NMC OSCE evidence-based practice 2026: the 15 adult topics explained

How the station works

Evidence-based practice is a 10-minute written station. You get:

• a short scenario, usually three or four lines
• a research article, about a page to a page and a half

You then write your answers based on the evidence: what current practice is for that topic.

Reading and summarising the article in 10 minutes is hard. The best preparation is to know the main points of current practice for every topic before exam day, so the article only confirms what you already know.

Which topics apply to the adult OSCE

The NMC’s station timings list more evidence-based practice topics than apply to adult nursing. Some, such as effective communication with colleagues (added for children’s nursing in March 2026), belong to other fields. The NMC’s adult nursing marking criteria (September 2026) cover 15 topics for the adult OSCE, and these still apply after the new stations added from 26 October 2026. The NMC updates the list regularly, so check the latest marking criteria before your exam.

The 15 topics and what the evidence says

1. Ankle sprain. An ankle sprain is a soft tissue injury, not a fracture. The question is whether paracetamol or an NSAID such as ibuprofen works better for the pain. The evidence shows both are equally effective, even though ibuprofen is often prescribed as if it were stronger. Ibuprofen is contraindicated in patients with renal, cardiac or respiratory problems, so for an asthmatic patient, for example, advise paracetamol.

2. Bedside handover. The evidence shows bedside handover is an effective communication tool. Patients and nurses both like it because it creates two-way communication and makes the patient part of their care. There are still challenges in practice, and how bedside handover is designed and delivered needs improving.

3. Cervical screening. You may be a practice nurse advising a woman who is unsure about her smear test. Explain why regular screening matters in preventing cervical cancer. The main cause is human papillomavirus (HPV), and cancer can take 10 to 20 years to develop after infection, so her current sexual behaviour does not necessarily reflect her current risk. The peak age is 30 to 45, but it can affect anyone with a cervix. Screening starts at 25, with invitations every five years up to 64. After 64, women are only invited if they have had an abnormal result. Discuss any worries she has about the test.

4. Cholesterol and coffee (new this year). Does coffee affect blood lipids? Some studies show it can lower cholesterol, others show a negative effect, so the evidence is not conclusive. Other studies link coffee with lower all-cause mortality. Most positive findings are at one to three cups a day, so current advice is no more than about three cups.

5. Dementia and music. Studies where patients had at least five sessions of music therapy show a positive effect on symptoms of depression, which many people with dementia develop. It may improve quality of life, though that evidence is less reliable, and there is little evidence that it helps agitation. There is no conclusive evidence on how long the benefits last after therapy ends.

6. Diabetes (hypoglycaemia). This topic is specifically about hypoglycaemia. Patients on insulin are at higher risk than those on tablets such as metformin, but both can have a hypoglycaemic episode. Episodes are often caused by diet, such as missing a meal or not eating enough carbohydrate. Advise the patient on the signs and symptoms (sweating, feeling faint or light-headed, blurred vision, new confusion, nausea), to eat regular meals, to call 999 if symptoms occur, and to tell family and friends to call 999 if they become confused or lose consciousness. During an acute illness they should check their blood glucose more often.

7. Female MI symptoms. You are advising a woman at high risk of a heart attack. The key message is that chest pain is not a reliable sign of a heart attack in women: it may be severe, mild or absent, while other symptoms are present, such as nausea or pain in the back, shoulder, neck, throat, jaw or arm. She should recognise the symptoms early and call 999 straight away, even if she is not sure it is her heart.

8. Fever in children. Paracetamol and ibuprofen are both effective at reducing fever in children. Only treat a fever if the child is uncomfortable or distressed with it, because fever is an important part of fighting infection. Ibuprofen is best taken with food to reduce stomach side effects, although it is safe with or without food in the short term (up to 7 days). Check whether the child has asthma, and note there is no evidence that ibuprofen has more side effects than paracetamol.

9. Honey and propolis for herpes simplex (HSV). Propolis is a resin-like substance bees make from plant sap. The evidence is strong: honey and propolis both work as antivirals by stopping the virus from replicating, and can be as effective as aciclovir, without its side effects. Patients can consider them as an alternative treatment.

10. Honey dressings for venous leg ulcers. Despite manufacturers’ claims, there is no evidence that honey dressings reduce ulcer size or healing time compared with standard dressings. In one large study, patients using honey also reported more pain, and there is no evidence honey is cost-effective. A very small study suggests it may help when the ulcer is infected with MRSA, because honey is antimicrobial, but more research is needed. Until then, follow the trust’s evidence-based wound care protocol.

11. Osteoporosis and exercise (new this year). Falling oestrogen during the menopause reduces bone density and raises fracture risk. The evidence clearly shows exercise helps preserve and sometimes improve bone density. The newer research favours high-intensity exercise over the low to moderate intensity traditionally advised. Any change should be discussed with her clinician.

12. Pressure ulcer prevention. A foam dressing on the sacrum has been shown to reduce pressure ulcer development by 10%, but a patient can still develop one, although it may happen later. Mild skin irritation is a very rare side effect. Men may be at higher risk. Advise on other prevention too (good diet, regular repositioning, caring for pressure areas) and say you will discuss the case with the tissue viability team.

13. Restraint. The evidence shows restraint harms the patient: it creates fear, can be seen as a show of power over patients, breaks down trust, and is distressing for staff. Compassionate communication may prevent the need for it. Use it only as a last resort when the patient’s or staff’s safety is at risk.

14. Saline versus tap water. Usually a community scenario: a patient with a chronic wound or leg ulcer asks whether they can clean it with tap water, because saline is expensive. Trials found no difference in wound infection or patient satisfaction between tap water and saline, and tap water is recommended as a cost-effective option. The evidence has limits: the trials used different definitions of wound infection, and there is little evidence on healing, pain or adverse events.

15. Smoking cessation. E-cigarettes appear more effective than nicotine replacement therapy and are more satisfying to use, but both can work and both have side effects: e-cigarettes more often irritate the mouth and throat, while nicotine replacement more often causes nausea. Without face-to-face support both work poorly, so signpost the patient to the local stop smoking service and encourage them.

How to prepare

Learn the main points of current practice for each of the 15 topics, then practise writing answers against a scenario and article in 10 minutes. Every topic has its own full video in our evidence-based practice playlist on YouTube.

Our online course covers all 10 OSCE stations, including evidence-based practice.