept a valid passport for
this purpose. If the name on your passport is different from the name on the application and/or on the
email/letter from the NMC authorising you to take the test, you must provide original evidence that
you are the person named in that email/letter. This may be:

• your marriage certificate

• a declaration from the awarding body that granted your midwifery qualification, stating that
both names relate to you.

If you do not bring the documents listed above, or if the passport is not valid or current, you will not
be allowed to take the OSCE.

NMC staff will also be there on the day for your NMC ID check. You will need to bring all the original
documents that you uploaded as part of your application. You will find a checklist of the documents
on the Test of Competence invitation email from NMC confirming your eligibility to sit the CBT and
the OSCE.

If for any reason you do not have all your original documents on the day, the NMC will schedule
another face-to-face appointment with you. These are offered either at the NMC’s London offices or
at one of the OSCE centres. You will still be able to sit your OSCE exam and receive your OSCE
exam result, but you will not be able to progress to the last stage of the registration process until you
have attended your follow-up ID check.

For more information on the NMC ID check, please visit the NMC website, or, for specific queries
about your ID check, please email [Link]@[Link].

ToC 2021 Midwifery OSCE information booklet V1.5 12

15. What can I expect in the OSCE?
In stations that involve demonstrating a practical skill, you will find a manikin, an actor or other piece
of equipment. Where a manikin plays the role of a woman, you must treat the simulated woman as
you would a woman in real life. An assessor will be in each station observing you, except for written
stations.

You must carry out effective hand hygiene before starting the stations. Soap, water and hand gel will
be available at all stations.

You may be asked to make a midwifery assessment or carry out a practical clinical skill. Each station
will have a scenario overview, which will give relevant information about the woman, such as name,
age and what is expected of you in the station.

Each station lasts between 8 and 30 minutes, and staff will be there to help you to make the
transition from station to station as needed.

A lead assessor will be overseeing the test day, with assessors based at each station, observing.
Each station has a camera and sound system installed. The built-in cameras will record the
examination and will be used to review the examination afterwards for quality-assurance purposes.
This is not optional but is part of the process, so you will be asked, at the point of booking, to consent
and that you understand that videoing will take place throughout the OSCE. The videos are used for
examination and reviewing purposes only, by the university and the NMC.

Please note: Filmed assessments are treated as examination scripts. Once the scripts have been
marked and moderated, the pass or fail decision is final, and candidates or any sponsoring authority
cannot request access to the film. An appeal or complaint may involve the investigator reviewing the
filmed assessments, but films will not be released to you or any sponsor.

16. How should I dress?

We require that you dress for the OSCE in a manner that is appropriate for a clinical environment. All
midwives must be dressed professionally, must maintain a high standard of infection control, and
must ensure their own health and safety and that of women in their care. The guidelines below are
based on the expected standards for pre-registration healthcare students at any UK university. They
mirror the professional standards required of all healthcare professionals in the UK.

• Clothing: Please dress as you would in clinical practice. In the UK, this is normally a clinical
dress, tunic or polo shirt with smart trousers or scrubs. You must not wear jeans or shorts.
Midwives in the UK frequently wear dark plain trousers and plain polo shirts/tunics. Where
possible, candidates should be dressed in a similar manner. Candidates who wish to wear
alternatives, for example because of cultural or maternity requirements, should discuss this
with the competence test centre before arriving for the OSCE.

• Shoes: Must be plain, flat, black and rubber-soled, enclosing the whole foot and not made of
porous or absorbent material.

• Fingernails: Must be kept short, unvarnished with no extensions or decoration.

ToC 2021 Midwifery OSCE information booklet V1.5 13

 • Hair: Must be tied up off the face and secured with simple hair ties/bobbles above the collar of
your tunic or polo shirt. Hair should be of a natural shade and style. Facial hair should be kept
clean, trimmed and tidy.

• Head scarf/turban: If you wear a head veil/turban, please ensure that it is appropriate in
colour (plain black or navy), and it must be tucked into the collar of your tunic or polo shirt.

• Jewellery: Plain ‘ball’ ear studs are allowed to be worn (maximum of one per ear). No tongue
piercings should be worn. A single plain band wedding/commitment ring is allowed. You must
be bare beneath the elbow: no bracelets or wristwatches are to be worn.

• Make-up: Must be kept to a minimum and must be discreet and natural.

• Socks/tights: Dark blue or black socks with trousers, and flesh-coloured or black tights.

17. What conduct is expected during the OSCE?

The OSCE is a formal examination and candidates are required to behave appropriately and in
accordance with university regulations and policies.

Candidates are already professional midwives, and they are expected to behave in a professional
manner at all times while at the competence test centre.

You will be provided with all the materials you need during the examination.

18. Competence test centre rules and regulations

All personal items must be placed in the small locker provided at the competence test centre. The
competence test centre will take no responsibility for any lost, stolen, or misplaced items.

The following items are not allowed in the OSCE, nor can they be accessed during your time at the
competence test centre:

• any educational, test preparation or study material

• mobile phones, hand-held computers, personal digital assistants (PDAs), pagers, watches or
any other electronic devices
• weapons of any kind.

Mobile phones, pagers or other electronic devices must be turned off before they are stored in the
locker.

During your time at the competence test centre, you will not be allowed to access personal items
other than any medication or foods required at a specific time. You must have arranged this in
advance with the competence test centre. If you require access to medical devices or aids during the
OSCE, please inform the centre staff when booking your OSCE examination.

