Implementation of NCLEX-RN exam in Canada inspires further research
The introduction of the National Council Licensure Examination (NCLEX-RN) exam in 2015 was a tumultuous time for Canadian nursing students and nurse educators alike.
While used in the U.S., the exam’s computer-adaptive format and the learning being tested were new to Canada—and it caused a huge amount of stress, worry, and frustration.
With little advanced understanding of the exam coming, universities across Canada, including AU’s Faculty of Health Disciplines (FHD), scrambled to respond. FHD quickly initiated an NCLEX-RN working group which attended national and provincial information meetings and worked to explore the exam and resources and to develop strategies to support student success.
“I watched students struggle, and it was frustrating,” says Kristin Petrovic, Academic Coordinator, Undergraduate Nursing. “It tugged at my heartstrings. We have fantastic nursing programs in Canada and I want students to be successful—but the initial pass rate for the NCLEX-RN was low.”
This difficult experience led Petrovic, a member of the working group, to work with FHD colleagues Dr. Annette Lane, Associate Professor, Dr. Emily Doyle, Academic Coordinator, Counselling, and Dr. Lynn Corcoran, Assistant Professor and Program Director, BN Clinical Affairs, to delve into what happened and explore what could be done to avoid situations like this in the future.
Together, they embarked on a multidisciplinary ethnographic research project to try to understand the stresses and impact of the exam’s introduction on students, educators, and institutions.
The group’s paper, “The work of preparing Canadian nurses for a licensure exam originating from the USA: A nurse educator’s journey into the institutional organization of the NCLEX-RN,” was published in the International Journal of Nursing Education Scholarship in March 2019. It was also presented at the Hawaii International Conference on Education.
“I watched students struggle, and it was frustrating. It tugged at my heartstrings. We have fantastic nursing programs in Canada and I want students to be successful — but the initial pass rate for the NCLEX-RN was low.”
– Kristin Petrovic, Academic Coordinator, Undergraduate Nursing
Petrovic explained that they wanted to know what made the initial implementation of this exam so hard for students.
“By looking at how the exam was administered, we learned that some students wrote in hotels near where their kids were playing on waterslides, and some were on computers where internet access would drop,” she said.
“We learned that some students who had been learning in French took the exam in English, due to translation concerns and because they were only able to study for the exam in English, as most prep materials hadn’t been translated into French.”
– Kristin Petrovic, Academic Coordinator, Undergraduate Nursing
“We learned that in early exam versions, students were asked questions, and needed to use measurements, relevant in the U.S. but not in Canada. We also learned that communication throughout was a huge issue.”
While each of these issues may not appear significant on the surface, taken together they had a major impact on students, and ultimately on students’ lives.
They wrote about what the FHD NCLEX-RN working group and program did to support students’ success, and about what other countries might want to consider if they also will be taking on this exam.
“This will help people and programs do things differently in the future,” says Petrovic.
