This literature review aims to explore the appropriateness of the objective structural clinical assessment (OSCA) as method of assessment for graduate perioperative nurses. The methodology used involved searches of the following databases: CINAHL and Science Direct. The terms used in the search were: OSCE; OSCA; competenc* AND nurs* assess*/measure*/evaluat*; graduate nurse assess*; Benner AND assess* and Bondy rat* scale from January 2001 to August 2011. Strict inclusion and exclusion criteria were applied. This resulted in the inclusion of 10 papers. These papers predominantly addressed the need to define clinical competence, the lack of appropriate measurement instruments used in OSCAs – specifically; the reliability, validity and establishment of more rigorous methods used to define success in OSCAs. The paper concludes by finding that the literature does not achieve consensus regarding the definition of competence nor does it identify appropriate measurement instruments. Gaps and contradictions in the literature are evident, leaving doubts over the reliability of using OSCAs as a means to determine the notion of “clinical competence”. Longitudinal studies are needed to define clinical competence and to track the use and relevance of OSCAs in the clinical setting.