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NCLEX to Become Canada's New Nursing Exam Standard

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By Megan M. Krischke, contributor 

August 6, 2012 - Taking the nursing exam is never easy, but at least U.S. nurses don’t have to wait weeks and weeks for their results.  Soon, Canadian nurses won’t have to, either.

After years of using the pen and paper-based Canadian Registered Nurse Examination (CRNE) as their entry to practice exam for RNs, Canadian nurse regulators identified a need to update their testing approach. Ten provincial Canadian registered nurse regulatory bodies put out a request for proposals for a new computer adaptive test (CAT) in September 2011.

In July, the National Council of State Boards of Nursing (NCSBN) announced a finalized agreement to provide the National Council Licensure Examination for Registered Nurses (NCLEX-RN)--currently used in the United States--in Canada beginning in 2015.  It will replace the CRNE as a licensure requirement.

“The Canadian nurse regulators are very excited about this new partnership with NCSBN. We are all committed to having an exam that ensures those entering the nursing profession are safe to practice,” commented Anne Coghlan, RN, MScN, executive director and chief executive officer of the College of Nurses of Ontario and recently elected president of the Canadian Council of Registered Nurse Regulators (CCRNR), which includes the 10 regulatory bodies that signed the agreement with NCSBN.

“The new exam will use state-of-the-art computer adaptive technology, which means it will be available year-round. It also meets the highest standard for validity and security,” Coghlan said.

The current CRNE is limited in that it is only offered three times a year and it takes four to six weeks for examinees to receive results. The NCLEX-RN’s year-round testing and ability to provide results within a number of days will mean that new nurses can enter the workforce more quickly.

As a precursor to developing the exam, Canadian nursing practice will be analyzed to determine the essential knowledge, skills and abilities for entry-level nursing. Over the next three years, Canadian regulators and nursing subject matter experts will review the current NCLEX-RN exam questions to ensure that none of the questions are biased toward U.S. or Canadian contexts, while remaining an accurate evaluation of a nurse’s ability to practice safely. There will be opportunities for Canadian nurses to volunteer to participate in the processes that are used to develop exam questions.

NCLEX and Canada
Anita Molzahn, PhD, RN, FCAHS, professor and dean, University of Alberta School of Nursing, is confident that the move to the NCLEX-RN exam will be a positive one for nurses and the Canadian health care system.

“While the U.S. and Canada have different health care systems, the work of nursing is mostly the same,” stated Anita Molzahn, PhD, RN, FCAHS, dean of the faculty of nursing at the University of Alberta School of Nursing. “Whether you are delivering a baby in Minneapolis or Toronto, the process is pretty much identical.”

“It is also important to remember that learning the entry competencies is only one part of a nurse’s education,” added Coghlan. “Nurses also need to learn about the laws, policies and cultural issues that affect their profession. They need to know about the policies and procedures of the facilities where they work, and the unique needs of the populations that they care for.”

“This is why the national RN exam is only one requirement for becoming a nurse,” she added. “In Ontario, for example, applicants are required to graduate from an approved nursing program and, starting in 2013, pass an exam that tests their knowledge of Ontario laws and regulations.”    

Although there is a change in the format of the test, it will still be testing the entry to practice competencies expected of RNs and does not require a change in what nursing students are taught.

“The regulators have assured us that they will work with [educators] to help us fulfill our responsibility to teach students how to write these computer-based exams,” noted Molzahn. “Even so, there are a lot of questions and some anxiety among students and educators. The regulators are working carefully with the NCSBN to guarantee the test is successful.”

“We all know that change can be difficult for everyone involved,” recognized Coghlan. “While we are moving from a written, pen and paper exam that is held a few times a year, to a computer adaptive test that is held year-round; it is important to remember that the purpose of the exam--to test the RN applicant’s knowledge of the competencies required for safe nursing care--is the same.”

“As nurse regulators, our primary accountability is to assure the public that nurses are safe to practice--an interest that is shared by nurses, hospitals, educators and patients,” she continued. “The new exam will be one of the ways we ensure RN applicants have the competencies needed to enter the profession.”



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