Why CNO must approve nursing programs

CNO's registration regulation requires that all applicants have graduated from a program approved by CNO's Council. CNO must consistently and effectively apply this regulatory accountability to all nursing education programs as a fundamental element of protecting the public.

Program approval ensures graduates are prepared to practice nursing safely, competently and ethically for the nursing category and class in which they want to register.

Finding an approved program

We list the approval status of all Ontario nursing education programs on our website. This information is updated annually.

Nursing Education Program Approval

Types of programs approved

Nursing Education Program Approval is CNO's evaluation and monitoring process for approving all entry-level nursing education programs in Ontario. These include the following types of programs:

  • Practical Nursing
  • Baccalaureate Nursing (including programs offered through colleges of applied arts and technology)
  • Nurse Practitioner
  • Bridging Program (for RPNs to graduate with a BScN and become eligible to write the RN registration exam)

CNO does not approve post-graduate programs. Only entry-level nursing programs require CNO Council approval. Although Nurse Practitioner programs are considered post-graduate programs, they are entry-level programs required to be eligible to register in CNO's Extended Class and therefore require approval.

Multiple approvals for schools

Schools that offer multiple nursing programs need to go through the program approval process for each program. These include:

  • schools that offer programs for different categories of nursing, such as Baccalaureate (BScN) and NP programs
  • schools that offer both two-year compressed and four-year direct-entry program streams for the same category of nursing

If a school offers the same program at multiple campuses, they only need one program approval. However, each campus's outcome indicators contribute to the program's overall score.

Approvals for university-college collaborative programs

For Baccalaureate nursing programs offered through a collaboration between a university and a college (or colleges), CNO gives the approval to the university that confers the nursing credential. The university and college work collaboratively to prepare the approval submission for the program.

Fees for the approval process

Nursing schools are required to pay a fee for the approval process to help cover the cost of administering approvals. These payments keep the approval process sustainable.

Objectives of program approval

The objectives of program approval are to:

  • fulfill CNO's legislative duty to approve entry-level nursing education programs
  • promote the safe practice of nursing through a standardized nursing education approval process for all categories and classes of nursing education
  • grant recognition in Ontario to nursing education programs
  • provide interested parties with a transparent account of program approval
  • support continuous evaluation and improvement of nursing education programs

The program approval process

CNO is responsible for administering all aspects of the program approval process. CNO assessors assess each program based on standardized indicators and criteria. They prepare program assessment scorecards and reports, which are reviewed by the CNO program approval staff. Staff make approval recommendations to Council. Council is accountable for the final program approval.

The same approval standards and process are applied to all entry-level nursing programs, such as Baccalaureate Nursing (RN) programs, Practical Nursing (PN) programs and Nurse Practitioner (NP) programs. Five principles guide the process:

  • regulatory-focused
  • transparent
  • evidence-informed
  • objective
  • sustainable

The approval process involves a comprehensive review of nursing education programs every seven years (this term may vary depending on results from the annual monitoring review). Programs are also monitored each year, based on a subset of outcome measures (for example, nursing registration exam results). Programs must meet or exceed the approval requirements to be approved by Council.

French program approval: All materials required by the schools to complete the program approval process are available in both French and English.

Program Approval Framework

We use the Program Approval Framework to evaluate all nursing education programs in Ontario. At the centre of the framework is the program's effectiveness in preparing graduates to practice in a safe, competent and ethical manner.

Each nursing education program is evaluated using three approval standards:

  • structure
  • curriculum
  • outcomes

Program Effectiveness: Structure, Cirriculum, Outcomes

Each of the three standards uses indicators and evidence requirements to evaluate a program's performance of that standard.

We use the following three processes to approve programs:

  • preliminary review process for new education programs
  • comprehensive review process
  • annual monitoring process

The comprehensive review is a rigorous evaluation of a program based on all three standards in the framework and the associated nine indicators. The comprehensive review is conducted every seven years.

The annual monitoring review involves an evaluation of the outcome indicators.

Comprehensive Review Process: Council Approval Process, Monitoring Review Process

Council uses these two review processes to determine a program's approval status.

Using registration exam results in the approval process

One of three outcome indicators CNO uses to approve nursing programs is the pass rate of a program's graduates when they take the entry-level registration exam for the first time. This indicator has a score, calculated using a three-year cumulative total of first-time pass rates, which contributes to the overall score for the program.

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