Ali Heywood is an RVN with over 25 years’ experience in education leadership, and quality assurance. She is passionate about shaping the future of veterinary nursing through quality education, compassionate leadership, and ensuring that the women in our profession can enjoy long, fulfilling, and sustainable careers.
Ali will be writing a series of blogs throughout 2026 linking to the BVNA Presidential theme of compassion and empathy. Check out Ali’s previous blogs here for the series so far.
There is a particular look that anyone who has supported students through OSCEs will recognise.
They have revised. They have practised. You’ve watched them perform the skill countless times in practice. You know they can do it, and somewhere underneath all those nerves, they know it too.
Then someone says, “You may begin.”
And suddenly, everything they know seems to disappear.
I’ve spent a considerable amount of my career involved with OSCEs in one form or another, and I’m still fascinated by what nerves can do to perfectly capable people. Over the years, I’ve seen the same thing repeatedly: knowing how to do something and being able to demonstrate it under pressure aren’t always quite the same thing.
When nerves get in the way of know-how
We expect students to be nervous about their OSCEs. They matter. Students have invested years of work in reaching them, and passing represents an enormous milestone.
But anxiety can interfere with the cognitive processes we rely upon when performing under pressure, particularly our ability to direct attention effectively.¹ That may help explain the frustrating experience of knowing that you know something, but being temporarily unable to access it when you need it most.
Anyone who has walked out of an exam and immediately remembered the answer to the question they couldn’t answer five minutes earlier will probably recognise the feeling.
The knowledge hadn’t disappeared. You just couldn’t find it when you needed it.
That’s an important distinction for those of us supporting student veterinary nurses.
When a student freezes during practice or forgets something we’ve watched them do successfully before, it’s tempting to say, “Come on, you know this.”
Usually, we mean it encouragingly. But what does the student hear?
Perhaps it’s not I know you can do this.
Perhaps it’s You should know this. Why don’t you?
There’s more at stake than an exam
Something I’ve noticed over the years is that students aren’t necessarily frightened only of failing the OSCE. Sometimes they’re frightened of failing us.
Their clinical supervisor has invested hours in them. Their practice has supported them. Their lecturers have encouraged them. Their family may have heard about little else for months. For a student who is already anxious, perfectionistic or desperate to please, that’s quite a lot of people to imagine disappointing.
And that’s where those of us around them have more influence than we sometimes realise.
An OSCE is a snapshot.
We have seen the journey.
We’ve seen the first hesitant attempt at a skill and the twenty-first confident one. We’ve watched the mistakes, the questions, the breakthroughs and all those ordinary days in practice when nobody was standing nearby with a stopwatch. We know what they’re capable of.
Perhaps one of the most valuable things we can give a student before an OSCE is the certainty that one performance won’t change that.
Let them get it wrong
Psychological safety is generally discussed in relation to workplaces and teams: creating environments where people feel able to speak up, ask questions and make mistakes without fear of humiliation [²]. I think that idea has real relevance to learning too.
Students need somewhere safe to get things wrong.
OSCE preparation shouldn’t be about creating a perfect performance every time. There is enormous value in the practice attempt that goes completely pear-shaped, provided what follows is curiosity rather than judgement. What happened? What went well? Where did you start to lose confidence? What would you do differently next time?
And then-crucially-let’s do it again.
That doesn’t lower standards. The standard remains exactly where it should be. Veterinary nurses need to be safe and competent, and assessment has an important role in ensuring that.
Kindness doesn’t mean pretending something was good enough when it wasn’t. It means helping someone work out how to make it better without making them feel that they are the thing that’s wrong.
Whose voice is in their head?
I learnt something about this long before I started thinking about OSCEs.
When I was learning to drive, I didn’t particularly like my driving instructor. He was quite a tough, slightly odd chap, and he narrated absolutely everything I did. Every mirror check, every signal, every turn. It used to irritate me enormously.
Then I took my driving test.
He wasn’t sitting beside me, but his voice was still there. At every junction and every turn, I could hear him telling me what came next. Even after I passed, his voice stayed with me for months while I was driving on my own. It was only in hindsight that I understood what he’d been doing. Through all that repetition, he’d given me a voice to fall back on when he wasn’t there. At the time I thought he was irritating me; actually, he was helping me develop the habits that would keep me safe when I had to make those decisions alone.
I think there’s something in that for those of us who support students.
The best OSCE preparation isn’t always elaborate. It’s practising a familiar task with a timer running. It’s occasionally standing back and allowing the student to work without prompts. It’s asking, “What went well?” before launching into everything that needs improving. It’s helping someone work out what to do when their mind suddenly goes blank rather than promising them that it won’t.
And sometimes it’s simply being calm when they aren’t.
Eventually, our students have to walk into that assessment without us. We can’t stand beside them, prompt them or remind them of the twenty times we’ve watched them perform that skill beautifully.
But our voice might still go with them.
So perhaps there’s a question worth asking ourselves: what voice are we leaving in their head?
Is it the voice saying, “Come on, you should know this”?
Or is it the calm one saying, “Read the task. Take your time. Think about what you know. You’ve done this before.”
I think that’s what being an OSCE whisperer really means.
Not knowing a secret formula for passing an exam. Not removing every obstacle, and certainly not telling students that everything will definitely be fine.
It’s quietly helping someone develop enough confidence in their own knowledge that, when we’re no longer beside them, they can find their way through the nerves.
One bad day does not make one bad nurse
And if the result isn’t what everyone hoped for?
One bad day does not make one bad nurse.
Failure gives us information. It tells us what needs more work, where confidence disappeared or where knowledge needs strengthening. It can be disappointing-sometimes enormously so-but it doesn’t erase everything that came before it.
Perhaps that’s one of the greatest gifts we can give the students we support: the understanding that we believe in their ability without making our belief dependent on a result.
High standards and empathy aren’t opposites. In fact, perhaps empathy helps create the conditions in which people are best able to demonstrate those high standards.
So, as the next OSCE season approaches, maybe our job isn’t only to ask, “Do they know enough?”
Perhaps we should also ask, “Have we helped them trust what they know?”
Because when the door closes and they’re standing there without us, we can’t tell them what to do next.
But if we’ve done our job well, perhaps they can still hear us.
References
- Eysenck MW, Derakshan N, Santos R, Calvo MG. Anxiety and cognitive performance: attentional control theory. Emotion. 2007;7(2):336-53
- Edmondson AC. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350-83