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

Closing the gap in education: Raising medical professionals' knowledge and attitudes in transgender health

Transgender and gender diverse (TGD) health is a rapidly evolving, underserviced, and underresearched healthcare field. This chapter will provide a brief review of the research in TGD health and medical education and offer further areas of research and curriculum design.

Recent research into healthcare professions regulation: a rapid evidence assessment

BACKGROUND AND AIMS

Over the last decade, regulators have taken significant steps towards tackling perceptions that regulatory systems are burdensome. There has been much international research activity in the regulation of health and care professionals. This article reports a review of studies on health professions regulation between January 2011 and March 2020. Its chief object was to provide robust and up-to-date evidence to assist regulators in policy development and implementation. The main objectives of this study were to: 1. Identify and retrieve research in the field of health and care professions regulation in English since 2011; 2. Evaluate the published research, exploring its utility to regulators and practitioners, and drawing out any key messages; 3. Draw conclusions concerning the scope and limitations of the research literature and identify areas for further research.

METHODS

We undertook a rapid evidence assessment (REA) of the international literature on health and care professions regulation, including reviewing ten UK regulators' websites to identify issues of concern and strategic priorities. We retrieved 3833 references, using a four-stage screening process to select the 81 most relevant.

RESULTS

Results are reported within six key themes: harm prevention and patient safety; fitness to practise; quality assurance of education and training; registration including maintenance of registers; guidelines and standards and relations with regulatory bodies.

CONCLUSIONS

Regulation of professionals in health and care is comparatively undeveloped as a field of academic study. Consequently, the published evidence is diffuse and small-scale. Most work presents relatively weak data of low relevance to regulators, mainly reporting or describing the current position. Few studies are able to show the impact of regulation or demonstrate a causal link between regulation and its effects. To inform their research and policy agendas health and social care regulators need to commission, interpret and apply the scholarly literature more effectively; academics need to engage with regulators to ensure that their research provides high-quality evidence with practical relevance to the regulators' agendas. Further study is needed to explore how effective academic collaborations between regulators and researchers may be created and sustained.

NCLEX-RN© preparation resources available online in French: An integrative review

AIM

This review describes the availability of online French NCLEX-RN^© preparation resources for candidates BACKGROUND: One entry to practice requirement for Canadian nurses is to successfully pass a licensing exam upon graduation from their educational program. In 2015, the American NCLEX-RN^© replaced the Canadian entry to practice licensing examination which was offered in Canada's two official languages: English and French. The NCLEX-RN^© was developed in English and later translated to French. Since its implementation, Francophone candidates and educators in Canada have reported a lack of preparatory resources available in their language and have had substantial lower NCLEX-RN^© pass rates, consistently below 50% METHODS: An integrative review using Whittemore and Knafl's framework was conducted between February and May 2019, and updated in September 2020, through online searches of CINAHL, PubMed, Science Direct and Google Scholar databases. Grey literature was included from 2012 onwards. Results are presented narratively.

RESULTS

A total of 17 French language preparatory resources were found. These resources were categorised into four main groups: (1) What is the NCLEX-RN^© ?; (2) What do I need to do prior to writing the NCLEX-RN^© ?; (3) What is assessed through the NCLEX-RN^© ? and finally, (4) How can I practice before taking the NCLEX-RN^© ?

CONCLUSION

Limited French-language NCLEX-RN^© preparatory resources exist for Francophone candidates. Furthermore, practice questions in French are few compared to what is available in English IMPLICATIONS FOR NURSING AND NURSING POLICY: Other countries may consider implementing an entry to practice exam such as the NCLEX-RN^© because of its availability in both the French and English language, as well as the possibility of translating the exam to other languages, creating a potential market for this test around the globe. The lack of preparatory resources in French is a major concern to Francophone candidates undertaking such a high-stakes examination in their language. Nursing stakeholders and policy leaders should acknowledge that such gaps place Francophone writers in a disadvantaged position in comparison to their Anglophone counterparts.

Identifying Indicators of National Council Licensure Examination for Registered Nurses (NCLEX-RN) Success in Nursing Graduates in Newfoundland & Labrador

In Canada in 2015, the pass rates on the National Council Licensure Examination (NCLEX-RN) were considerably lower than pass rates on the Canadian Registered Nurse Examination (CRNE) causing nurse educators to express concern regarding the NCLEX-RN. The purpose of this study was to examine the relationship between candidate variables (e. g. academic performance, demographics) on their NCLEX-RN outcome (pass/fail). A cross-sectional data linkage design was employed using multiple sources of data on nursing graduates who wrote the NCLEX-RN in 2015, 2016 and 2017 (n = 259). Results showed that fewer questions answered on the NCLEX-RN and higher grades in various nursing courses (e. g. Introduction to Nursing, Statistics) predicted higher odds of passing the NCLEX-RN. To improve pass rates, nurse educators must integrate diverse methods of testing into existing curricula that mimic the NCLEX-RN exam, specifically computer adaptive exams. Further research is needed to determine other possible challenges for countries considering adopting the NCLEX-RN.

The Work of Preparing Canadian Nurses for A Licensure Exam Originating from the USA: A Nurse Educator’s Journey into the Institutional Organization of the NCLEX-RN

The licensing exam for registered nurses in Canada has recently been changed from a Canadian developed, owned and delivered exam to the National Council Licensure Examination for Registered Nurses (NCLEX-RN) which originates from the United States. Rationale for this exam change focused on transitioning to a computer-based exam that has increased writing dates, with increased security, validated psychometrics, increased exam result delivery, and an anticipated decrease in expense to students. Concerns have arisen around the acceptance, implementation and delivery of this exam to Canadian nursing students that reflects the broad Canadian landscape of education and nursing practice. The experience of a Canadian nurse educator in working to facilitate students’ transition to this exam is addressed using an institutional ethnographic lens. Finally, we come to conclusions about the importance of countries utilizing licensing exams that reflect their nursing education and practice

Altered nursing student perspectives: Impact of a pre-clinical observation experience at an outpatient oncology setting

This study examined the influence of an observation experience at an outpatient oncology setting on first-year nursing students. This experiential learning opportunity occurred prior to any formal clinical practice course. A hermeneutic phenomenology approach was used to uncover pre-licensure nursing students' perspectives about cancer, as well as their understanding of the roles and responsibilities of registered nurses in cancer care both before and following their experience. A total of 10 nursing students agreed to participate in the study. Data were collected through semi-structured interviews following which data were analyzed and interpreted to understand the meaning in the experience. Two overarching themes were identified including circles of relationships, and the many sides of outpatient oncology. This study reveals that experiential learning in the form of a low-risk, observation-only experience may be an opportunity for pre-licensure students to gain new perspectives about cancer care and nurses roles in caring for individuals and families who are impacted by cancer.