By Fortu West International
August 30, 2026
3–4 minutes read
Master the Charts, Strengthen Your NMC OSCE Performance
The NMC OSCE is designed to assess more than your ability to perform a clinical procedure. You also need to demonstrate that you can assess a patient, interpret clinical information, document findings and respond safely to potential risks.
One area that candidates sometimes underestimate is the use of clinical assessment charts.
In an assessment station, you may be required to use or interpret different scoring tools depending on the patient scenario. Knowing the purpose of each tool can help you work more confidently and avoid preventable documentation errors.
The five important charts to become familiar with are:
- NEWS2
- Glasgow Coma Scale (GCS)
- 6CIT
- MUST
- 2-Level Wells Score for DVT
Let’s look at what each one does and what you should remember during your OSCE.
1. NEWS2: Recognising Patient Deterioration
The National Early Warning Score 2 (NEWS2) is used to identify patients who may be experiencing clinical deterioration.
It brings together several physiological observations and converts them into a combined score. This gives healthcare professionals a structured way of recognising changes in a patient’s condition.
What does NEWS2 assess?
The assessment includes:
- Respiratory rate
- Oxygen saturation
- Supplemental oxygen or air
- Temperature
- Systolic blood pressure
- Pulse rate
- Level of consciousness
Each observation receives a score according to the NEWS2 system.
Your OSCE focus
When completing NEWS2, don’t rush through the numbers. Make sure that you:
Record → Score → Total → Interpret → Escalate
An abnormal score should not simply be written down and ignored. Demonstrate that you understand the significance of deterioration and would follow the appropriate escalation pathway.
Avoid these mistakes
- Missing an observation
- Putting a value in the wrong section
- Adding scores incorrectly
- Forgetting to record the total
- Failing to communicate concerning findings
2. GCS: Assessing Level of Consciousness
The Glasgow Coma Scale is particularly important when assessing a patient’s neurological status.
It may be relevant in scenarios involving conditions such as head injury, neurological deterioration, reduced consciousness or a subdural haematoma.
GCS is divided into three areas.
Eye Opening – E
Assess the patient’s eye-opening response.
Verbal Response – V
Assess how appropriately the patient responds verbally.
Motor Response – M
Assess the patient’s motor response.
The three scores are combined to provide the total GCS.
Remember: Document E, V and M
One common mistake is recording only the final number.
Instead, where the chart requires it, document the individual components before recording the total:
E + V + M = Total GCS
This provides a clearer picture of the patient’s neurological assessment.
OSCE tip
If you identify a concerning change in the patient’s level of consciousness, demonstrate appropriate clinical reasoning and escalation. The examiner is assessing your judgement, not just your ability to calculate a score.
3. 6CIT: Screening Cognitive Function
The Six-Item Cognitive Impairment Test (6CIT) is a brief screening tool used to identify possible cognitive impairment.
It can assess areas such as:
- Orientation
- Memory
- Attention
- Concentration
A 6CIT assessment may be relevant when a patient presents with confusion, memory problems or suspected cognitive impairment.
A crucial point for candidates
6CIT is a screening tool, not a standalone diagnostic test.
A score suggesting impairment does not, by itself, establish a diagnosis.
How to approach the assessment
During the OSCE:
- Communicate with the patient respectfully.
- Ask the questions according to the assessment.
- Record the responses accurately.
- Follow the scoring instructions.
- Calculate the total carefully.
- Communicate any concerns appropriately.
Don’t allow the pressure of the examination to affect the way you communicate with the patient. Maintain dignity, patience and professionalism throughout.
4. MUST: Identifying Nutritional Risk
The Malnutrition Universal Screening Tool (MUST) helps identify adults who are malnourished or at risk of malnutrition.
It uses information including BMI, unplanned weight loss and acute disease effect.
The five-step approach
The MUST assessment can be remembered as a structured five-step process.
Step 1 – BMI
Determine the patient’s BMI and identify the appropriate BMI score.
Step 2 – Weight Loss
Assess relevant unplanned weight loss and assign the appropriate score.
Step 3 – Acute Disease Effect
Consider the acute disease effect according to the MUST criteria.
Step 4 – Overall Score
Add the applicable scores together.