ToC 2021 Midwifery OSCE information booklet V1.5 14

 19. Confidentiality
As a registered midwife , you are bound by NMC (2018) ‘The Code’12. Any cheating or misconduct
during the OSCE or breaching the examination’s confidentiality may bring your profession into
disrepute and may raise doubts about your fitness to practise. Such incidents will be reported to the
NMC by the assessors and will be investigated.

You must not seek help, or attempt to seek help, from any other party during the OSCE. This
includes in person or by phone, text, messaging, email or any form of social media.

You must not disclose information about the OSCEs to, or discuss with, anyone, including
instructors. This includes posting or discussing the scenarios or skills on the internet or on any form
of social media.

20. Taking the OSCE

The results of the OSCE must be an accurate reflection of the authorised candidate’s knowledge and
professional skills as a midwife.

• You must not take or attempt to take the OSCE for anyone else.
• You must not allow, or attempt to allow, anyone else to take the OSCE for you.
• You must not engage in any behaviour deemed to be disruptive at any time while in the
competence test centre or when taking the OSCE.

21. Grounds for dismissal or cancellation of OSCE results

All candidates must comply fully with the competence test centre staff’s instructions and the rules
and regulations, or they will risk having their OSCE results withheld, dismissed, or cancelled.
Candidates who do not comply with this may be asked to leave the competence test centre, and their
fees will not be refunded. Such incidents will be reported by the assessors and investigated. The
OSCE result may be withheld during an investigation.

Please note: The competence test centre will always report such incidents to the NMC.

22. How is the OSCE assessed?

Each OSCE station has a unique criterion-based assessment sheet, which is matched to the
scenario or skill being assessed. Assessors will score each criterion. The criteria are mapped against
NMC (2018) ‘Standards for pre-registration midwifery education’13 and NMC (2018) ‘The Code’ 14.

The assessment, planning, implementation and evaluation stations are mapped against the above.
The skills assessments are also mapped against the above but also against an appropriate evidence
base for that station. The evidence base for each station is published in the Reading List (available
on the competence test centre support site).

12 [Link]
13 [Link]
14 [Link]
ToC 2021 Midwifery OSCE information booklet V1.5 15
The following are examples of planning station criteria:

• Clearly and legibly handwrite answers.

• Identify two relevant midwifery problems/needs.
• Set an appropriate evaluation date for both problems.

23. The passing standard

The pass scores for each OSCE station are set using an appropriate combination of professional
judgement and statistical information. To pass the OSCE, the candidate must achieve a pass score
for every station. For more information about the passing standards, please refer to section 6
(standards and results) of the test specification.

24. Can I have my OSCE remarked?

All OSCEs are recorded, and all OSCEs deemed a fail will always be reviewed by the panel of
assessors on the day of the OSCE. Failed OSCEs are automatically remarked and checked as part
of the quality-assurance process.

The academic lead/centre manager and administration team will co-ordinate any appeals,
complaints, reasonable adjustments and fitness-to-practise issues, and will refer such matters to the
test panel for investigation and reporting to the NMC.

25. Unsafe practice and cessation of assessment

In the event that any candidate demonstrates unsafe practice, which may place the candidate,
simulated pregnant woman or assessor at risk, then a red flag will be raised by the assessor. All red
flag judgements will be reviewed by the panel assessors on the day of the OSCE. An agreed red flag
always denotes an OSCE station fail.

26. How do I get the results of the OSCE?

The NMC will inform candidates of the result of the OSCE usually within 5 working days after the test
is taken. In some instances, this may take up to 10 working days if new OSCE content is being
introduced.

The NMC test of competence Part 2 is made up of ten stations, split into:

• Four scenario stations (assessment, planning, implementation and evaluation)

• two sets of two linked skills stations

• Two written stations, one assessing professional values and one assessing evidence based
practice.

If you are unsuccessful in up to seven stations, your re-sit will be charged at 50% cost: £397.
If you are unsuccessful in eight or more stations, your re-sit will be charged at 100% cost: £794.

ToC 2021 Midwifery OSCE information booklet V1.5 16

27. What will the feedback look like?
You can expect to receive feedback on those aspects of the OSCE in which you failed to meet the
level of competence. This will be a brief account of how you failed to show competence. The
competence test centre is not allowed to teach you how to pass the exam, so the feedback will be
short and factual. For example, if a candidate failed aseptic non-touch technique (ANTT) for
contaminating their sterile clinical waste bag when setting up the field, the feedback may read as
follows:

Aseptic non-touch technique (ANTT): The candidate failed to show competence in this station.
When setting out the sterile field, they contaminated the orange bag and, as a result,
contaminated the sterile field. This is a safety risk, resulting in a fail.

28. What are the potential results?

Result Description Outcome Cost

Passed all Congratulations!
Pass stations taken The NMC will be in touch to issue your NMC N/A
PIN.
Will require a re-sit at 50% cost.
Failed up to You will need to re-sit only the stations you
seven stations failed. If you need to re-sit the APIE
Fail £397
1–7 stations across both station(s), you will be given your original
the APIE paperwork from the APIE stations you
and/or skill passed in your previous attempt, to
complete the re-sit stations in sequence.
stations
Will require a re-sit at 100% cost.
Failed eight or You will need to re-sit the APIE station(s)
Fail you failed and the skill station(s) you failed.
more stations You will be given the same scenario and
8–10 stations across both your original paperwork from the APIE £794
the APIE and stations you passed in your previous
skill stations attempt, to complete the re-sit stations in
sequence.
Fail any station
on the third Will require 6 months to elapse before you
Full fail can reapply to the NMC. N/A
attempt

29. What happens if I pass?

Your OSCE result will be uploaded to your NMC application and you will be able to continue your
application for registration providing you have passed the CBT, paid your registration fee of £153
and the NMC have received your supporting declarations.

