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Introduction
The Nursing and Midwifery Council Test of Competence, or NMC ToC, is a two-part exam made up of a written paper and a ten-station objective structured clinical examination (OSCE). One of these stations is the professional values and behaviours station, which assesses a candidate’s understanding of the NMC Code and how to apply these standards and conduct in practice.
Professionalism and the NMC
All nurses and midwives are expected to uphold the standards and values set out in the NMC Code:
- Prioritise people
- Practise effectively
- Preserve safety
- Promote professionalism and trust1
They are also expected to be familiar with relevant legislation, including the principles of confidentiality and capacity. The NMC have issued specific guidance about raising concerns, the duty of candour, and social media use.
Before sitting the ToC OSCE, candidates should ensure that they have read and understood the NMC Code and the relevant guidance and legislation outlined above. For a summary, read the Geeky Medics guide to professional values for nurses and midwives.
The professional values and behaviours station
Every candidate will have one OSCE station dedicated to professional values and behaviours. This is a silent station, meaning there is no communication with the examiner or the patient. The candidate will be given a piece of paper with a written scenario that presents a professional, ethical, or legal issue. They will also be given a blank sheet of paper, where they will need to write down how they would approach this scenario and the actions that they would take, using bullet points. A total of 10 minutes is allowed for this station.2
Possible scenarios
The NMC has given the following list of possible scenarios for the adult nursing professional values and behaviours stations. These are subject to change:
- Bullying
- Drug error
- Falsifying observations
- Falsifying timesheets
- Hospital food
- Impaired performance
- Laboratory results
- Possible abuse
- Racism
- Social media
- Witnessed abuse3
How the station is assessed
Each station has a specific mark scheme relevant to that scenario. The candidate is assessed based on what they have written on their answer sheet. The following considerations serve as a starting point for approaching these stations.
Identify the issue
This is usually quite clear, for example, theft, bullying, etc.
Link the issue to relevant aspects of The Code
Remember the four pillars of the code: prioritise people, practise effectively, preserve safety, and promote professionalism and trust. All NMC-registered professionals must uphold these values.
The candidate should clearly state which part of the NMC Code hasn’t been upheld, e.g. a drug error scenario wouldn’t demonstrate the preservation of safety.
Identify any patient safety risk
This does not apply to all cases, but where a patient safety risk is identified, a plan should be put in place to preserve patient safety. For example, in cases where a drug error has occurred, there is a risk of clinical harm. Document how you would address this risk, e.g. informing the nurse in charge, informing the medical team, taking advice, and performing a clinical assessment with observations as soon as possible.
Identify any legal aspects
This might include identifying behaviours which violate human rights, such as racism or bullying. There may be a criminal aspect to the scenario, such as theft or fraud. Patient confidentiality is also enshrined in law.
Identify any other relevant aspects of the case
Outside of the law, there may be policies and procedures that are appropriate to reference. For example, in a case of a colleague being bullied, it is worth acknowledging that employees have the right to work in a safe environment.
There would also be employer policies and procedures related to preventing and addressing bullying. In other cases, there may be relevant NMC guidance, such as the social media guidance.
Identify your professional duties in this case
There may be a professional duty to raise concerns, a duty to submit a safeguarding concern, or other appropriate duties, such as the duty of candour.
Communicate appropriate and specific actions to address the issue
If not already done, then patient safety concerns should be addressed first.
The candidate is expected to raise concerns with their senior nurse or line manager as soon as possible, both verbally and in writing. Concerns should be raised in a clear, objective and honest manner.
Candidates may be expected to document events in patient notes, for example, in the case of a drug error. It may be appropriate to submit an incident report, such as a Datix. In some cases, a witness statement should be written, signed, and dated; this may then be referenced by other bodies, such as a fraud team or the police.
There may be specific actions to take to rectify the situation, such as providing a new meal for a patient who has missed theirs in order to maintain adequate nutritional intake.
Recognise the consequences of not taking action
This includes consequences specific to the scenario, e.g. if a colleague is regularly falsifying observations, then there is a patient safety risk if this isn’t addressed.
Candidates should always acknowledge personal professional consequences too. The NMC guidance is explicit that registered professionals have a duty to raise concerns where appropriate, and neglecting this duty can put one’s fitness to practice and registration at risk.
Reflective aspects
In some scenarios, one should recognise the role of reflection and learning in preventing further incidents. For example, if there has been a drug error, then this also represents a learning opportunity. There is likely a drug administration policy that needs to be revisited, perhaps some relevant e-learning or training, and an opportunity to reflect on and learn from the error.
Support for others
In some cases, there may also be an expectation of providing empathy or support for a colleague or patient, or directing them to sources of support, such as alcohol support services.
Write clearly and neatly
Last but not least, marks can only be awarded for statements that the examiner can read! It is expected that candidates’ written communication is clear and neat.
Revising for the professional values station
Being familiar with The Code and relevant guidance is key for performing well in this OSCE station. We have a detailed article covering professional values for nurses and midwives. It is also worth practising going through different scenarios and thinking about what your answers would be. Ten minutes is not a long time, and it is important to ensure that you have rehearsed your approach and made sure you can neatly write down all of your ideas in the time allocated.
Summary
The Professional values OSCE station asks candidates to demonstrate their understanding of the NMC code and how it relates to practice. Although there are multiple different scenarios, similar themes underpin them all, and a similar approach can be taken to address all situations. Candidates must demonstrate that they can identify professional, legal, and ethical issues and address them in a timely and appropriate manner.
Editor
Dr Jamie Scriven
References
- NMC. The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. 2018. Available from: [LINK].
- NMC. Test of competence: Nursing (all fields); Candidate information booklet. V2.3. 2025. Available from: [LINK].
- NMC. Test of Competence: Marking criteria; Adult nursing. 2025. Available from: [LINK].
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