Nurses Association of New Brunswick lifts exam restriction

Nursing graduates in New Brunswick will no longer be limited to two attempts to pass a national exam to qualify to practice as a nurse in the province.

With a pass rate of 71 per cent on the new exam that was introduced in January 2015, New Brunswick nursing graduates have the lowest pass rate in the country.

• New Brunswick nurses 47% fail rate on NCLEX-RN

The Nurses Association of New Brunswick announced Friday it will remove the restriction that allows a nursing graduate only two attempts to pass the exam in a two-year temporary registration period. Previously, the graduate's temporary registration was cancelled after a second failed attempt at the exam.

Nursing graduates will now have an unlimited number of opportunities to take the exam, with a requirement there be 45 days between attempts, which is the policy of the provider of the national exam.

It's not clear why New Brunswick nursing grads in particular have been struggling with it.

"I believe its the best exam for New Brunswickers and for the rest of Canada," said Laurie Janes, the executive director of the Nurses Association of New Brunswick. "However, I think we're in the middle of a very rough transition period."

Two factors appear to be creating significant stress for nursing graduates.- Laurie Janes, executive director

"Two factors appear to be creating significant stress for nursing graduates," said Janes. "The number of times a graduate can write the exam, and the period of temporary registration are definite areas of concern."

The nurses association said the previous system of allowing only two attempts "contributed to the economic burden for nursing graduates and their families and generated stress on human resources within the healthcare system."

As for the worry that students will simply get to know the questions on the test after several tries, Janes said there's a built-in system that makes that impossible.

"Every student, every time they write, gets a different exam, and no two exams are alike," she explained.  "So we don't have that concern about a student gaining knowledge as they repeat, and inadvertently registering a nursing graduate for practise who perhaps is not in fact competent."  

Francophone concerns

The association and provincial government are reviewing the process used to translate the exam for francophone graduates. Both the nurses association and the exam provider have agreed to an external review of exam questions if it is deemed necessary.

Francophone students have expressed a concern about a lack of access to resource materials in French to prepare for the exam.  The association said it provides material in both languages on its website and bilingual exam preparatory workshops are available through the RN-Professional Development Centre. 

"What is not available to francophone nursing graduates are commercial/retail materials, similar to 'prep guides' offered by third parties in English for the new exam," states the association's release.

"Commercial 'prep guides' are not endorses by NANB since the quality of content can vary widely."

The association said it is working with other groups and government officials to find funding to develop a preparatory guide in both official languages.

"The responsibility for development and delivery of such a resource needs to be determined, as development and delivery of exam preparation guides and materials is not a mandate of NANB."

Incorrect perception

The association also states there is perception that the exam is a U.S. exam and does not test for Canadian nursing competencies, but the association said that perception is "incorrect."

"Development of an exam that could be used for nurses both in Canada and the US began in 2010. Since that time studies were completed that indicate both U.S. and Canadian nurses require the same competencies as they transition from a student role to practising nurse," states the release.

"The exam is only 'American' in the sense that the exam was designed to test Canadian as well as U.S. nursing competencies was purchased from a U.S.-based exam provider, just as are some exams offered within Canada for nurse practitioners."