30. Can I have more than one attempt at the OSCE?

Candidates have three opportunities to attempt each part of the test of competence.

In exceptional cases, a further attempt at each part may be offered. This attempt will be agreed only
by application to the NMC. The additional attempt will be granted in situations such as the following:

• The test centre did not follow agreed processes.

• The assessor behaved in a way that demonstrably did not comply with the agreed processes.

ToC 2021 Midwifery OSCE information booklet V1.5 17

 • There was an unanticipated interruption to the assessment, such as a fire alarm.
• Illness or severe anxiety in the candidate.

Candidates must wait at least 10 days between each sitting. Candidates can choose to take longer
than 4 weeks between the second and final attempts.

The CBT (Part 1) and the OSCE (Part 2) can be taken in either order, although most candidates take
the CBT first.

The OSCE will be passed or failed for each individual station. Re-sits will be required only for those
stations the candidate failed. Re-sit candidates will take the same or a similar but different station(s)
to the one(s) they failed. If the stations are not all passed in three sittings, then the whole OSCE
must be re-taken.

ToC 2021 Midwifery OSCE information booklet V1.5 18

SECTION 3: Candidate guidance
The next section of this information booklet provides guidance for you when considering applying for
mitigating circumstances, appeals or complaints. The competence test centre manager will always
offer guidance and advice in such matters. If, after pursuing such issues, you remain unhappy with
the outcome and decisions reached, you have the right to raise the matter with the NMC.

31. Can I appeal my result?

If you believe that a mistake has been made at any point during the process of your test of
competence, or that an irregularity has occurred in the conduct of the OSCE, and you think that this
has had a direct and demonstrably detrimental effect on your performance, you may be able to make
an appeal. You cannot appeal the result; you can only appeal the process. See Annexe 2 for
guidance on the appeal process and form.

32. What is a complaint and how can I make one?

If you are dissatisfied with a service that the competence test centre is providing, or with the person
who is providing it, you can raise the matter as a complaint. You should always try to resolve a
problem as close as possible to its source. So, for example, if you have a problem with your
assessor, you should speak to the lead assessor or invigilator at the time. If you are dissatisfied with
the outcome, you can make a formal complaint to the NMC. See Annexe 3 for the candidate
guidance on the complaint process and form.

Please note: Candidates do not have the right to see their filmed assessment. It is treated as an
exam script. Once the script has been marked and moderated, the pass or fail decision is final and
candidates or any sponsoring authority cannot request access to the film. An appeal will involve the
investigating panel reviewing the candidate’s filmed assessments, but films will not be released to
candidates or their sponsors.

33. Fitness to practise during the OSCE

Your fitness to practise during the OSCE may be questioned if a member of the competence test
centre staff, an assessor, a simulated woman, or another candidate expresses concerns that you are
failing to maintain standards and/or that your conduct is inappropriate to your profession. Examples
may include a breach of confidentiality and professional misconduct (which may call into question
your honesty and integrity). If this occurs, your OSCE may be stopped and an incident form will be
completed and forwarded to the NMC. If you are allowed to continue, an incident form will still be
submitted, and you will be informed of this at the time of your OSCE.

34. What happens if I am unable to attend the OSCE because of sudden illness or
circumstances beyond my control?
Candidates must make every attempt to attend their booked OSCE appointment. Cancellations
made at least 2 working days before the OSCE will not incur a financial penalty if there are mitigating
circumstances (see Annexe 1). However, cancellations made fewer than 2 working days before the
OSCE will not be refunded. Evidence of special circumstances must be provided. Neither
cancellation will count as an OSCE attempt to the NMC.

ToC 2021 Midwifery OSCE information booklet V1.5 19

 35. When can you apply for mitigating circumstances to be considered?
If you are unable to attend the OSCE examination because you are ill or you have a personal issue
that prevents you from attending, you should contact the relevant competence test centre by email or
telephone. You must remember to include independent evidence, for example a hospital
appointment letter or copy of a prescription. Please note: It is your responsibility to collect this
evidence.
If you arrive to sit your OSCE and you do not feel well enough to proceed, or you become unwell during
the exam, you must inform the invigilator and lead assessor straight away, and they will support and
advise you further.

Before taking the OSCE, you will be asked to declare yourself fit to take the exam, and you will be
unable to defer an assessment once you have commenced, or appeal on the grounds that you were
unfit. Evidenced personal circumstances, such as sudden illness, may be permitted as reasons for
re-booking the OSCE at short notice.

36. How will the OSCE be affected if I am pregnant or breastfeeding a young baby?
The competence test centre will seek to support candidates who are pregnant or have very young
children. The competence test centre will be flexible to enable the candidate to take the OSCE as
planned, whenever possible, except when a significant risk is identified. The competence test centre
must be informed in advance. Candidates can find guidance in Annexe 4.

