Nova Scotia nursing students have slightly higher failure rate on new test

Nursing graduates in Nova Scotia performed better on a new U.S.-based licensing exam than most of the graduating classes across the country this year, but the failure rate was higher than usual.

The new computer-based test was introduced this year in every province except Quebec.

Of the 254 nursing students in Nova Scotia who took the NCLEX-RN exam this year, 205 passed. That's a success rate of about 81 per cent.

Unlike a paper-based test, the computer-assisted NCLEX-RN — developed by the nursing licensing body in the United States — includes multiple choice questions as well as the use of graphs, video and audio clips.

The test is not only more interactive, it's designed to offer harder or easier questions based on how the student is performing as they progress through the exam.

A video demonstration of NCLEX-RN, posted on the National Council of State Boards of Nursing website, suggests it's a more reliable way to test the competency of graduating nurses.

Pass rate of 92 per cent last year

Nova Scotia students had consistently been getting better at the old test.

Students who wrote the traditional Canadian Registered Nurses Exam in 2014 had a pass rate of 92 per cent. The pass rate rose from 88 per cent in 2012 to 90 per cent in 2013.

On average, Americans fared better than Canadians on the new test. The overall pass rate in Canada was 70.6 per cent. In the U.S., 78.3 per cent of those who took it passed.

Canadian experts helped tailor the new test for use in this country, but nursing graduates in Canada and the U.S. use the same test.

Among the 10 provinces, Nova Scotia nursing graduates had the third highest pass rate behind British Columbia and Newfoundland and Labrador.

Nursing students from the Northwest Territories and Nunavut scored ahead of Nova Scotia, but with a much smaller sample size of 17 students combined.

New Brunswickers struggled most with the exam. Of the 265 people who took the test in that province this year, only 144 passed — slightly more than half.

'Valid and reliable exam'

Sue Smith, the CEO of the College of Registered Nurses of Nova Scotia, is satisfied with how the new system is working.

"Based on the results, so far we are encouraged that this is a valid and reliable exam," she said.

The 49 Nova Scotians who failed the exam can take it again. If a person fails three times, he or she cannot obtain a nursing licence.

Graduates who had been offered jobs in a hospital or another care facility — in anticipation of being fully licensed — will not be able to practise unsupervised if they fail the test. Their duties would be restricted to what they would have been allowed to do as nursing students.

Leo Glavine, Nova Scotia's Minister of Health and Wellness, called the higher than normal failure rate "an anomaly." He also said it didn't created major problems.

"We have not had, you know, major impacts in the workplace and so these nurses now are, in fact, getting the help of the three universities, the college in preparing to do the rewrite," he said.

His colleague, the Minister of Advanced Education Kelly Regan, was also not overly concerned about the higher failure rate.

"It's just a different kind of test and that may take some getting used to," she said.