Step 5 – Management
Identify the nutritional risk category and follow the appropriate management plan.
Why candidates lose marks
MUST involves several stages, so rushing can result in mistakes.
Common problems include:
- Incorrect BMI calculation
- Forgetting weight loss
- Missing the acute disease component
- Incorrect addition
- Misinterpreting the final risk category
- Failing to consider the management plan
OSCE strategy
Don’t try to complete MUST from memory alone if the chart provides the relevant scoring information.
Follow the chart step by step.
That simple approach can reduce calculation errors and help you remain organised.
5. 2-Level Wells Score: Assessing DVT Likelihood
The 2-Level Wells Score for DVT is used to estimate the likelihood of deep vein thrombosis.
It helps classify a patient as:
- DVT likely
- DVT unlikely
It is a clinical prediction tool and does not, by itself, confirm the diagnosis.
How should you approach it?
Read the scenario carefully and consider each criterion provided on the chart.
Then:
Identify the criterion → Award the points → Calculate the total → Interpret the result → Communicate appropriately
Be careful with assumptions
One of the easiest ways to make an error is to award points based on what you think might be happening.
Only use information supported by the scenario and assessment findings.
Never invent information to complete the chart.
Which Chart Should You Expect for Different Scenarios?
Understanding the relationship between the patient scenario and the assessment tool can make revision easier.
| Scenario or Clinical Concern | Relevant Assessment Tool |
|---|---|
| Patient deterioration | NEWS2 |
| Reduced consciousness or neurological concerns | GCS |
| Confusion or possible cognitive impairment | 6CIT |
| Malnutrition or nutritional risk | MUST |
| Suspected DVT | 2-Level Wells Score |
Remember that the exact documentation provided can depend on the individual OSCE scenario and current examination requirements.
The Golden Rule: Don’t Just Calculate—Interpret
A common mistake during assessment stations is focusing so much on completing the chart that the patient’s clinical condition becomes secondary.
The examiner wants to see that you understand what the result means.
For example:
A score is not the end of the assessment.
You should be able to recognise when a finding is concerning and demonstrate appropriate communication, monitoring or escalation according to the relevant clinical pathway.
This is where clinical judgement becomes important.
6 Documentation Habits That Can Protect Your OSCE Marks
1. Write clearly
Your documentation should be legible and understandable.
2. Complete every required section
Don’t leave boxes blank when information is available.
3. Double-check calculations
A few seconds spent checking your total can prevent an avoidable error.
4. Don’t make assumptions
Use only information provided in the scenario and assessment.
5. Recognise abnormal results
Don’t simply record an abnormal finding—show that you understand its importance.
6. Communicate concerns
If the patient’s condition requires escalation, demonstrate that you know when and how concerns should be communicated.
A Simple Method to Remember Every Assessment Chart
When you see a chart during your OSCE, use this mental sequence:
READ
Understand the scenario and instructions.
ASSESS
Collect the required information.
RECORD
Document findings in the correct sections.
CALCULATE
Work out the score carefully.
INTERPRET
Understand what the score indicates.
ACT
Communicate, monitor or escalate appropriately.
This method can be applied across NEWS2, GCS, 6CIT, MUST and Wells scoring.
Final Thoughts
Clinical assessment charts may look complicated when you first begin preparing for the NMC OSCE. However, once you understand the purpose and sequence of each assessment, they become much easier to manage.
Focus on understanding:
NEWS2 → Deterioration
GCS → Consciousness
6CIT → Cognitive screening
MUST → Nutritional risk
Wells → DVT likelihood
Most importantly, remember that the OSCE is not simply testing whether you can complete a form. It is testing whether you can combine clinical assessment, accurate documentation, communication and safe decision-making.
Practise each chart repeatedly, work systematically and avoid rushing through calculations.
Assess carefully. Document accurately. Interpret confidently. Escalate safely.
Prepare for Your NMC OSCE with Fortu West International
Consistent practice can help you become more familiar with assessment stations, clinical documentation and OSCE communication. Build your confidence by practising realistic scenarios and developing a structured approach to every assessment.
Fortu West International — supporting your journey towards NMC OSCE success.