37. I have a disability. Can the competence test centre accommodate my needs?
Our staff are committed to ensuring impartiality and equality of opportunity in the delivery of our
services. Our premises are wheelchair accessible, and the competence test centre will also act on
NMC guidance regarding this. Special adjustments are made for candidates with disabilities, or for
those registered as dyslexic or with other additional needs. Candidates are asked to declare their
needs for reasonable adjustments when booking their OSCE, for which they will be required to
produce supporting evidence. The academic lead/manager will seek advice on the reasonable
adjustments possible for the candidate. Simple changes such as lowering beds, accommodating the
need to sit or stand, or the increased need for toilet breaks during pregnancy can easily be arranged
when the competence test centre is notified in advance.

Candidates who need to access medical devices during the OSCE can be accommodated with
advance notification prior to booking. The competence test centre will not allow the required level of
competence to be reduced because of a disability. The standard or competence itself is not subject
to a reasonable adjustment.

The request for reasonable adjustments must be made before the date of the OSCE examination, by
contacting the test delivery centre. Candidates with additional needs must declare them via the
reasonable adjustments form that will be emailed to candidates once the competence test centre has
been notified by the candidate and a booking made. Reasonable adjustments are offered within the
scope of the Equality Act 2010 15.

15 The Equality Act 2010 does not apply in Northern Ireland, but there are very similar equality requirements spread across

several pieces of legislation. For example, section 75 of the Northern Ireland Act 1998 also includes consideration of
‘political opinion’ as a protected characteristic, the Disability Discrimination Act 1995 still apples to employment in Northern
Ireland, and the Special Educational Needs and Disability (Northern Ireland) Order 2005 applies in all education settings.
ToC 2021 Midwifery OSCE information booklet V1.5 20
A reasonable adjustment will allow for a candidate to evidence during their assessment midwifery
care that:

• remains effective and does not result in altered woman care

• is accepted within professional midwifery practices
• enables the candidate to demonstrate competence
• will not place the candidate or woman at risk of harm by injury or illness.

ToC 2021 Midwifery OSCE information booklet V1.5 21

SECTION 4: Annexes
Please note: Blank copies of these forms are available to download on the competence test centres’
learning platforms. These annexes are for candidates’ reference only.

ToC 2021 Midwifery OSCE information booklet V1.5 22

Annexe 1: Mitigating circumstances guide and form
Mitigating circumstances guide
What are mitigating circumstances?
Mitigating circumstances are events that have significantly disrupted your OSCE.

They must be:

• serious or acute
• beyond your ability to foresee and control.

When can you apply for mitigating circumstances to be considered?

If you are unable to attend because you are ill, or if you have a personal issue that prevents you from
engaging with the OSCE, you should complete and submit the mitigating circumstances form in this
booklet. You must remember to include independent evidence with your application, such as a
hospital appointment letter or a copy of a prescription. It is your responsibility to collect this evidence.

What outcome can you expect if you apply for mitigating circumstances?
There are a number of issues that cannot be addressed by submitting a mitigating circumstances
application:

1. Under no circumstances will the grades awarded in your OSCE be changed. All OSCEs are
graded upon their own merits, and no allowance will be made for mitigating circumstances. A
mitigating circumstances application will not be considered for a completed OSCE.

2. Only in very exceptional cases will applications for mitigating circumstances be accepted after the
deadline set for the examination has passed. If you do apply late, you must explain why.

3. A known disability is not itself a reason to submit a mitigating circumstance application, although
(for example) unforeseen illness resulting from a disability may be. Reasonable adjustments to
OSCE examinations will normally be made to support candidates who have a disability. Requests for
such adjustments should be discussed with the academic lead and competence test centre
administration team in advance of the OSCE.

4. The NMC determines the number of opportunities a candidate has to take the OSCE
examination. The maximum is three opportunities within a single application. If you have successfully
applied for mitigating circumstances, your attempt will not count. If you sit the OSCE and are
unsuccessful in applying for mitigation, the attempt will count.

What happens if I am ill on the day of an OSCE?

If you are too ill to start the OSCE, then you need to let the competence test centre know as soon as
possible. You then need to submit an application for mitigating circumstances.

If you become ill during an OSCE examination, you need to let the invigilator know straight away.

Candidates should make every effort to cancel their OSCE a minimum of 2 working days before the
exam is booked. (If the exam is on a Monday, cancellation should occur on the Thursday before.)
Refunds will not be given routinely if OSCEs are cancelled at short notice.

ToC 2021 Midwifery OSCE information booklet V1.5 23

Mitigating circumstances form

Your details:

Name: Number:

Tel: Email:

OSCE
date:

OSCE affected by mitigating circumstances:

OSCE number Original exam date:

Date FORM passed to AA: Filter: 1 2 3

Chair’s Action: Date:

Decision: Upheld Declined

Student status:

Reason for decision:

SAT: Log in Letter Log outcome H grade Exams/Module leader

ToC 2021 Midwifery OSCE information booklet V1.5 24

 Your mitigating circumstances:
You must provide precise dates of any illness or other circumstances. State how your OSCE was
affected and what steps you took to recover the situation.

Declaration:

I declare that the details included in this application, including any appended statements, are true
and that I have read and understand the foregoing mitigating circumstances guide.

