The College of Nurses of Ontario is one of 10 regulators who have entered into an agreement with the National Council of the State Boards of Nursing (NCSBN), a U.S.-based not-for profit organization, to collaborate on the development of a new national RN entry-to-practice exam. Here, the College answers questions from Ontario nurses, educators and nursing students, and addresses misconceptions about the exam.
Will personal information be protected?
Yes, the College will be addressing issues around the security and confidentiality of exam writers’ personal information as it works with National Council of the State Boards of Nursing (NCSBN) in the development of the exam. A review of Canadian privacy protection legislation at both the federal and provincial levels has already been conducted to ensure that exam services will comply with Canadian privacy requirements.
Canadian and Ontario privacy laws do not restrict the transfer of information from Ontario to the U.S. In fact, there are many ways that personal information is transferred across borders in the course of a person’s day-to-day activities such as online shopping, purchasing airline tickets or subscribing to U.S. magazines.
The College takes its accountability for protecting exam writers’ privacy and confidentiality seriously and is responsible for ensuring that the information provided by candidates is protected in accordance with Canadian privacy legislation and that strong data-security measures are in place.
Could personal information be accessed through the Patriot Act?
The Patriot Act was introduced after the events of Sept. 11, 2001 to support the U.S. government’s anti-terrorism efforts. It allows the U.S. government to seek a court order to access a person’s personal records (usually travel or financial information) for the purpose of anti-terrorism investigations. Similar legislation exists in Canada and other countries. The likelihood of the U.S. government seeking access to information belonging to Canadian exam writers is extremely low. Several U.S.-based exams, including the Medical College Administrations Test (MCAT) and the Law School Admissions Test (LSAT), have been used in Canada for several years. To our knowledge, no Canadian’s personal information supplied for these exams has ever been accessed by the U.S. government through the Patriot Act.
Will this exam make it easier for nurses to move to the U.S.?
Successful completion of the RN exam is only one of several entry-to-practice requirements that applicants have to meet before being registered in the jurisdiction in which they want to work. Similarly, American nurses who want to work in Ontario will be required to meet all of the College’s entry-to-practice requirements.
Although nursing is a global and mobile workforce, nurses choose where they work for a variety of reasons. Among these are an area’s available employment opportunities, proximity to where they studied, or changes in family or relationship situations.
Ontario is recognized as an attractive place to live and work. Over the past 10 years, the College has seen significant increases in the number of applicants for registration from around the world. For example, in 2001, the College had 1,997 applicants for RN registration and 248 applicants for RPN registration from other countries. In 2010, these numbers had increased to over 2,400 RN and 1,640 RPN applicants.
Are the differences between the Canadian and the U.S. health care systems addressed?
The American exam, called the NCLEX®, is being used as the basis for the new exam; however, Canadian regulators will ensure that the exam tests the entry-to-practice competencies for the Canadian nursing profession. It is not the purpose of the entry exam to test applicants’ knowledge of the Canadian health care system or ‘culture’. Cultural values, legislation and health-delivery systems vary across borders – urban/rural and provincial, federal and international. For an entry-to-practice exam to be valid, psychometrically sound and legally defensible, it must focus on testing only the competencies required for nursing practice. The focus on the exam is ensuring that applicants will be able to provide safe care as they begin their nursing careers.
Applicants’ knowledge of Ontario’s specific health care legislation, standards, culture and systems will be assessed by a second exam. This “jurisprudence exam” will contain questions that test applicants’ preparedness to practise in Ontario’s health care environment. (Note: this exam is part of the proposed amendments to the Registration Regulation and will come into effect when the regulation is approved by government later this year.)
Why were nurses not consulted about this change?
Canada’s nursing regulators have been mandated by their provincial governments to make decisions about the education and examination required to enter the nursing profession. The regulators’ role is to make decisions that are in the best interest of the public and support access to the nursing profession.
Will Canadian nurses participate in the exam’s development?
Nurses and nurse educators from across Canada will be involved in many aspects of the development of the exam over the next three years. For example, nurses will be involved in item writing, reviewing French translations, and ensuring that questions are free of cultural, gender, jurisdictional, language and other biases.
What are the new exam’s benefits?
Nursing students and international applicants have expressed a desire for more frequent access to the entry-to-practice exam and the faster issuing of exam results. The new exam provider will address these issues, and will also ensure the administration of the exam is cost-effective. The exam will also be a state-of-the-art computer-adaptive exam, which is more secure than a paper-based exam.
Will Canadian nursing schools have to change their curricula?
No, Canadian nursing schools will continue to teach based on the Canadian entry-to-practice competencies.
What personal information has to be provided?
The information applicants provide before writing the exam is less than is required when applying for a credit card. For example, applicants will have to provide their name, an email address and a phone number, but a Social Insurance Number will not need to be provided.
When will the exam be introduced?
The new RN entry-to-practice exam will be introduced in January 2015.
Why was the NCSBN chosen?
The National Council of State Boards of Nursing has a proven track-record of developing and administering computer-adaptive exams successfully, and their proposal met all of the requirements for the exam sought by the Canadian regulators. The NCSBN was selected through a formal RFP process.
What is the NCSBN?
The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization that brings together U.S. nursing boards together to address matters concerning public health, safety and welfare, including the development of licensing examination for nurses. Members include all of the U.S. state boards of nursing as well as international associate members, including the College of Nurses of Ontario and four other Canadian regulatory colleges. For more information, visit www.ncsbn.org/