U.S. terms baffle nursing students
Canadian students tripped up by U.S. nursing exam
A new U.S.-designed exam that uses American terminology and mixes imperial and metric measurements is tripping up Canadian nursing students, especially francophones, who have struggled with poor translations and English-only preparatory materials.
In some cases, French-speaking students have opted to take the exam in English.
“Most of the time I didn’t understand what they were saying,” said Elise Grenier, a University of Ottawa graduate who failed her first attempt, in French, of the new exam.
“I’m French — hardcore French — and I was like, ‘What are you asking me?’ ” Grenier said.
Since Jan. 1, nursing students have had to pass the new test, the National Council Licensure Examination for Registered Nurses (NCLEX), to practise professionally. During the first six months the exam has been used, the Canadian pass rate was 70.6 per cent, well below the 78.3 per cent pass rate achieved by Americans. In Ontario, the rate was even worse: 68.1 per cent for the 1,600 nursing students who took the test from Jan. 1 to June 30. In New Brunswick, with its high percentage of francophones, the pass rate was 54 per cent.
In contrast, the 2014 Ontario pass rate for the previous Canadian-designed exam was 84.7 per cent.
“We’ve had really disgusting pass rates through, I believe, no fault of the nursing students,” said Linda Haslam-Stroud, president of the Ontario Nursing Association. “I believe it’s the fault of the exam and our regulators in putting forward an exam that’s not based on our curriculum and not based on the prep material they used.”
Until this year, nurses had to pass the Canadian Registered Nurse Examination to be accredited. That changed when the College of Nurses of Ontario and other bodies that regulate the profession formed a national federation and switched to the American test. The switch was announced in 2011 — plenty of time, the college says, for schools and students to prepare for the new exam.
But the test, now used in every province except Quebec, has left many Canadian students floundering.
“You shouldn’t have to be taught toward an exam, but these students are scrambling,” Haslam-Stroud said. “You have to realize that they started in a curriculum prior to this exam ever being in existence.”
One problem is that though the exam questions are in metric, the American-designed prep material is all in imperial measurements. Some questions involve medications that aren’t even approved for use in Canada, said HaslamStroud.
Very little of the prep material is available in French and what is offered is poorly translated, said Elise Grenier’s mother, Carole Bourcier, a 27-year RN and nursing educator. “It looks like they used Google Translate,” she said.
Elise had a job lined up at the Ottawa Hospital’s General campus when she failed the NCLEX test in French last spring. When six of Elise’s friends failed too — all of them francophones — she and Bourcier set up a Wednesday night study group at their home. Part study circle, part support group, the sessions helped Elise pass the exam when she took it again in August.
On a recent Wednesday night, the young women fired questions at one another, shared advice and socialized by playing RNtertainment, a Trivial Pursuit-type board game designed to help students study for the NCLEX (Sample question: “A hospitalized client has developed a superficial thrombophlebitis of the right hand in an intravenous catheter site. The nurse should plan to do which of the following ...”).
Elise booked her second test at the University of Toronto, where an instructor said her chances would be better if she took the exam in English. “She said, if you can understand English you should take it in English,” said the fluently bilingual Elise, now a proud registered nurse.
Five of the original study group members have now passed and the sixth will take the exam next year after missing classes because of a broken arm. Bourcier is confident that she, too, will get a passing grade.
“I’m so proud of them. They’re my little girls,” she said.
I believe it’s the fault of the exam and our regulators in putting forward an exam that’s not based on our curriculum.