Cape Breton nursing school grads fared best on 2015 licensing exam

Nursing graduates from Cape Breton University fared the best in last year's licensing exam, according to numbers obtained by CBC News through an access to information request. 

Of the 61 CBU students who took the test, only 11 failed — a pass rate of 82 per cent.

The much larger class of 2015 from Dalhousie University had the second-best pass rate in the province. On their first try, 208 Dal grads took the test and 158 passed while 50 failed — a pass rate of 76 per cent. 

St. FX had lowest success rate

St. Francis Xavier University's nursing students struggled the most with the new computer-based test. Of the 124 nursing grads at St. FX, 90 passed and 34 failed — a 72.6 per cent pass rate.

Those test results seemed to spook some nursing graduates at all schools. Of the 95 who failed the test the first go around, 82 took the test again last year. Fifty passed and 32 failed for a 61 per cent pass rate.

Cape Breton students did better than those at St. FX or Dal in their second attempt, but that may be because only nine students wrote the test, compared to 45 Dal grads and 28 from St. FX.

The third attempt

Between the schools, only four students had a third kick at the can. Two Dal students failed, two at St. FX passed.

Those nursing students would normally have to redo their training, but the College of Registered Nurses of Nova Scotia has recently decided to give students who fail an unlimited number of tries to pass the exam.

These results are included in an appendix to a report by the college. It was sent to the provincial government, but the college refused to release it to the public.

Numerous email exchanges

In the lead up to the public release of the overall test scores on Sept. 8, 2015, there were numerous email exchanges between the college and provincial bureaucrats. Both were worried about the impact of anticipated higher fail rates and the inevitable criticism that would ensue.

Last July, the Department of Health and Wellness prepared a minister's briefing "on the topic of Higher than Usual Failure Rate on New National Entry-to-Practice Examination for Registered Nurses."

A briefing note prepared for that meeting included information that suggested the college originally thought the exam results would not change after the traditional pencil-and-paper-based exam was replaced with the new computerized system.

"Throughout the development and implementation of the new exam over the last three years, CRNNS (College of Registered Nurses of Nova Scotia) has assured the Department of Health and Wellness that there was no reason to anticipate any change in pass rates between the old and new exams," the background note read. 

Redacted information

In the week leading up to the official release of the 2015 results, the communications team at the Department of Health and Wellness crafted "Key Messages" for Minister Leo Glavine, but that information has been redacted from the documents sent to CBC News. 

A week after the results were made public, internal departmental emails focus on the college's policy for issuing temporary licenses, which allow those who've failed the entrance exam to continue working with certain conditions.

"The policy will be revised to permit those who have failed the NCLEX twice to apply for a reissued temporary licence with the same conditionals and restrictions that are applied once someone fails the exam the first time," wrote Cindy Cruickshank, executive director of the department's Health System Workforce Branch.

She also noted "No news release is planned" to announce or explain the change in policy.

'Monitoring the situation closely'

Department staff have continued to keep tabs on the issue.

In an email dated Nov 17, 2015, Cruickshank sent the minister's executive assistant Peter Bragg a note that said, "We are monitoring the situation closely."

The department is keeping in touch with the college, as it shares updates on how well Nova Scotia graduates are doing on subsequent tests. 

"The overall pass rate for Nova Scotia graduates as of today is 87 per cent," Cruickshanks wrote to her team on Nov. 27.

According to the data pulled from the information request, the pass rate for the three universities after the first, second and third attempts made by students is 89.1 per cent.