Background: Assessment of clinical competence is an essential, mandatory requirement and critical norm for accountability of educational objectives as the traditional testing tools cannot evaluate clinical competence. But it became a tough job for nurse educator as it poses several challenges in terms of objectivity and reliability. In spite of increasing usage of OSCE in nursing and the huge number of studies published about it, it is still debatable about advantages of its using. OSCE costs remain an obstacle facing its use.

The aim of this study: was to assess challenges affecting quality of OSCE and suggestions of improvement as perceived by academic nursing staff.

Design: A descriptive exploratory research design was used.

Setting: Faculty of Nursing, Minia University.

Subjects: A purposive sample of 40 clinical instructors and assistant lecturers at medical-surgical, pediatric, obstetric, and community health nursing that using OSCE in students' clinical evaluation.

Tools: I-Socio-demographic data sheet II- Self-administered questionnaire to assess the perceived challenges affects quality of OSCE among study participants and to obtain their suggestions to overcome these challenges.

Results: The highest manpower related challenges perceived by participants were insufficient faculty members (83%) and OSCE is stressful for students (81%). For non-human challenges, the most prominent ones were that some procedures require longer time than others (90%), unsuitability of the available settings to the number of students (83%) and insufficient needed materials/equipment (73%).

Conclusion: The founded human and non-human challenges of the current study may affect the quality of OSCE in all steps, from preparation to application and subsequent suggestions are interrelated. Staff suggested improving in labs preparation and increasing labs numbers. Also, allocating sufficient budget and increasing number of trained staff.

Recommendations: Increase the number of clinical instructors, budget and the work hours of OSCE to accommodate with the increased number of students and permit periods of rest for both staff and students.