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Updating RPN competencies and exam
CNO and the British Columbia College of Nurses and Midwives (BCCNM) are working together to develop a new entry-to-practice exam for Practical Nurses. We have partnered with the National Council of State Boards of Nursing (NCSBN) to develop the exam, known as the Regulatory Exam–Practical Nurse™ (REx-PN™), which will launch on January 4, 2022.
The REx-PN will test Canadian PN entry-to-practice competencies. It’s based on current RPN practice, is focused on client safety, and will ensure nurses who enter practice have the knowledge, skills and judgment needed at the beginning of their careers to practice safely.
Currently, all regulatory jurisdictions (except for Quebec, which uses its own exam) use the Canadian Practical Nurse Registration Examination (CPNRE), an exam developed and administered by Yardstick Assessment Strategies Inc. (YAS). CNO and BCCNM will continue to use the CPNRE until December 31, 2021, the end date for the current exam as approved by CNO's Council.
Health care continues to advance rapidly and, as a result, the competencies nurses need to apply are constantly evolving. In addition, the large and growing population in both Ontario and British Columbia is increasing the need for nurse resources. Each year in Ontario and British Columbia, about 7,000 people apply to write the regulatory exam needed to practice as a Practical Nurse (PN). As two of the country’s largest regulators of PNs, we face similar challenges when assessing this large number of applicants to ensure they are ready to practice safely. Given the similarities in the issues we face, Ontario and B.C. are working together on developing a new exam and related processes that will allow us to continue to test effectively this large number of applicants for competencies they need to practice safely.
After a thorough review of possible vendors to assist us with this work, CNO and BCCNM chose the National Council of State Boards of Nursing (NCSBN). NCSBN brings expertise in exam development, security, technology, research and administration in a way that most closely aligns with our current needs, our plans for future growth and the potential enhancement in testing methodology and safety.
In addition, we worked with other Canadian regulators to create a national set of entry-to-practice competencies needed by RPNs. As part of this work, we got input from Canadian educators from French and English nursing programs, recent graduates, current RPNs and other stakeholders. This collaborative work will ensure that the content covered by the new exam are reflected in what is being taught, and that academic institutions have the time they need to make any necessary changes to their curriculum (see PN Exam Transition Working Group for the latest updates).
Benefits of these changes will include:
- Staying current: We're always looking for ways to improve public safety, and routinely review the latest evidence to see where we can make improvements. This review also considers the current competencies needed by nurses today.
- Improved security: Advancements in technology continue to make it easier to proactively monitor and rapidly respond to breaches in exam security.
- No limit on writes: Writers of the current CPNRE exam are limited to three attempts to pass the exam. Because the REx-PN will be a computerized adaptive test (CAT exam), it allows for no limit on the number of times a writer can attempt it. The system knows if a writer is retaking the exam and supplies them with a set of questions different from those the writer had in previous attempts.
Regardless of the number of attempts, the only way a person will successfully pass the REx-PN is if they are able to show they have the knowledge, skill and judgment to practice safely as an entry-level RPN.
- Accessible: The REx-PN will be available to write at any time in permanent and temporary centres of the exam provider, Pearson Vue. REx-PN writers will have to wait a minimum of 60 days between attempts, which equates to a maximum of six attempts per year.
- Fast feedback: REx-PN exam writers will usually have their results within two business days after writing. If a writer is not successful on their exam, CNO will send them a Candidate’s Performance Report (CPR) that will provide information about how they did in each section of the exam, indicating whether they performed above, near or below the passing standard to help them prepare for a future exam write.
- Availability of prep materials: A Practice Exam is available from the exam developer. It gives the "look and feel" of writing a Computerized Adaptive Test (CAT), which is the format of the REx-PN and one that some exam writers may not be familiar with. The Practice Exam is not intended to be a study guide or to determine readiness to write the REx-PN.
A RPN applicant's nursing education and the resources provided on this page should be enough to prepare them to write the REx-PN. Third-party vendors may develop and offer REx-PN preparation courses, but it is important to be know that they do not have access to the REx-PN question bank. CNO is aware of some prep courses being developed in English but CNO cannot attest to their success in helping someone to prepare to write the REx-PN. To date, we have not been made aware of any preparation courses being produced in French, although we continue to make inquiries
- Increased stakeholder involvement: Nurses in Canada form the committees working on the exam. French educators from Ontario are involved in the development and translation process, which is rigorous and evidence informed. We’ve been speaking with educators of Practical Nurse programs about our plans, and solicited their early feedback on the time they’ll need to incorporate any revised competencies and exam format into a new curriculum. We’ve also been engaging with other stakeholders and will continue to do so throughout the project exam development and after.
Resources for Educators
The following resources show what is behind the development of the REx-PN.
To start the process of creating a new exam, we first conducted a Practice Analysis in early 2019, which included participants from both B.C. and Ontario. We assembled a panel of subject matter experts who helped to create a list of RPN activities that we then incorporated into a survey sent to new RPNs. We analyzed the survey data. The recently revised national entry-level/entry-to-practice competencies were also mapped to the Practice Analysis to ensure the exam includes competencies essential for safe nursing practice.
Because the Canadian health care industry is evolving rapidly, Practice Analysis studies will be conducted by CNO and BCCNM every five years.
The REx-PN will not test everything an RPN needs to know throughout their career. It will test the competencies — knowledge, skill and judgement — nurses are expected to have within the first year of practice in order to keep patients safe. The Test Plan can be used by applicants to help guide them in preparing to write the REx-PN, the Test Plan details the content areas to be tested in the REx-PN. It also describes how the exam is structured including the length of the exam and how it is scored. The Test Plan can also be used by educators to guide them in writing REx-PN-type questions so they can help students prepare for the exam.
The Test Plan is also used to provide direction to those developing exam questions.
Questions for the REx-PN are developed by Canadian nurses.
- Mapping document To show how the REx-PN will test specific RPN competencies, we've mapped the competencies to the content areas of the Test Plan.
- Video: Computerized Adaptive Testing (CAT)
Practice Exam: A set of two REx-PN practice exams is available from the exam developer. They give the look and feel of a Computerized Adaptive Test (CAT) — the format of the actual REx-PN exam applicants will take on their test day.
Field Testing with students
To ensure that the questions on the REx-PN are a fair test of the knowledge, skill and judgement needed by RPNs entering practice, we are field tested questions with final-year Practical Nursing students first. We are grateful to the hundreds of students across Ontario and British Columbia who are giving their time to this testing. By participating, they are showing leadership and accountability to their future profession.
A collaborative process
We are committed to engaging with stakeholders throughout the exam development process and following the exam's implementation. Opportunities to contribute and be involved, such as item writing and item review panels, are posted on the CNO and BCCNM websites. We will continue to offer workshops for educators, as well as information sessions.
If you have questions about the REx-PN project, contact us at RExPN@cnomail.org.
Additional REx-PN Resources
- REx-PN™: FAQs
- National Council of State Boards of Nursing (NCSBN): Additional REx-PN™ Information
- REx-PN Practice Analysis