U.S.-centric test imposed on nurses

Manitoba union critical of exam that references Obamacare

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A new American-supplied test for Canadian nursing grads is being blamed for soaring failure rates, raising concerns potentially good caregivers will be forced out of the profession.

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Hey there, time traveller!
This article was published 17/10/2015 (2606 days ago), so information in it may no longer be current.

A new American-supplied test for Canadian nursing grads is being blamed for soaring failure rates, raising concerns potentially good caregivers will be forced out of the profession.

The computer-generated NCLEX exam, supplied by the U.S. National Council of State Boards of Nursing, was instituted in Canada at the beginning of this year.

Critics say the new test, which supplanted a long-standing written exam, is rife with Americanisms and fails to reflect the scope of Canada’s four-year nursing programs.

Mike Aporius / Winnipeg Free Press Sandi Mowat: 'a lot of hard feelings' among nurses

They say they are concerned that during the first six months of its existence, only about 70 per cent of nursing grads in Canada — about 68 per cent in Manitoba — have passed the test. This is significantly lower than passing rates in the high 70s and low 80s previously.

“We’re at risk of losing a very precious group of potential nurses,” said Donalda Wotton, a University of Manitoba nursing instructor. “We’re short of nurses.”

Wotton said the new test contains questions that reference Obamacare and U.S.-approved drugs that are not available in Canada.

She said test questions, in a bid to be “unbiased,” strip patients of their age, gender, ethnicity and demography — something that runs counter to what they’re taught. “Our students aren’t just servicing those who are insured like they do in the United States,” she said. “We service everybody who comes to the door.”

The head of the Canadian Association of Schools of Nursing is incensed Canadian regulatory colleges are using the new test.

Kirsten Woodend, the group’s president, said the high failure rates could lead schools to teach to the test at the expense of covering a broad curriculum.

“It will take time away from what it is that we really need to be teaching nurses in order to practise safely and well in the Canadian health care system,” said Woodend, dean of the Trent-Fleming School of Nursing in Peterborough, Ont.

Woodend said less than 50 per cent of the competencies students are to have by graduation are tested in the NCLEX exam.

“I think there is the potential for this test to degrade nursing care and health care and therefore patient care in this country,” she said.

However, the exam’s defenders say the purpose of the test is to assess “entry-level competencies” — what a nurse needs to practise safely and competently — not to examine all that a student learned during a four-year degree and practicum. They say that was true for the old test that NCLEX replaced.

Katherine Stansfield, executive director of the College of Registered Nurses of Manitoba, a regulatory body that participated in the acquisition of the test, said before settling on NCLEX, Canadian regulators conducted an extensive review of what competencies were required by nurses as they entered practice in Canada, using B.C. and Ontario as templates.

“Those were compared to the American competencies, and they were seen to be equivalent,” she said.

‘We’re at risk of losing a very precious group of potential nurses’ — Donalda Wotton, University of Manitoba nursing instructor

Stansfield said there was an effort made to eliminate American cultural or jurisdictional biases that may have crept into the exam. “Where they were found, they were removed,” she said.

Stansfield pointed out a relatively low number of students write their nursing exam in the first half of the year — the majority write in the fall. She said it’s possible the early pass-fail results may have been skewed by a low sample.

The Manitoba Nurses Union and the Winnipeg Regional Health Authority are both concerned about the sudden drop in pass rates brought on by the new test.

“We raised issues (with the test) right from the get-go… because we were concerned that they were going to use an American-based exam. And we were assured that it would be Canadian content,” said MNU president Sandi Mowat.

Nursing graduates can work as nurses before they write the entry-to-practice exam, but if they fail it twice, they lose their licence to practise until they pass it. And if they fail the exam a third time, they’re out.

Lori Lamont, the WRHA’s chief nursing officer, said the number of employed graduate nurses who fail twice is generally low. “It happened occasionally in the past, but certainly not as often,” she said, adding she knows of about six instances this year.

“If that were to increase, then that would certainly be a significant concern for us as an employer,” Lamont said.

larry.kusch@freepress.mb.ca

Larry Kusch

Larry Kusch
Legislature reporter

Larry Kusch didn’t know what he wanted to do with his life until he attended a high school newspaper editor’s workshop in Regina in the summer of 1969 and listened to a university student speak glowingly about the journalism program at Carleton University in Ottawa.

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