Changing nurse licensing examinations: media analysis and implications of the Canadian experience

Abstract

Aim: This study examines perceptions of the implementation of National Council Licensing Examination in Canada through a content analysis of articles in the media.

Background: Public opinions of nursing in the media have been acknowledged as important for the profession, specifically in relation to their portrayal of nursing.

Introduction: The Canadian Council of Registered Nurse Regulators began using the US-based National Council Licensing Examination as entry examination (also known widely as NCLEX) for Canada's registered nurses, discontinuing the previous Canadian Registered Nurse Examination in 2015.

Methods: A qualitative content analysis was conducted of media reports that emerged following adoption of the National Council Licensing Examination in Canada, and highlight the image of nursing portrayed in the media during this key regulatory policy change.

Results: Release of the examination results for the first three quarters of 2015 identified a much lower overall Canadian pass rate than with the previous exam. Media reports highlight differences in perception of the examination between Canadian regulators and other stakeholders in the context of the examination experiences reported and test results. Issues around applicability of the examination to Canadian nursing practice, curriculum alignment, language translation concerns and stakeholder engagement were identified.

Discussion: The implementation of the National Council Licensing Examination in Canada highlighted lack of communication among nursing stakeholders in the country.

Conclusions: Most of the media reporting has been negative and poses a reputational risk to the Canadian nursing profession.

Implications for nursing policy: This change in the licensing requirement has significant policy implications for nursing in Canada and globally. Issues such as appropriate examination translation, access to appropriate test preparation materials, assurance that the examination reflects distinctive aspects of a country's healthcare system and the need for stakeholder engagement were identified.

Keywords: Canada Entry to Practice; Lisensure Examination; Media; NCLEX; Nurse Regulation; Nursing; Registered Nurses.