The Applicability of the NCLEX-RN to the Canadian Testing Population: A Review of Regulatory Body Evidence

Abstract

Abstract:The NCLEX-RN® was adopted by Canadian regulators in 2011 as the test which entry-level nurses must pass in order to be certified to practice. As part of their justification for adopting the exam, the Canadian regulators pointed to two studies conducted by the National Council of State Boards of Nursing (NCSBN). These studies aimed to determine the applicability of the NCLEX-RN® test plan to the Canadian testing population (NCSBN, 2014),with the NCLEX-RN® providing "a fair, valid, and psychometrically sound measurement" of nursing competencies of entry-level RNs in Ontario, Canada (NCSBN, 2012 , p. 8). The purpose of this article is to report the findings from a review of the above two NCSBN studies in order to assess whether they provide sufficient evidence to conclude that the NCLEX-RN® is applicable to the Canadian testing population. While some evidence was found of the use of best practice principles in survey and research design, both authors call into question the evidence provided by the NCSBN, and deny the claims that the NCLEX-RN®, as currently designed, is an appropriate assessment tool for Canadian entry-level nurses.

Author response to Dickison, P. et al. 2018 Letter to the Editor re McGillis Hall, L. et al. 2018. Changing nurse licensing examinations: media analysis and implications of the Canadian experience. International Nursing Review 65, 13–23

“…The authors are aware that individual readers interpret materials differently; however, more recent publications on this topic identify similar challenges to those that emerged in this analysis, specifically from a policy perspective (MacMillan et al 2017;Salfi & Carbol 2017).…”

A comparative analysis of NCLEX pass rates: Nursing health human resources considerations

“…Regulators in Canada disagree, stating that the NCLEX‐RN does not “test knowledge of a particular health care system, cultural issues or legislation” (Tarjan, , p. 7). Other authors suggest that this is not acceptable (Salfi & Carbol, ; Sellman, ). An analysis of the evidence utilized by regulators to determine the applicability of the NCLEX‐RN for Canadian use calls into question the validity of the U.S. examination for Canadian writers (Salfi & Carbol, ).…”

Americanizing Canadian Nursing: Nursing Regulation Drift

“…There have been fragmented and independent Canadian studies. Recently Salfi and Carbol (2017) published an analysis of the entry to practice competencies comparisons and justification for adoption of the NCLEX-RN. They are critical of the methods (design flaws and postdecision timing) and possible conflicts of interest in the contract awarding processes.…”

“…These two projects were used to support the decision to select the USbased vendor to carry out examinations for Canadian nurses. However, the two countries have very different health care and nursing educational systems (Salfi and Carbol 2017). The United States prepares most nurses to work in institutional care settings, through a threeyear, six-semester, community college program.…”