Signed: Date:

ToC 2021 Midwifery OSCE information booklet V1.5 25

Annexe 2: Appeal process guide and form

Candidate submits the level 1 appeal form to the

relevant competence test centre:
Oxford Brookes University | CTC@[Link]
Ulster University | CTC@[Link]
University of Northampton | CTC@[Link]
within 5 working days of receiving the result.
Competence test
centre manager will
respond to candidate
NOT with reasons within 10
Competence test ADMISSIBLE working days.
centre manager
addresses whether the
case is admissible. End-of-process
Candidate satisfied? YES letter issued to
candidate.
ADMISSIBLE NO

Appeal is reviewed by
Level 1
provision lead of
Lead assessor competence test
independent to the centre to address
assessment ADMISSIBLE whether the case is
investigates. admissible.

Candidate will receive Candidate will receive

a response within 20 a response within 5
working days. working days.

NOT
ADMISSIBLE
End-of-process YES Candidate satisfied?
letter issued to
candidate.
NO Completion of
procedures issued
to candidate.
Candidate submits request to review appeal to the
relevant competence test centre:
Oxford Brookes University | CTC@[Link]
Ulster University | CTC@[Link]
University of Northampton | CTC@[Link]
within 10 working days of receiving
level 1 response.

Level 2
Request to review
A different lead
appeal on time?
End-of-process assessor,
Completion of
letter issued to NO YES independent to the NOT
10 working days from UPHELD procedures issued
candidate. assessment and
receiving Level 1 to candidate.
Level 1 investigation,
response.
investigates.

Candidate will receive a

response within 20
working days.

UPHELD

1) Actions recommended

2) Further actions assigned if

necessary and reported to NMC
monthly meeting and clinical
working group.

ToC 2021 Midwifery OSCE information booklet V1.5 26

What grounds can I use as the basis for an appeal?
If you believe that your result is incorrect, that a mistake occurred during the process of your
assessment, or that an irregularity occurred in applying the assessment regulations or in the conduct
of the examination, and you think that that had a direct and demonstrably detrimental effect on your
performance, you may be able to make an appeal.

In which situations might an appeal be worthwhile?

The marks awarded to your work will have been through a rigorous process of moderation involving
at least two internal markers and the oversight of marking standards by an external assessor, who
approves all grades awarded. The university will not accept an appeal against the academic and/or
professional judgements of assessors per se.

Where can I obtain advice?

If you are uncertain about any of the information contained in this guide, you should consult the
relevant competence test centre administration team.

How should I appeal?

You will need to complete a level 1 appeal form, which is found on the Moodle/NILE/Blackboard
Learn learning platform. Once completed, please submit it to the CTC administration team within 5
working days of receiving your OSCE result.

Where should I submit the form?

Please email your appeal form to the relevant competence test centre:
• Oxford Brookes University | ctc@[Link]
• Ulster University | ctc@[Link]
• University of Northampton | ctc@[Link].

How will my appeal be dealt with?

The CTC administration team will forward your appeal for review. If you make a legitimate appeal on
acceptable grounds, an assessor independent to your OSCE will examine your case. The
investigator will come to a conclusion, and will write to you stating either that your appeal should be
upheld or that it should not. This will include the rationale for the reviewer’s decision. See Annexe 1
for candidate guidance on the process.

How long will it take to reach a decision?

If you make an appeal, the investigation will normally be completed within 20 working days. If you
want an update on the progress of your appeal, you should contact the relevant CTC administration
team:
• Oxford Brookes University | ctc@[Link] | 01865 488 418
• Ulster University | ctc@[Link] | 02871 675 150
• University of Northampton | ctc@[Link] | 01604 892 066

What outcome can I expect if I make an appeal?

Your appeal will be partially upheld, upheld or not upheld. You will be notified of this decision by
email.

ToC 2021 Midwifery OSCE information booklet V1.5 27

What should I do if I am dissatisfied with the outcome?
Once your appeal has been formally heard by the university and the level 1 outcome communicated
to you, you can submit a request for your appeal to be reviewed at level 2. This request must be
submitted within 10 working days of your level 1 appeal response.

A different assessor, independent to your OSCE and the level 1 investigation, will investigate. The
investigation will normally be completed within 20 working days. You will receive notification of this
decision by email. This concludes the university’s appeal process.

The complaints procedure is outlined on the NMC website: [Link]

us/complaints-about-us.

ToC 2021 Midwifery OSCE information booklet V1.5 28

Appeal form – Level 1

This form should be submitted to the CTC administration team within 5 days of receiving your OSCE result.

Name
Candidate number
Correspondence address
Email address
Date of test of competence (OSCE)
Grounds for appeal
(You should provide full details of the nature of the irregularity that you feel occurred.)

I declare that the information given is true and that I am willing to answer further questions if necessary:

Signed: Date:

Please email your appeal form to the relevant competence test centre below:
• Oxford Brookes University | ctc@[Link]
• Ulster University | ctc@[Link]
• University of Northampton | ctc@[Link].

(For official use)

Date received: Date logged:

Date File created: Appeal acknowledged:

ToC 2021 Midwifery OSCE information booklet V1.5 29

Annexe 3: Complaint process guide and form

Candidate submits the level 1 complaint form to the

relevant competence test centre:
Oxford Brookes University | CTC@[Link]
Ulster University | CTC@[Link]
University of Northampton | CTC@[Link]
Competence test
centre manager will
respond to candidate
NOT
with reasons within 10
Competence test centre ADMISSIBLE working days.
manager addresses
whether the case is
admissible.
End-of-process letter
Candidate satisfied? YES issued to candidate.

