Assessment of clinical skills: a new approach to an old problem.

The changed nature of clinical placements, with shorter in-patient episodes and staff in clinical areas carrying increasingly high workloads, has prompted changes in the teaching learning and assessment of clinical skills. The 'Bart's Nursing OSCE' is an innovative approach to the assessment of clinical skills, through the medium of simulated professional practice. The antecedents of this educational development are discussed before detailed description of the Bart's Nursing OSCE. Discussion focuses upon: the rationale, authenticity, validity and reliability of the assessment; the roles of assessors and simulated patients; feedback to and from students and other stakeholders; the educational impact of the innovation; and management issues.