The study examined the differential impact of high-stakes and routine OSCE (Objective Structured Clinical Examination) stations on stress levels and clinical competency in nursing students. This was an experimental study conducted at Torbat Heydariyeh University of Medical Sciences. The research aimed to compare how a high-stakes OSCE station (with higher consequences for outcomes) affects student stress compared to a routine OSCE station. The study measured stress levels and clinical competency in nursing students under both conditions. The research has been completed and contributes to understanding the impact of high-stakes pressure on student performance in medical education.