ADMISSIBLE NO

Level 1 Complaint is reviewed by

provision lead of
Provision lead of competence test centre to
competence test address whether the case
centre investigates. ADMISSIBLE is admissible.

Candidate will receive Candidate will receive a

a response within 20 response within 5 working
working days. days.

End-of-process NOT
letter issued to YES Candidate satisfied? ADMISSIBLE
candidate.
NO Completion of
procedures issued
to candidate.
Candidate submits request to review complaint to the
relevant competence test centre:
Oxford Brookes University | CTC@[Link]
Ulster University | CTC@[Link]
University of Northampton | CTC@[Link]
within 10 working days of receiving level 1
response.

Level 2

AESC, quality
Request to review assurance team and
complaint on time? head of midwifery
End-of-process Completion of
letter issued to NO YES (members outside the
10 working days from procedures issued to
candidate. competence test NOT
receiving level 1 UPHELD candidate.
centre) will investigate.
response.
Candidate will receive
a response within 20
working days.

UPHELD

1) Actions recommended.

2) Further actions assigned if

necessary and reported to
NMC monthly meeting and
clinical working group.

ToC 2021 Midwifery OSCE information booklet V1.5 30

Candidate complaint guide

What is a complaint?
If you are dissatisfied with a service that the university is providing, or with the person who is
providing it, you can raise the matter as a complaint.

How should I make a complaint?

You should always try to resolve a problem as close as possible to its source. So, for example, if a
problem has arisen with your assessor, you should speak to the lead assessor or invigilator on the
day of your OSCE.

What outcome can I expect if I make a complaint?

The university expects its entire staff to be receptive to issues raised by candidates. Complaints will
be addressed initially through an informal process, involving discussions with people in the
department where the difficulty has arisen.

What should I do if I am dissatisfied with the outcome?

In some cases, it may be felt that the candidate’s complaint has not been resolved by the informal
process. In such cases, you can progress the complaint to level 1 by completing the level 1
complaints form and submitting it by email to the relevant competence test centre. See Annexe 2 for
candidate guidance on the process.

What happens if I make a formal complaint?

The university will appoint an investigator to carry out an investigation into the matter(s) that you
have raised and will report back to you within 20 working days. You should note that you should not
submit a formal level 1 complaint unless you have already attempted to resolve your issue(s) via the
informal process.

Will my assessors treat me differently if I make a complaint about them?

It is part of the university’s policy that no one bringing a complaint, whether successfully or
otherwise, will be treated less favourably by any member of staff than if the complaint had not been
brought. If evidence to the contrary is reported, the member of staff may be subject to disciplinary
proceedings.

Where can I obtain advice?

If you are uncertain about any of the information in this booklet, you should consult the relevant CTC
administration team on:
• Oxford Brookes University | ctc@[Link] | 01865 488 414
• Ulster University | ctc@[Link] | 02871 675 150
• University of Northampton | ctc@[Link] | 01604 892 066.

What if I am dissatisfied about the level 1 complaint outcome?

You should submit a request to review the complaint via email to the relevant competence test
centre within 10 working days of receiving your level 1 response. This then escalates to a level 2
complaint. Members of staff outside the competence test centre will now investigate. You will receive
a response within 20 working days.

ToC 2021 Midwifery OSCE information booklet V1.5 28

How long will it take to make a decision?
If you can resolve your issues at the informal stage, it will not take very long at all. If you make a
formal complaint, the investigation may take longer, but the university aims to provide you with a
response within 20 working days of receiving your complaint at either level 1 or level 2.

ToC 2021 Midwifery OSCE information booklet V1.5 29

Complaint form – Level 1

Name

Candidate number (if applicable)

Correspondence address

Email address

Date of test of competence (OSCE)

Please give a brief outline of your complaint.

Please explain what steps you have taken to resolve your complaint with the relevant
department (in accordance with the informal process outlined in the complaints guide above
and the complaints policy).

ToC 2021 Midwifery OSCE information booklet V1.5 30

 Please explain why you are dissatisfied with the response you have received.

Please indicate what outcome you are expecting from further action.

Please provide any documents you believe support your complaint.

I declare that the information given is true and that I am willing to answer further questions if necessary:

Signed: Date:

This form should be submitted to:

• Oxford Brookes University | ctc@[Link]
• Ulster University | ctc@[Link]
• University of Northampton | ctc@[Link].

ToC 2021 Midwifery OSCE information booklet V1.5 31

Annexe 4: Pregnant candidate checklist, risk assessment and support
plan and guidance

New and expectant mothers

This checklist aims to guide discussions with candidates during their pregnancy and maternity. It should
be completed and agreed with the candidate. It is not intended that the form be completed in full at a
first meeting, as initially a candidate will be unable – and should not be expected – to respond to all the
questions raised. All information obtained will be kept in confidence.

The form should be reviewed at key stages or if the candidate’s circumstances change.

