Canadian NCLEX Milestone

The Canadian version of the NCLEX-RN, the adaptive, computerized testing program brought in this year to assess the skills of Canadian nursing students, reached an impressive benchmark this week with it's 1,000th test taker. The test has been operational since January 5th, assessing the qualifications of registered nurses in British Columbia, Alberta, Saskatchewan, Ontario, New Brunswick, Nova Scotia, P.E.I, Newfoundland and Labrador, Northwest Territories and Nunavut. 

The exam was selected to replace the older Canadian Registered Nursing Exam in 2012, but it wasn't until January of this year that the new testing regime began. The new format offers increased test security, accessibility, precise assessment and provides more timely results than the CRNE. The United States has been using the NCLEX-RN since 1994.

Anne Coghlan, the President of the Canadian Council of Registered Nurse Regulators believes the switch has been close to seamless. "The launch of the NCLEX-RN in Canada has gone extremely well," she said, "and it is very exciting to reach this milestone. Through the collaborative efforts of NCSBN and CCRNR, we are furthering our shared commitment to excellence in nursing regulation."

There are currently 10 other countries offering the NCLEX-RN test but Canada is the only country outside of the U.S. that uses it as a domestic licensing examination.

Students can take the exam at any Pearson Vue testing facility in the country or abroad. Permanent centers are located across Canada, but there is also temporary centers setup in February, June and October, for end of semester examinations.

Canadian nursing students can prep for the exam by enrolling in a NCLEX prep course. PRIMED Education currently offers classes in facilities across the country and online. These courses help nursing students practice for the exam, work through topics that they are struggling with and review core material. They are an excellent tool for first time NCLEX-RN test-takers or for students who will be repeating. Find out more at: http://www.primededucation.ca/

What is CRNBC?

Many nurses that are registering in Canada for the first time, whether they are Canadian graduates or international nurses may be a bit confused by the regulatory system in Canada.

In British Columbia (BC), nursing has been a self-governing profession since 1918. This means that nursing governs or exercises control over itself. This is accomplished by a provincial regulatory body. Every province has its’ own regulatory body. In BC the College of Registered Nurses of British Columbia (CRNBC) regulates over 39, 000 registered nurses, nurse practitioners and licensed graduate nurses. Under provincial law, called the Health Professions Act, it is the duty of the CRNBC to protect the public by regulating its members.

CRNBC’s mission: Protecting the public through the regulation of registered nurses by registered nurses, setting standards, supporting registered nurses to meet standards, acting if standards are not met (CRNBC website, 2009).

More specifically, the CRNBC makes these commitments to fulfilling its mandate and mission:

• Public Interest - To protect the public through the regulation of registered nurses
  
• Self-regulation - To manifest the College's commitment to the privilege and responsibility of self-regulation.
  
• Education Standards - To establish entry-level competencies that reflect practice requirements and to recognize entry and re-entry nursing education programs in B.C. where graduates meet these competencies and the College's Standards of Practice.
  
• Registration Standards - To ensure that all registrants meet the standards for entry and re-entry into the profession and that these standards reflect British Columbia practice requirements.
  
• Standards of Practice - To establish and communicate Standards of Practice that define the level of practice that registered nurses are required to meet.
  
• Continuing Competence - To support registered nurses to understand and fulfill their obligation to uphold the Standards of Practice by maintaining their professional ethics and competence.
  
• Practice Environments To work with registered nurses, health organizations and other stakeholders to create and sustain practice environments that support safe, competent and ethical nursing care for the public.
  
• Complaint Process To provide an accessible and responsive complaint process to ensure that concerns about the practice of registered nurses are addressed in the public interest
  (CRNBC, 2009)
  Other activities carried out by the CRNBC include:

• Setting requirements to enter the profession of nursing

• Ensuring the standards of nursing practice are developed, monitored and enforced

• Require initial and annual registration to ensure safe, ethical and competent practice.

The CRNBC will support nurses to carry out their mission, and intervene when they feel nursing practice is questionable.

CRNE Exam Questions..Isn't there more than 1 right answer?

One of the most common concerns we have from students is that the CRNE exam often appears to have more than 1 right answer in the list of choices.
Lets work through an example:

Question:

1.  Jonathan is a 4 year old boy who was recently diagnosed with diabetes.  His family appears to be coping well, but they tell you they feel as though they are alone, and can't speak to their friends about their experiences.  Which of the follow responses would be most appropriate?

a. "I can see you are upset, would you like to talk about it?"
b. "You seem to be coping very well, I know things are difficult now, but most families say things improve with time"
c.  "It is important to remember that although diabetes is difficult, it is not as terrible as some of the other diseases that can effect children"
d.  "Many families find it helpful to speak with other people who have experienced similar feelings or circumstances, would you like me to arrange for you to speak with one of these families?"

First, lets look at option a.


"I can see you are upset, would you like to talk about it?"


Good Points:  This is often answer students choose.  It is the first answer, and it appears to be supportive, open ended and appears that the nurse is approaching the family in a caring way.
Bad Points:  Although this answer invites more questions, it doesn't address the families concerns.  Remember, the family has stated that they feel alone, and that they can't speak to their friends about their experiences.


Ok, let's deconstruct option b.

"You seem to be coping very well, I know things are difficult now, but most families say things improve with time"


Good Points:  Good points are hard to find with this response.  You are acknowledging what you are seeing in the family, but you are not addressing the families concerns.
Bad Points:  Again, you are not addressing the families concerns.  Think about how the family would feel, they would most likely feel as though the nurse gave them the "brush off".  The CRNE exam is designed to ensure that you are responding to the patient.  So, Eliminate b as an option!


Now, lets look at option c.

"It is important to remember that although diabetes is difficult, it is not as terrible as some of the other diseases that can effect children"


Good points: I can't think of any!  This is a complete brush off, and does not address the concerns of the family at all.
Bad Points:  Option C is designed to be a dead give away.  Remember, on a multiple choice exam there is often 1 answer that you can eliminate right at the beginning.  


Finally, lets look at option d.

"Many families find it helpful to speak with other people who have experienced similar feelings or circumstances, would you like me to arrange for you to speak with one of these families?"

Good points:  This question is both supportive, as well as responsive to the families concerns.  Return to the original question...what is the family telling you?  They are telling you they feel alone.  Offering to connect them to other families is the right answer.

Connecting the dots.....
-Hopefully you would have been struggling to choose between a. and d.
If you read the question carefully, you realize that d is the response that best answers the families concerns.

This is just one example of a question that can confuse you on the CRNE Exam.
Make sure you read the question carefully and choose the response that best addresses the concerns of the patient, family, or situation.

If you would like to work through more of these types of questions, join us for our course, January 9th and 10th, 2010!