Intensive care units in South Africa have been faced with various challenges which in turn affect the working condition of critical care nurses, thus leading to poor productivity. Nurses in the work environment blame this poor work quality of nursing to the way critical care nurses are trained and assessed in nursing schools. There is general concern that graduate nursing students lack the knowledge and skills necessary to equip them to work in intensive units. Objectives: To measure the perceptions of critical care nursing students as well qualified critical care nurses on the use of OSCE as a valid and reliable tool to assess clinical competence in critical care nursing students. Methods: A quantitative approach and descriptive survey was administered to critical care nursing students and qualified critical care nurses who had participated in OSCE examination. The intensive care departments of two provincial (states) hospitals and (provincial) nursing college that trained critical care nurses were used. Results: The findings revealed that OSCE was still overwhelmingly accepted as a relevant tool for assessing clinical competencies in Critical Care courses by both students and staff. It was also clear that the students did not believe that all the competencies required in the ICU environment can be assessed using the OSCE method. Discussion: Critical care nursing educators are facing a challenge to develop more comprehensive method for assessing clinical skills in critical care students nurses since OSCE x examination cannot assess all the skills that are necessary in intensive care environment. In order for effective learning to take place during assessment, it is extremely important for nurse educators to give formative feedback in OSCE. / M.N. University of KwaZulu-Natal, Durban 2012.