Section 1 – Candidate to complete

Contact details
Candidate details
Name
Address
1
Contact number
Email address
Candidate ID
Emergency contact details
Relationship to candidate
2
Contact number
Test details
Title NMC test of competence Part 2 OSCE examination

3 Faculty
Responsible to
Date of OSCE
First point of contact details
Name NMC competence test centre administration team
OXFORD
SWINDON
ULSTER
Location (tick as appropriate) NORTHAMPTON
N

Oxford Brookes University | 01865 488 418

Contact numbers Ulster University | 02871 675 150

University of Northampton | 01604 892 066

ToC 2021 Midwifery OSCE information booklet V1.5 32

 Email address Oxford Brookes University | ctc@[Link]
Ulster University | ctc@[Link]
University of Northampton | ctc@[Link]

Key dates
5 What is the candidate’s due date?
How many weeks pregnant will the
6
candidate be on the OSCE date?
Communication with the candidate
What is the candidate’s preferred
7
method of communication?
Further information
.
8 Any other information or comments?

Extenuating circumstances

Please sign and date to show that you

have read and are aware of the
mitigating circumstances policy in the Please refer to the candidate handbook.
event of your pregnancy or maternity
9
affecting examinations and
assessments.
Signature
Date

Section 2 – Academic lead to complete

Informing other staff

Who will need to be informed of the candidate’s pregnancy?

Title Date
Academic lead
10 Invigilator
Administrator
Project manager

Health and safety risk assessment

Has a health and safety risk assessment been conducted by the academic lead in consultation with
11 the candidate, if relevant? See section 3.
Date completed

ToC 2021 Midwifery OSCE information booklet V1.5 33

 Where changes are required to alleviate
or minimise risks, who is responsible for
ensuring that they are implemented?

Rest facilities
Has the candidate been informed of
Date completed
rest facilities on campus for use by YES
12 pregnant candidates?
NO
See support plan.
Pregnancy-related absence
Have you discussed any pregnancy-
related illness that has affected the YES Date completed

13 candidate’s ability to undertake the

OSCE? NO
See support plan.
Further information
Any other information or comments.

14 Candidate to provide any additional

information or comments that may be
relevant.

Section 3 – Risk assessment – Academic lead to complete

Upon receiving notification of pregnancy, the responsible person in the competence test centre will carry
out this risk assessment.

Please contact the centre of occupational health and/or wellbeing teams if specific advice is required.

HAZARD IDENTIFICATION

Action must be taken to avoid exposure to identified risks, by using substitutions with safer substances or
by making adaptations to the competence test centre to allow the OSCE to be conducted safely and
without risk to health.

PHYSICAL HAZARDS

Ionising radiation Yes No

Non-ionising radiation Yes No

Manual handling Yes No

Adverse movements and postures Yes No

Details:

ToC 2021 Midwifery OSCE information booklet V1.5 34

Action:

CHEMICAL HAZARDS Yes No

Details:
Action:

BIOLOGICAL HAZARDS Yes No

Details:
Action:

OTHER HAZARDS

Work with computers Yes No

Confined spaces Yes No

Mental and physical fatigue Yes No

Lone working Yes No

Stress Yes No

Shift work Yes No

Working at heights Yes No

Adverse thermal environments Yes No

Travelling for work Yes No

Standing for prolonged periods Yes No

Details:
Action:

Further comments:

ToC 2021 Midwifery OSCE information booklet V1.5 35

Signed (candidate) Date

Signed (academic lead) Date

Section 4 – Support plan

Timetable for
agreement or decline Date flexibility
Proposed flexibilities to be
and by whom agreed or Comments
investigated
(Date of reviews) declined

Station height of bed can be On the day of the Assessors to check each
adjusted, and manikins will be exam. station prior to
moved by the assessor to commencement.
reduce physical stress on
candidate.
A chair is available for the On the day of the All assessors to check
candidate to rest after exam. each station prior to
completing each station. commencement.
Drinks and toilet breaks will On the day of the See risk assessment.
be available. exam.

The candidate must declare On the day of the Assessors to ask the
that she is fit and well to exam. candidate whether they
undertake the OSCE. are fit and well before
undertaking each station.

Signatures
Agreed by academic lead
Signature Date

Agreed by candidate
Signature Date

ToC 2021 Midwifery OSCE information booklet V1.5 36

New and expectant mothers’ guidance

Introduction
The competence test centre recognises that being or becoming pregnant, or having a very young
child should not itself be a barrier to applying for, starting, succeeding in, or completing the test of
competence. The competence test centre will be as flexible as is reasonable, in accordance with
university regulations and the legal framework in which the university operates.

This guide provides information and advice about the university’s approach to supporting a
candidate who is pregnant.

Definitions
• Candidates: referring to those who are pregnant or have very young children.
• Very young children: those under 26 weeks of age.
• New parent: those with children under 26 weeks of age.

The university will:

• ensure that a candidate who is pregnant, or who has given birth within the past 26 weeks, is
protected from unfavourable treatment
• accommodate their needs both before and during the OSCE as far as is reasonably
practicable to allow the candidate to successfully complete the OSCE
• publish this guidance and review/update as necessary, so that all members of the
competence test centre community are aware of the support available and their role in
providing that support
• encourage candidates to disclose a pregnancy to the competence test centre in confidence
at an early stage.

When a candidate’s pregnancy is disclosed, the academic lead and competence test centre
administration team is expected to:
• read and follow this guidance
• treat any disclosure confidentially, and verify that a candidate has no objections to their
pregnancy being discussed with other competence test centre staff
• agree a support plan and ensure that it is implemented
• complete a risk assessment.

