From Bridging Programmes to Outcomes-Based Assessment-Equity, Workforce Integration and Regulatory Implications for Internationally Qualified Nurses in Australia: A Rapid Scoping Review.

aimTo map and synthesise available direct, regulatory and contextual evidence relating to the implementation, reported challenges and potential equity implications of the OBA pathway for IQNs seeking registration in Australia, 5 years after its introduction in March 2020.

designRapid scoping review. REVIEW

methodsA rapid scoping review incorporating document analysis was conducted in accordance with PRISMA-ScR, with PRISMA-S informing search reporting. The original database and grey-literature searches were undertaken between February and March 2026. An update search was undertaken in September 2026 to capture newly published OBA/OSCE evidence, including a directly relevant 2026 evaluation of the nationwide licensing OSCE. Regulatory and policy documents were analysed using the READ framework, and heterogeneous evidence was integrated using narrative synthesis incorporating thematic analysis.

resultsTwenty-four sources were included, comprising 13 peer-reviewed evidence sources and 11 regulatory or policy documents. Regulatory evidence clearly documented the structure and requirements of the OBA pathway. The updated evidence base now includes direct empirical evaluation of the nationwide licensing OSCE, demonstrating the value of triangulating psychometric, cost, acceptability and stakeholder data to optimise high-stakes OSCE design and delivery. Nevertheless, direct evidence concerning candidate equity, accessibility and longer-term workforce outcomes remains limited; broader IQN evidence remains predominantly contextual rather than OBA-specific. DATA SOURCES: Scopus, Web of Science, CINAHL, MEDLINE, ProQuest One Academic, targeted grey-literature and regulatory sources, citation searching, Google Scholar and Google; eligible sources were published from 2020 to September 2026.

conclusionEvidence concerning OBA is strengthening, particularly for the OSCE component, but remains uneven. The pathway and its assessment architecture are well documented, and direct OSCE evaluation now provides evidence relevant to assessment quality and defensibility. Evidence directly linking OBA to equity, candidate burden and post-registration workforce outcomes remains insufficient. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurse regulators, educators and organisations should distinguish assessment of entry-to-practice competence from broader transition and workforce integration needs. Preparation, orientation and post-registration support should be evaluated alongside regulatory assessment, without assuming that broader IQN transition challenges are caused by OBA. IMPACT: This review maps the evolving evidence on Australia's OBA pathway, incorporates new direct evidence evaluating the national licensing OSCE, and identifies priority gaps in equity, candidate experience and workforce-outcome evaluation. NO PATIENT OR PUBLIC CONTRIBUTION: This study involved analysis of existing literature and publicly available documents only.