New exam for Quebec nursing students will likely be delayed: sources

The chances of a new exam for Quebec's nursing hopefuls by next spring are slim; the Office des professions du Québec (OPQ), which oversees Quebec's professional orders, is far from enthusiastic about adopting the American NCLEX-RN exam.

Last May, in response to a damning report on the quality of nursing exams in Quebec, the provincial nurses' order (OIIQ) announced its intention to ditch its own exam in favour of the American national test.

The NCLEX-RN is already used in several Canadian provinces to assess the competence of nursing candidates.

According to OIIQ's initial plan, the last exam under the old format should be on Sept. 18, with the American exam adopted by spring 2024.

However, this scenario appears unrealistic; to proceed with this major change, the OIIQ has filed a request to amend the "Regulation respecting terms and conditions for permits," the OPQ confirmed.

This request must be the subject of legal analysis and an assessment of the "appropriateness of the desired measure and the accompanying dragt regulatory test," the Canadian Press has learned. It's this part of the process that seems to be getting in the way.

According to a well-informed source, the OPQ has raised doubts about the relevance of translating and adapting the American exam to a Quebec context.

The only known experience with a French translation of the NCLEX-RN is in New Brunswick, where it proved so disastrous that the Société de l'Acadie and the Université de Moncton's student federation sued the profession's governing body in the Atlantic province.

And even if the format is adapted appropriately, there's still a need to outline a course of action, which could take months and even a few years.

The OPQ has reportedly requested additional information from the OIIQ following the submission of its application, and some responses are still pending.

The office of Treasury Board President Sonia LeBel, which oversees the OPQ, believes that the NCLEX-RN "cannot be a short-term solution."

A spokesperson confirmed the minister is following the file very closely and that this option "must be the subject of serious analysis to ensure that the examination applies to the Quebec context."

In an e-mail reaction, the OIIQ stated that "for the moment, the file is following its course" and that "should the timetable be postponed," stakeholders will be informed "as soon as possible."

Still, according to the OIIQ, "the work involves the contribution of external partners for whom [it has] no control over deadlines."

The nurses' order said it will comply with deadlines imposed by the OPQ, but the objective remains the spring of 2024.

WARNINGS FROM COMMISSIONER

In a report on low pass rates for the September 2022 OIIQ exam, a Quebec commissioner highlighted a series of methodological flaws and weaknesses. He also offered possible solutions to improve the test, but warned against the temptation to import a foreign format.

"An examination is more than a technical assessment tool; it includes the professional standard and is built around it. The exam also reflects a vision of the profession against which we want to assess a candidate's aptitude," wrote André Gariépy in his report.

He said a proper assessment must consider the practice context, network organization, reserved activities, training received and legal frameworks.

Using a tool designed aboard would mean "losing some control over the professional standard itself and the vision of the profession," Gariépy argued, stressing that such a major change must be approached with caution.

This report by The Canadian Press was first published in French on Sept. 8, 2023.