Electronic exam for nurses coming to Canada

Alfred Lam practises taking the blood pressure of first year nursing student Jaclyn Dell'Unto. (Sahar Fatima/Ryersonian Staff)

Alfred Lam practises taking the blood pressure of first year nursing student Jaclyn Dell’Unto. (Sahar Fatima/Ryersonian Staff)

Aspiring registered nurses in Canada will write an American entrance exam starting next year, and some Ryerson students are worried they won’t be prepared.

New nurses currently write the Canadian Registered Nurse Examination, which tests their competence, before they can practise.

But starting in 2015, regulating bodies for registered nurses in each province and territory, excluding Quebec, will introduce the computerized National Council Licensure Examination for Registered Nurses (NCLEX-RN) in an effort to keep up with advancing technology.

The same exam will be used in the U.S. where versions of it have been administered for years.

“Our curriculum hasn’t really adapted and changed yet so that’s … worrying,” said Alfred Lam, a third-year student at Ryerson’s Daphne Cockwell School of Nursing. His graduating class will be the first to write the new exam after regulators decided in 2011 to bring it up north.

“The Canadian exam is more based on looking at the social determinants of health,” Lam said he’s heard from professors, while “(the NCLEX-RN) is more based on hard facts, hard sciences…that we aren’t really focusing on in school. I’m sure we’re being taught this stuff but I don’t know if we’re focusing on the right things right now.”

But Kileen Tucker Scott, a professor at Ryerson’s School of Nursing, said the two exams are the same content-wise.

According to the College of Nurses of Ontario, the province’s regulating body for registered nurses, studies and surveys “revealed a 98 per cent congruency in nursing practice and competencies” between Canada and the U.S. The regulator’s website also said that Canadian representatives will be involved at each stage of the NCLEX-RN’s development to address any differences in terminology.

Tucker Scott said the major difference between the NCLEX-RN, developed by American not-for-profit organization National Council of State Boards of Nursing, and its Canadian predecessor is the format and marking method.

“We’ve been aware of it since its adoption, and we have begun already to format some of our exams that we give students … along the same format as the NCLEX,” Tucker Scott said.

While both exams feature only multiple choice questions, the NCLEX-RN selects its questions based on how candidates answered the previous question. Once the computer has concluded whether the exam taker is above or below the passing standard, the test is over. This means that candidates could answer anywhere from 75 to 265 questions, depending on how long it takes to determine their competence level.

Tucker Scott said Ryerson is preparing students with multiple choice exams that feature audio, video and ordering lists by priority.

“We’ve been incorporating as much as we can within the limits of the exam support systems within the university,” she said.

Outside of class, the Chang School will provide NCLEX-RN preparation workshops to help students prepare for the exam after graduation, according to Nancy Purdy, the associate director of the Collaborative Degree program at Ryerson.

Mary Wei, another third-year nursing student and president of Ryerson’s Nursing Course Union, agreed that her university exams are adapting.

“They’re only really starting to kind of prepare us now,” she said. “I feel like it’s just not as smooth as I would have liked it to happen.”

Both she and Lam said a representative from a test preparation company recently visited their class to discuss the NCLEX-RN and give all third-year students free access to an online preparation course.

“They have been trying. I give kudos to them for that,” said Lam. “Given the amount of time before our actual NCLEX exam, I don’t know if that’s enough time to fully prepare us, because we’ve already gone through a year or two of nursing school.”

This story was first published in The Ryersonian, a weekly newspaper produced by the Ryerson School of Journalism, on February 26, 2014.
This version corrects the title for Kileen Tucker Scott.

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