Candidates (and applicants) are advised to:

• read this guidance to understand the university’s approach to supporting candidates who are
pregnant or have very young children, as defined above
• disclose their pregnancy at the earliest opportunity, to enable the consideration of any
necessary support arrangements or adjustments during the OSCE
• discuss any concerns relating to their pregnancy with their own GP and competence test
centre team
• ensure that they have received a copy of the completed risk assessment, if appropriate.

Guiding principles
Avoiding less favourable treatment: The university will not treat a candidate (or applicant) less
favourably than other candidates.

ToC 2021 Midwifery OSCE information booklet V1.5 37

Taking a flexible approach: The university will take a flexible approach, in line with university
regulations, to facilitate the ability of the candidate to take the test of competence.

Demonstrating a non-judgemental and sensitive approach: All those involved should take an open-
minded and non-judgemental approach. Information provided by the candidate should be treated
sensitively and only passed on to others on a need-to-know basis.

Enabling informed choices: No one should attempt to influence candidates’ decisions directly or
unduly. The university’s role is to provide context and advice, and to explore, in consultation with the
candidate and others, any flexibility that can be applied to the test of competence. The emphasis is
on candidates making informed choices, based on full knowledge of the implications of those
choices. However, in exceptional circumstances, where it has been identified that there is a
significant risk to the health and welfare of the candidate and/or the unborn child, the university may
have to advise a course of action that is not negotiable.

Notification of pregnancy
Candidates are strongly advised to inform the competence test centre of their pregnancy as soon as
is practicable. This is particularly important where there may be a risk to the health and safety of the
candidate and/or her unborn child.

Candidates are not obligated to inform the competence test centre if they become pregnant, decide
to terminate a pregnancy, or miscarry. However, it is important to note that the university can adopt a
flexible approach, provide support or make adjustments only if it is aware of the situation.

When deciding whether to notify the competence test centre, the candidate is encouraged to
consider that there may be elements of the test of competence that could present a health and
safety risk to her and/or her unborn child.

Process
Step 1: The candidate is strongly advised to consult her GP to discuss medical issues relating to her
pregnancy prior to approaching the competence test centre.

Step 2: Candidates should inform the competence test centre of the pregnancy and/or pregnancy
issues when booking the OSCE. A checklist will then be sent to the candidate to be filled in. A risk
assessment is undertaken (see step 3) to ensure that all issues are discussed at an early stage and
a support plan initiated (see step 4).

Step 3: Risk assessment – The academic lead should ensure that appropriate steps are taken in
relation to health and safety issues. This will involve a risk assessment for the individual candidate.

Step 4: Candidate support plan – Once discussed and agreed, a candidate support plan for the test
of competence will detail any specific flexibility agreed. This should be given/sent to the candidate.

Step 5: Communicating the support plan – The academic lead will communicate the agreed
candidate support plan to other relevant assessors. Information should be passed on sensitively and
in confidence.

ToC 2021 Midwifery OSCE information booklet V1.5 38

Determining flexibility
The competence test centre does not have to agree to any or all requests. There may be situations
in which it is not possible to agree to a particular request, such as where the consequences of
agreeing to requests are likely to have a detrimental effect on the candidate. The candidate must be
made fully aware of these consequences. However, the final decision of whether to sit the OSCE will
rest with the candidate.

When considering declining a request, the university’s equality and diversity adviser should be
consulted before the decision is made. Candidates can seek bespoke advice from the university’s
equality and diversity adviser on what might constitute appropriate flexibility in a particular case.

If a request is declined, the reasons will be recorded, and the candidate will be informed as to why
this particular request is not considered ‘reasonable’ in the circumstances. This will be recorded in
the candidate support plan.

If deferring the OSCE means that it would take longer to complete the test of competence than
normally permitted by the NMC, the competence test centre should still strive to demonstrate a
flexible approach, where practicable, in relation to this deadline for completion, while ensuring that
the student does not exceed the overall time limit allowed by the NMC. If, because of pregnancy, the
candidate is likely to exceed the time allowed to complete the test of competence, they should
contact the NMC for advice.

If a candidate is unhappy with the competence test centre’s decision, they can appeal or complain
(whichever is most appropriate) to the competence test centre administration team, who will refer all
complaints or appeals to the appropriate person.

Occupational health adviser

If at any stage the academic lead would like some assistance in thinking through the practical
implications of an individual pregnancy or would like advice on health and safety issues including risk
assessments, they should contact the university’s occupational health adviser. The academic lead
may also wish to consult their line manager or other senior managers at the test of competence or
the university.

The university will also consider flexibility for a candidate who has recently become a parent. As
above, what constitutes a reasonable degree of flexibility to take account of a candidate’s
caring/parental responsibilities may vary for particular circumstances.

Small babies/children on campus

Small babies, children, partners and relatives are not allowed in the laboratory/examining area of the
competence test centre at any time.

Candidates may be accompanied by children in general public areas, such as the restaurants and
the library, provided that they are supervised at all times and are not disruptive to others. It is
particularly important that children are not brought into areas where there is the possibility of a risk to
health and safety. The university cannot accept any liability for the child in these circumstances.

ToC 2021 Midwifery OSCE information booklet V1.5 39

There are no restrictions on breastfeeding on campus. If additional support is required for
breastfeeding while candidates are on campus, candidates should contact the competence test
centre administration team prior to their OSCE date.

Last updated: 25 January 2022

ToC 2021 Midwifery OSCE information booklet V1.5 40