Pain Assessment – OSCE Guide

Pain is one of the most common patient problems and can be very difficult to assess and manage.¹

This guide provides a step-by-step approach to performing a pain assessment in an OSCE setting.²

Introduction

Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and water.

Don PPE if appropriate.

Introduce yourself to the patient including your name and role.

Confirm the patient’s name and date of birth.

Briefly explain what the assessment will involve using patient-friendly language: “I am going to ask you some questions about the pain you may be experiencing. This will allow me to offer you the right pain relief or escalate concerns to other members of the team.”

Gain consent to proceed with a pain assessment.

Check if the patient has any allergies, ensuring to check their allergy wristband.

Pain assessment

To begin the assessment, start by observing the patient from the end of the bed. Note any signs of pain, such as grimacing, agitation, or crying.

Next, ask the patient questions relating to their pain. The PQRST approach can be used to structure your questioning.

Provokes

As part of the pain assessment, ask the patient:

• Where is the pain? Consider asking them to point to the area
• What causes the pain? Have they identified any triggers or patterns?
• What makes the pain better?
• What makes the pain worse?

Quality

As part of the pain assessment, ask the patient:

• What does the pain feel like? E.g. is it sharp, stabbing, crushing?
• Is the pain intense?

Radiating

As part of the pain assessment, ask the patient:

• Does the pain move around, or does it stay in one place?
• Did the pain start somewhere else?

Severity

As part of the pain assessment, ask the patient:

• How bad is the pain on a scale of 0/10 – 10/10?
• Use the universal pain assessment tool to evaluate the severity of pain.

Time

As part of the pain assessment, ask the patient:

• When did the pain start?
• How long has the pain lasted?
• Is it constant or does it come and go?
• Did it come on suddenly or gradually?

Some patients may have communication difficulties. You should consider using the Distress and Discomfort Assessment Tool (DisDAT) when assessing these patients.

To complete the procedure…

Explain to the patient that the assessment is now complete.

Acknowledge that the patient is in discomfort and offer to make them more comfortable. This might include repositioning them.

Ask if they have had any analgesia so far and state that you will arrange for suitable analgesia.

Thank the patient for their time.

Dispose of your PPE and other clinical waste into an appropriate clinical waste bin.

Wash your hands.

Communicate your findings with the multidisciplinary team.

Regularly reassess the patient based on the severity of the pain.

Document the details of the assessment in the patient’s notes including the date and time of completion, your name, grade and signature.

Reviewer

Melanie Muston

Pain Clinical Nurse Specialist

Dr Smita Gohil

Consultant Anaesthetist

Editor

Dr Jamie Scriven

References

1. Ford C. Adult pain assessment and management. British Journal of Nursing. 2019. Available from: [LINK].
2. NMC. Test of Competence: Marking Criteria. Adult Nursing. 2025. Available from: [LINK].